Rickets prevented by single injection of vitamin D or weekly supplementation – RCT Jan 2014

A Randomized Controlled Trial on Safety and Efficacy of Single Intramuscular versus Staggered Oral Dose of 600 000IU Vitamin D in Treatment of Nutritional Rickets

J Trop Pediatr (2014) doi: 10.1093/tropej/fmt105 First published online: January 8, 2014
Krishanu Mondal 1,
Anju Seth 1, <[email protected]>.
Raman K. Marwaha 2,
Dinesh Dhanwal 3,
Satinder Aneja 1,
Ritu Singh 4 and
Pitambar Sonkar 5
1Department of Paediatrics, Lady Hardinge Medical College, Kalawati Saran Children’s Hospital, New Delhi, DL 110001, India
2Department of Endocrinology, Institute of Nuclear Medicine and Allied Sciences, New Delhi, DL 110001, India
3Department of Medicine, Maulana Azad Medical College, New Delhi, DL 110001, India
4Department of Biochemistry, Lady Hardinge Medical College, New Delhi, DL 110001, India
5Department of Radiology, Lady Hardinge Medical College, Kalawati Saran Children’s Hospital, New Delhi, DL 110001, India

Objective: Comparison of efficacy and safety of two different regimens of vitamin D—600 000 IU as a single intramuscular dose, and 60 000IU orally once a week for 10 weeks—in treatment of nutritional rickets.

Methods: Children with nutritional rickets (age: 0.5–5 years, n = 61) were randomized to receive either 60 000IU vitamin D orally once a week for 10 weeks or 600 000IU single intramuscular injection. Serum calcium, phosphate, alkaline phosphatase, urinary calcium/creatinine ratio, serum 25 hydroxy vitamin D and radiological score were compared at 12-week follow-up.

Results: No difference was found in efficacy of the two regimens on comparing biochemical and radiological parameters. Serum 25 hydroxy vitamin D >100 ng/ml was found in two children in the oral group and one child in the intramuscular group. No child developed hypercalcemia or hypercalciuria after starting treatment.

Conclusion: Staggered oral and one-time intramuscular administrations of 600 000IU vitamin D are equally effective and safe in treatment of nutritional rickets.

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