A new study published in the journal Neurological Sciences provides insights into the effect of vitamin D levels on multiple sclerosis (MS) activity in real-world clinical practice. This work, led by Prim. MUDr. Marta Váchová, uses data from the Czech nationwide ReMuS registry and focuses on assessing the association between vitamin D levels and the risk of relapses in MS patients, with the aim of identifying the optimal level for reducing disease activity.
Vachova, M., Stastna, D., Mazouchova, A., Hruskova, P., Uher, T., Preiningerova Lizrova, J., Potuznik, P., Drahota, J., Kubala Havrdova, E. (2025). From sunlight to MS fight: impact of vitamin D levels on multiple sclerosis activity. Neurological Sciences, 47(1), 38. https://doi.org/10.1007/s10072-025-08729-z PMID: 41432824
Vitamin D, a key factor affecting the immune system and often supplemented in MS patients, was evaluated in a 10-year data set including 1,861 adult MS patients. This research confirmed that higher levels of this vitamin may be an effective strategy to reduce the risk of relapses, even in patients already treated with disease-modifying therapies (DMTs). Thus, the results of the study may contribute to a better understanding and use of personalized vitamin D supplementation in clinical practice.
Abstract
Introduction: Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system with a multifactorial aetiology, including vitamin D levels, that have been linked to disease activity. Given the inconsistent findings on the vitamin D supplementation in MS, we aimed to analyse the connection between 25(OH)D levels and disease activity and to identify an optimal level of 25(OH)D in MS utilizing our real-world database.
Objectives: To analyse the association between 25(OH)D levels and disease activity and to identify the optimal 25(OH)D level in MS.
Methods: This study utilized a 10-year dataset from the Czech national multiple sclerosis registry (ReMuS), encompassing 1,861 adult MS patients. Patients had a minimum of one year of follow-up, with subgroup analysis for those with at least five years. A mixed-effects model tested the impact of 25(OH)D and cholesterol levels on relapse incidence. Subgroup analysis categorised patients by average 25(OH)D levels and analysed relapse incidence using the Kruskal-Wallis test and Kaplan-Meier survival analysis.
Results: Higher serum 25(OH)D levels and age correlated with reduced relapse risk (p < 0.001 for both). Each 10 nmol/L increase in 25(OH)D levels associated with a 6.7% decrease in relapse risk (p < 0.001). Cholesterol levels and sex did not significantly affect relapse rate. Subgroup analysis revealed that patients with 25(OH)D levels above 100 nmol/L had significantly fewer relapses compared to those with levels below 75 nmol/L.
Conclusion: Our findings suggest that optimising 25(OH)D levels may reduce the risk of relapse in pwMS. Causation cannot be confirmed. Results highlight the importance of personalized vitamin D supplementation strategies and support the potential benefit of maintaining optimal serum 25(OH)D levels in MS management.
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