Besides vitamin D supplementation as a potential add-on to long-term immunotherapeutic treatment, a recent laboratory study of our group pointed toward a beneficial effect of vitamin D to improve the efficacy of glucocorticoids in relapse therapy. An explanation for missed primary endpoints may be underpowered trials. In this regard, prospective vitamin D supplementation studies missed statistical significance in its primary endpoints but showed promising results in secondary outcome measures or post hoc analyses. However, this finding does not demonstrate causality. MS patients with lower serum vitamin D concentrations were shown to have higher disease activity. From different risk factors contributing to the development of MS, vitamin D status is of particular interest since it is not only a modifiable risk factor but is also associated with MS disease activity. Over the past decades, increasing evidence suggested that hypovitaminosis D is a contributing factor to the risk of developing MS. It is one of the most common neurological disorders in young adults. Multiple sclerosis (MS) is characterized as an autoimmune disease affecting the central nervous system. Department of Neurology, University Hospital Bern and University of Bern, Bern, Switzerland.Andrei Miclea *, Maud Bagnoud, Andrew Chan and Robert Hoepner

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