Oral Cyanocobalamin is Effective in the Treatment of Vitamin B12 Deficiency in Crohn's Disease - PubMed (original) (raw)

Multicenter Study

Oral Cyanocobalamin is Effective in the Treatment of Vitamin B12 Deficiency in Crohn's Disease

Fernando Gomollón et al. Nutrients. 2017.

Abstract

Cobalamin deficiency is common in patients with Crohn's disease (CD). Intramuscular cobalamin continues to be the standard therapy for the deficiency and maintenance treatment in these patients, although oral route has been demonstrated to be effective in other pathologies with impaired absorption. Our aims were to evaluate the efficacy of oral therapy in the treatment of cobalamin deficiency and in long-term maintenance in patients with Crohn's disease. We performed a multicenter retrospective cohort study that included 94 patients with Crohn's disease and cobalamin deficiency. Seventy-six patients had B12 deficiency and 94.7% of them normalized their cobalamin levels with oral treatment. The most used dose was 1 mg/day, but there were no significant differences in treatment effectiveness depending on the dose used (≥1 mg/24 h vs. <1 mg/24 h). Eighty-two patients had previous documented B12 deficiency and were treated with oral B12 to maintain their correct cobalamin levels. After a mean follow-up of 3 years, the oral route was effective as maintenance treatment in 81.7% of patients. A lack of treatment adherence was admitted by 46.6% of patients in who the oral route failed. In conclusion, our study shows that oral cyanocobalamin provides effective acute and maintenance treatment for vitamin B12 deficiency caused by CD with or without ileum resection.

Keywords: Crohn’s disease; acute treatment; cobalamin deficiency; ileal resection; maintenance treatment; oral treatment; vitamin B12 deficiency.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1

Figure 1

Serum cobalamin levels (pg/mL) before and after treatment with oral cyanocobalamin. * Extreme value (1369 pg/mL).

Figure 2

Figure 2

Serum cobalamin levels (pg/mL) during maintenance therapy; at the beginning of follow-up and at the end of follow-up. * Extreme values (1513 pg/mL, 1500 pg/mL and 1304 pg/mL, see Table 5).

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