Aaron Lerner^{1, 2,}, Jozélio Freire de Carvalho^3,, Motti Haimi^{4, 5}, Carina Benzvi¹

Vitamin C (VC) is a potent antioxidant that was tested in a few rheumatic diseases. However, no updated systematic review is available in the literature. PubMed/MEDLINE, EMBASE, and Scielo were searched for articles on VC and rheumatologic diseases between 1966 and March 2023. Eight articles were found, including 227 patients. The investigated diseases were fibromyalgia (n=2), rheumatoid arthritis (n=2), systemic lupus erythematosus (n=1), antiphospholipid syndrome (n=1), Kawasaki disease (n=1) and vasculitis (Wegener’s granulomatosis and microscopic polyangiitis) (n=1). Age varied from 7.1 to 53.5±2.7 years old, and female gender ranged from 50% to 100% in the included articles. Disease duration ranged from 10.2 to 14 ± 8 years. VC dosage ranged from 133 mg to 3,000 mg/day. Concerning outcomes, the fibromyalgia studies showed an improvement in clinical and laboratory parameters. Interestingly, one study in RA showed a significant decrease in disease activity after VC. The other studies showed an improvement in these oxidant levels. Specifically, the Kawasaki disease article showed an improvement in vasodilation after intravenous VC injection; while the lupus study did not observe this benefit. Vitamin C is a safe therapy for various rheumatologic diseases. The improved subjective complaints, objective signs and laboratory parameters are promising. However, reconfirmation in more well-controlled, double-blind, cross-over studies, is highly needed.

Vitamin C, anti-oxidants, anti-inflammatory, rheumatoid arthritis, fibromyalgia