Adjunctive Vitamin D Supplementation In Tuberculosis Treatment: A Systematic Review And Meta-Analysis Of Sputum Conversion, Clinical Outcomes, And Safety
DOI:
https://doi.org/10.66021/pakmcr1762Keywords:
Tuberculosis, Vitamin D Supplementation, Sputum Conversion, Meta-Analysis, Adjunctive Therapy, Clinical Outcomes, Safety Profile.Abstract
Objective: This systematic review and meta-analysis evaluates the efficacy and safety of adjunctive vitamin D supplementation in tuberculosis (TB) treatment, focusing on sputum conversion rates, clinical outcomes, and adverse effects.
Methods: A comprehensive search of PubMed, Cochrane Library, EMBASE, and clinical trial registries was conducted from inception to August 2025. Randomized controlled trials (RCTs) examining vitamin D supplementation alongside standard anti-TB therapy were included. Primary outcomes included sputum conversion rates at 8 weeks and time to sputum conversion. Secondary outcomes encompassed clinical cure rates, radiological improvement, and safety parameters.
Results: Twenty-three RCTs involving 4,187 participants were included. Adjunctive vitamin D supplementation significantly improved 8-week sputum conversion rates (RR: 1.18, 95% CI: 1.09-1.28, p<0.001) and reduced time to sputum conversion by 6.3 days (95% CI: 3.2-9.4 days, p<0.001). Clinical cure rates showed modest improvement (RR: 1.12, 95% CI: 1.04-1.21, p=0.003). No significant increase in adverse events was observed (RR: 0.94, 95% CI: 0.82-1.08, p=0.38).
Conclusion: Adjunctive vitamin D supplementation demonstrates significant benefits in accelerating sputum conversion and improving clinical outcomes in TB treatment with favorable safety profile. These findings support consideration of vitamin D as adjunctive therapy in TB management protocols.
