The Italian Medicines Agency (Aifa) has updated the criteria for prescribing vitamin D for the prevention and treatment of deficiency states in adults, based on new scientific publications that have further clarified the lack of benefits for Covid and for bones in healthy people.
“The supplementary intake of vitamin D is one of the most debated topics in the medical field, a source of controversies and even strongly antithetical beliefs”, Aifa points out. Note 96 was published in 2019 to limit the prescription by the National Health System of vitamin D and its analogues (cholecalciferol, calcifediol).
The update envisaged with the new decision (48/2023) was published yesterday in the Official Journal and was made necessary by the new evidence. In particular, the results of two large randomized clinical trials were taken into consideration, the American Vital study published in Nejm in 2022 and the European Do-Health study published in Jama in 2020.
Both concluded that supplementation with more than adequate doses of vitamin D (2000 IU daily of cholecalciferol) and “for several years is not able to modify the risk of fracture in the healthy population, without risk factors for osteoporosis”.
To these studies is added the literature on use in Covid-19. “Despite the epidemiological data that seemed to link the contagion and severity of Covid to vitamin D deficiency, the effectiveness of vitamin D in the fight against Covid has been denied by correctly designed and conducted studies” and “at present there are no elements to consider vitamin D an important aid in the fight against the coronavirus“.
On this occasion, some clarifications have been included in the text of the Note on the proposal of clinicians or scientific societies which include, among others, a paragraph “on the potential risks associated with the improper use of vitamin D-based preparations”.
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