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On the ethics of not supplementing low 25-hydroxyvitamin D levels in a controlled study in relapsing remitting multiple sclerosis

  • Joost Smolders
    Correspondence
    Corresponding author at: Department of Neurology, Canisius Wilhelmina Hospital, PO Box 9015, 6500 GS Nijmegen, The Netherlands.
    Affiliations
    Academic MS Center Limburg, Zuyderland Medical Center, Sittard, The Netherlands

    Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
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  • Linda Rolf
    Affiliations
    Academic MS Center Limburg, Zuyderland Medical Center, Sittard, The Netherlands

    School for Mental Health and Neurocience, Maastricht University Medical Center, Maastricht, The Netherlands
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  • Jan Damoiseaux
    Affiliations
    Central Diagnostic Laboratory, Maastricht University Medical Center, Maastricht, The Netherlands
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  • Raymond Hupperts
    Affiliations
    Academic MS Center Limburg, Zuyderland Medical Center, Sittard, The Netherlands

    School for Mental Health and Neurocience, Maastricht University Medical Center, Maastricht, The Netherlands
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      We thank Shukla et al. for their critical appraisal of our work. Regarding the first comment: we agree, as already mentioned in the manuscript, that our exploratory study has its limitations and did not reveal major new insights in the role vitamin D3 may have in the treatment of major depression in multiple sclerosis (MS). Regarding the ethical concerns of Shukla et al., we think there are some important nuances which make our study different from the study discussed by Lo and Grady [
      • Lo B.
      • Grady D.
      Addressing ethical lapses in research.
      ].
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