Effects of oral crystalline cyanocobalamin 1000 μg/d in the treatment of pernicious anemia: An open-label, prospective study in Ten Patients - PubMed (original) (raw)
Effects of oral crystalline cyanocobalamin 1000 μg/d in the treatment of pernicious anemia: An open-label, prospective study in Ten Patients
Emmanuel Andrès et al. Curr Ther Res Clin Exp. 2005 Jan.
Abstract
Background: Standard treatment of cobalamin (vitamin B12) deficiency involvesregular (1000 μg/mo) IM cyanocobalamin administration. It has been suggested that high-dose (>2000 μg/d) oral cyanocobalamin may be effective in patients with pernicious anemia.
Objective: The aim of this study was to assess the efficacy and tolerability of oral crystalline cyanocobalamin 1000 μg/d in patients with cobalamin deficiency related to established pernicious anemia.
Methods: This open-label, prospective study was conducted at StrasbourgUniversity Hospital, Strasbourg, France. Patients aged ≥18 years with well-documented cobalamin deficiency related to pernicious anemia were enrolled. Patients received crystalline cyanocobalamin 1000 μg QD PO (capsule) for at least 3 months. Serum cobalamin, folate, iron, and homocysteine concentrations were measured, and a complete blood count was obtained, before (month 0; baseline) and after treatment.
Results: Ten patients (7 women, 3 men; mean [SD] age, 72.1 [15.5] years) entered the study. After 3 months of treatment, serum cobalamin concentration increased in all 9 patients in whom it was measured (mean [SD] increase, 117.4 [30.8] pg/mL; P < 0.001 vs baseline). Serum cobalamin concentrations were normalized (>200 pg/mL) in 6 patients. The serum cobalamin concentration was unavailable in 1 patient because of technical problems. Eight patients had increased hemoglobin concentrations (mean [SD] increase, 2.5 [2.4] g/dL; P < 0.01 vs baseline). All 10 patients had decreased mean erythrocyte corpuscular volumes (mean [SD] decrease, 10.4 [6.2] fL; P < 0.003 vs baseline). Four patients received concomitant blood transfusions or folate and iron supplementation. Three patients experienced clinical improvement in paresthesia, reflex abolition, or combined medullary sclerosis (each, 1 patient).
Conclusion: The results of this small study in patients with cobalamin deficiencyrelated to pernicious anemia suggest that oral crystalline cyanocobalamin 1000 μg/d may be an effective treatment.
Keywords: cobalamin deficiency; oral cyanocobalamin treatment; pernicious anemia.
Similar articles
- Efficacy of short-term oral cobalamin therapy for the treatment of cobalamin deficiencies related to food-cobalamin malabsorption: a study of 30 patients.
Andrès E, Kaltenbach G, Noel E, Noblet-Dick M, Perrin AE, Vogel T, Schlienger JL, Berthel M, Blicklé JF. Andrès E, et al. Clin Lab Haematol. 2003 Jun;25(3):161-6. doi: 10.1046/j.1365-2257.2003.00515.x. Clin Lab Haematol. 2003. PMID: 12755792 Clinical Trial. - Oral versus intramuscular cobalamin treatment in megaloblastic anemia: a single-center, prospective, randomized, open-label study.
Bolaman Z, Kadikoylu G, Yukselen V, Yavasoglu I, Barutca S, Senturk T. Bolaman Z, et al. Clin Ther. 2003 Dec;25(12):3124-34. doi: 10.1016/s0149-2918(03)90096-8. Clin Ther. 2003. PMID: 14749150 Clinical Trial. - A randomized, double-blind, placebo-controlled study of oral vitamin B12 supplementation in older patients with subnormal or borderline serum vitamin B12 concentrations.
Seal EC, Metz J, Flicker L, Melny J. Seal EC, et al. J Am Geriatr Soc. 2002 Jan;50(1):146-51. doi: 10.1046/j.1532-5415.2002.50020.x. J Am Geriatr Soc. 2002. PMID: 12028259 Clinical Trial. - Oral Vitamin B12 Replacement for the Treatment of Pernicious Anemia.
Chan CQ, Low LL, Lee KH. Chan CQ, et al. Front Med (Lausanne). 2016 Aug 23;3:38. doi: 10.3389/fmed.2016.00038. eCollection 2016. Front Med (Lausanne). 2016. PMID: 27602354 Free PMC article. Review. - Treatment of vitamin b(12)-deficiency anemia: oral versus parenteral therapy.
Lane LA, Rojas-Fernandez C. Lane LA, et al. Ann Pharmacother. 2002 Jul-Aug;36(7-8):1268-72. doi: 10.1345/aph.1A122. Ann Pharmacother. 2002. PMID: 12086562 Review.
Cited by
- Etiology, Clinical Manifestations, Diagnosis, and Treatment of Cobalamin (Vitamin B12) Deficiency.
Jajoo SS, Zamwar UM, Nagrale P. Jajoo SS, et al. Cureus. 2024 Jan 12;16(1):e52153. doi: 10.7759/cureus.52153. eCollection 2024 Jan. Cureus. 2024. PMID: 38344487 Free PMC article. Review. - The Impact of Vitamin B12 Supplementation on Clinical Outcomes in Patients With Diabetic Neuropathy: A Meta-Analysis of Randomized Controlled Trials.
Karedath J, Batool S, Arshad A, Khalique S, Raja S, Lal B, Anirudh Chunchu V, Hirani S. Karedath J, et al. Cureus. 2022 Nov 22;14(11):e31783. doi: 10.7759/cureus.31783. eCollection 2022 Nov. Cureus. 2022. PMID: 36457818 Free PMC article. Review. - Vitamin B12 Supplementation in Diabetic Neuropathy: A 1-Year, Randomized, Double-Blind, Placebo-Controlled Trial.
Didangelos T, Karlafti E, Kotzakioulafi E, Margariti E, Giannoulaki P, Batanis G, Tesfaye S, Kantartzis K. Didangelos T, et al. Nutrients. 2021 Jan 27;13(2):395. doi: 10.3390/nu13020395. Nutrients. 2021. PMID: 33513879 Free PMC article. Clinical Trial. - Systematic Review and Pragmatic Clinical Approach to Oral and Nasal Vitamin B12 (Cobalamin) Treatment in Patients with Vitamin B12 Deficiency Related to Gastrointestinal Disorders.
Andrès E, Zulfiqar AA, Serraj K, Vogel T, Kaltenbach G. Andrès E, et al. J Clin Med. 2018 Sep 26;7(10):304. doi: 10.3390/jcm7100304. J Clin Med. 2018. PMID: 30261596 Free PMC article. - Pernicious Anemia Associated Cobalamin Deficiency and Thrombotic Microangiopathy: Case Report and Review of the Literature.
Yousaf F, Spinowitz B, Charytan C, Galler M. Yousaf F, et al. Case Rep Med. 2017;2017:9410727. doi: 10.1155/2017/9410727. Epub 2017 Feb 6. Case Rep Med. 2017. PMID: 28265287 Free PMC article.
References
- Lindenbaum J., Rosenberg I.H., Wilson P.W. Prevalence of cobalamin deficiency in the Framingham elderly population. Am J Clin Nutr. 1994;60:2–11. - PubMed
- Andrés E., Goichot B., Schlienger J.L. Food cobalamin malabsorption: A usual cause of vitamin B12 deficiency. Arch Intern Med. 2000;160:2061–2062. - PubMed
- Loukili N.H., Andrés E. Vitamin B12 in the adult: Of metabolism and deficiencies. Ann Endocrinol (Paris) 2003;64:376–382. [in French] - PubMed
- Toh B.H., van Driel I.R., Gleeson P.A. Pernicious anemia. N Engl J Med. 1997;337:1441–1448. - PubMed
- Elia M. Oral or parenteral therapy for B12 deficiency. Lancet. 1998;352:1721–1722. - PubMed
LinkOut - more resources
Full Text Sources
Other Literature Sources