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JU INSIGHT: Effect of Vitamin D Supplementation on Overactive Bladder and Urinary Incontinence Symptoms in Older Men: Ancillary Findings From a Randomized Trial
By: Alayne D. Markland, DO, MSc; Camille P. Vaughan, MD, MS; Alison J. Huang, MD, MAS, MPhil; Eunjung Kim, MS; Vadim Y. Bubes, PhD; Vin Tangpricha, MD, PhD; Julie R. Buring, ScD; I-Min Lee, MBBS, ScD; Nancy R. Cook, ScD; JoAnn E. Manson, MD, DrPH; Francine Grodstein, ScD | Posted on: 17 Jan 2023
Markland AD, Vaughan CP, Huang AJ, et al. Effect of vitamin D supplementation on overactive bladder and urinary incontinence symptoms in older men: ancillary findings from a randomized trial. J Urol. 2023;209(1):243-252.
Study Need and Importance
Very few clinical trials exist to guide recommendations about vitamin D supplementation for overactive bladder (OAB) and urinary incontinence (UI), especially in men. To further evaluate the prevalence, incidence, and progression of OAB and UI symptoms among men taking vitamin D supplementation compared to placebo, we conducted an ancillary study of OAB and UI symptoms among men enrolled in a nationwide vitamin D and omega-3 prevention trial for cancer and cardiovascular disease, the VITamin D and OmegA-3 TriaL (VITAL).
What We Found
In this ancillary analysis of VITAL, a randomized trial including 11,486 older men, daily vitamin D3 supplementation did not reduce OAB and UI prevalence, incidence, or progression relative to placebo over 2 to 5 years (see Figure). In the planned subgroup analysis of men with low pre-randomization serum 25-hydroxyvitamin D levels, we found inconsistent findings with reduced OAB at year 5 and increased UI when associated with sleep or other reasons. Our subgroup findings were paradoxical for the use of vitamin D supplementation in older men with low serum 25-hydroxyvitamin D.
Limitations
This ancillary clinical trial analysis has several strengths, including the large sample size, high retention rate, and follow-up for 5 years, including a subgroup of men with serum levels of 25-hydroxyvitamin D. However, we did not have baseline UI or OAB data, and thus could not formally consider UI incidence or progression throughout the full study period and could only assess OAB at year 5. We only assessed OAB and UI symptoms through self-reported questionnaires.
Interpretation for Patient Care
Our study provides evidence that vitamin D supplementation does not broadly treat or prevent UI in older men. Our findings also indicate that long-term vitamin D supplements reduced the potential for OAB in men with low serum 25-hydroxy vitamin D levels, although inconsistent findings included possible increases in UI in this subgroup.
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