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Background <p>Serum 25-hydroxyvitamin D (25-OH-D) deficiency is considered a modifiable risk factor for the development of multiple sclerosis (MS). However, its impact on the long-term clinical course and disability progression in early MS remains unclear.</p> Methods <p>We conducted a retrospective observational cohort study at the MS Centre of the University Hospital Ostrava, including patients with clinically isolated syndrome (CIS) or relapsing–remitting MS (RRMS). Mean serum 25-OH-D concentrations over a five-year follow-up were analyzed in relation to clinical outcomes, including therapy escalation and a composite progression severity score (PSS) based on EDSS change and treatment escalation. Multivariable logistic regression models were used to assess independent associations, adjusting for age, sex, and baseline EDSS.</p> Results <p>A total of 106 patients (73 women, 69%) were included, with a mean age at treatment initiation of 32.8 ± 9.32&#xa0;years. Higher mean serum 25-OH-D levels were associated with lower odds of therapy escalation (OR = 0.923 per 1&#xa0;nmol/L; 95% CI 0.886–0.962; p &lt; 0.001) and a more favorable disease course according to the PSS (OR = 0.892 per 1&#xa0;nmol/L; 95% CI 0.848–0.937; p &lt; 0.001). Patients with a favorable prognosis had significantly higher mean serum 25-OH-D concentrations compared to those with unfavorable outcomes (70.43 ± 13.99 vs. 56.07 ± 11.25&#xa0;nmol/L; p &lt; 0.001).</p> Conclusion <p>Higher mean serum 25-OH-D levels were associated with a more favorable disease course and lower likelihood of therapy escalation in early MS. These findings highlight the potential role of serum 25-OH-D as a marker of disease activity; however, given the observational design and the use of a study-specific composite outcome, the results should be interpreted with caution and confirmed in prospective studies.</p>

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Serum Vitamin D Levels as a Potential Predictor of Disability Progression and Therapy Escalation in Early Multiple Sclerosis: A 5-Year Retrospective Cohort Study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月18日

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  • Milos Chudy,
  • Radovan Bunganic,
  • Adela Novotna,
  • Martina Kovalova,
  • Marek Buzga,
  • Lubica Argalasova,
  • Pavel Hradilek

摘要

Background

Serum 25-hydroxyvitamin D (25-OH-D) deficiency is considered a modifiable risk factor for the development of multiple sclerosis (MS). However, its impact on the long-term clinical course and disability progression in early MS remains unclear.

Methods

We conducted a retrospective observational cohort study at the MS Centre of the University Hospital Ostrava, including patients with clinically isolated syndrome (CIS) or relapsing–remitting MS (RRMS). Mean serum 25-OH-D concentrations over a five-year follow-up were analyzed in relation to clinical outcomes, including therapy escalation and a composite progression severity score (PSS) based on EDSS change and treatment escalation. Multivariable logistic regression models were used to assess independent associations, adjusting for age, sex, and baseline EDSS.

Results

A total of 106 patients (73 women, 69%) were included, with a mean age at treatment initiation of 32.8 ± 9.32 years. Higher mean serum 25-OH-D levels were associated with lower odds of therapy escalation (OR = 0.923 per 1 nmol/L; 95% CI 0.886–0.962; p < 0.001) and a more favorable disease course according to the PSS (OR = 0.892 per 1 nmol/L; 95% CI 0.848–0.937; p < 0.001). Patients with a favorable prognosis had significantly higher mean serum 25-OH-D concentrations compared to those with unfavorable outcomes (70.43 ± 13.99 vs. 56.07 ± 11.25 nmol/L; p < 0.001).

Conclusion

Higher mean serum 25-OH-D levels were associated with a more favorable disease course and lower likelihood of therapy escalation in early MS. These findings highlight the potential role of serum 25-OH-D as a marker of disease activity; however, given the observational design and the use of a study-specific composite outcome, the results should be interpreted with caution and confirmed in prospective studies.