RT Journal Article SR Electronic T1 Vitamin D Supplementation in Childhood Asthma: A Systematic Review and Meta-analysis of Randomised Controlled Trials JF ERJ Open Research JO erjor FD European Respiratory Society SP 00662-2021 DO 10.1183/23120541.00662-2021 A1 Jogender Kumar A1 Prawin Kumar A1 Jagdish Prasad Goyal A1 Chirag Thakur A1 Puja Choudhary A1 Jitendra Meena A1 Jaykaran Charan A1 Kuldeep Singh A1 Atul Gupta YR 2021 UL http://openres.ersjournals.com/content/early/2021/12/02/23120541.00662-2021.abstract AB Background There is conflicting evidence for vitamin D supplementation in childhood asthma. We aimed to systematically synthesize the evidence on the efficacy and safety of vitamin D supplementation in childhood asthma.Methods We searched electronic databases (Medline, Embase, Web of Science) and register (CENTRAL) for randomised controlled trials (RCTs) published until September 30, 2021. RCTs enrolling asthmatic children (1–18 years) and comparing vitamin D against placebo/routine care were included if they met at least one of the endpoints of interest (asthma attacks, emergency visits, hospitalisation). We used the Risk of Bias (RoB) 2 tool for risk of bias assessment. Random-effects meta-analysis with RevMan 5.3 software was done. The GRADE approach was used to assess the level of certainty of the evidence.Results Eighteen RCTs (n=1579 participants) were included. The pooled meta-analysis did not find a significant effect of vitamin D supplementation on asthma attacks requiring rescue systemic corticosteroids (6 studies, 445 participants, Risk ratio: 1.13; 95% CI: 0.86 to 1.48, I2–0%) (Moderate-certainty evidence). In addition, there was no significant difference in the proportion of children with asthma attacks of any severity (11 trials, 1132 participants, RR: 0.84; 95% CI: 0.65 to 1.09; I2–58%) (Very-low certainty evidence). Vitamin D does not reduce the need for emergency visits (3 studies, 361 participants, RR: 0.97; 95% CI: 0.89 to 1.07, I2–0%) and hospitalisation (RR: 1.38; 95% CI: 0.52 to 3.66, I2–0%) (Low certainty evidence).Conclusion Very low to moderate certainty evidence suggests that vitamin D supplementation might not have any protective effect in childhood asthma.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Jogender Kumar has nothing to disclose.Conflict of interest: Prawin Kumar has nothing to disclose.Conflict of interest: Jagdish Prasad Goyal has nothing to disclose.Conflict of interest: Chirag Thakur has nothing to disclose.Conflict of interest: Puja Choudhary has nothing to disclose.Conflict of interest: Jitendra Meena has nothing to disclose.Conflict of interest: Jaykaran Charan has nothing to disclose.Conflict of interest: Kuldeep Singh has nothing to disclose.Conflict of interest: Atul Gupta has nothing to disclose.