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Effects of vitamin D supplementation on patients with systemic lupus erythematosus: A systematic review and meta-analysis.

  • 2026-05
  • Autoimmunity reviews 25(5)
    • Jiale Lu
    • Qingmiao Zhu
    • Jiaxun Yu
    • Zhuchen Tan
    • Yingxin Kang
    • Qice Sun
    • Ting Zhao

Study Design

Type
Meta-Analysis
Sample size
n = 847
Population
847 participants from 10 RCTs involving patients with systemic lupus erythematosus (SLE)
Methods
A systematic search of PubMed, Web of Science, Embase, Cochrane Library, CNKI, and Wanfang Data was conducted from inception to March 2025. Randomized controlled trials (RCTs) were included. Data extraction and statistical analyses were performed using Review Manager 5.3 and Stata/MP 16.0. Risk of bias was assessed using the Cochrane Collaboration tool.

Background

Systemic lupus erythematosus (SLE) is a complex autoimmune disease frequently associated with vitamin D insufficiency. Vitamin D supplementation has been proposed as a potential adjunctive therapeutic strategy for SLE.

Objective

To evaluate the effects of vitamin D supplementation on disease activity and related clinical outcomes in patients with SLE.

Methods

A systematic search of PubMed, Web of Science, Embase, Cochrane Library, CNKI, and Wanfang Data was conducted from inception to March 2025. Randomized controlled trials (RCTs) were included. Data extraction and statistical analyses were performed using Review Manager 5.3 and Stata/MP 16.0. Risk of bias was assessed using the Cochrane Collaboration tool.

Results

10 RCTs involving 847 participants were included. Vitamin D supplementation significantly improved serum 25(OH)D status (SMD = 3.46, p < 0.001) and reduced disease activity in SLE (SMD = -0.54, p < 0.001). Significant improvements were also observed in complement component C3 (MD = 14.49, p = 0.03) and C4 (SMD = 2.08, p = 0.04). No significant effects were found for erythrocyte sedimentation rate (ESR) (MD = -10.19, p = 0.24) or fatigue severity (SMD = -1.77, p = 0.07). Anti-dsDNA antibody levels showed no significant change (MD = 7.78, p = 0.82), while positivity rates were significantly improved (RR = 5.44, p = 0.001).

Conclusion

Vitamin D supplementation may reduce disease activity and improve complement levels in SLE, but evidence for other outcomes remains inconsistent, warranting further high-quality trials.

Research Insights

  • Vitamin D→Improved Complement C3 Level

    Significant improvements were also observed in complement component C3 (MD = 14.49, p = 0.03) and C4 (SMD = 2.08, p = 0.04).

    Effect
    Beneficial
    Effect size
    Moderate
  • Vitamin D→Improved Complement C4 Level

    Significant improvements were also observed in complement component C3 (MD = 14.49, p = 0.03) and C4 (SMD = 2.08, p = 0.04).

    Effect
    Beneficial
    Effect size
    Large
  • Vitamin D→Reduced Anti-dsDNA Positivity

    Anti-dsDNA antibody levels showed no significant change (MD = 7.78, p = 0.82), while positivity rates were significantly improved (RR = 5.44, p = 0.001).

    Effect
    Beneficial
    Effect size
    Large
  • Vitamin D→Reduced Disease Activity

    Vitamin D supplementation significantly improved serum 25(OH)D status (SMD = 3.46, p < 0.001) and reduced disease activity in SLE (SMD = -0.54, p < 0.001).

    Effect
    Beneficial
    Effect size
    Moderate
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