Mecobalamin.
BACKGROUND
Mecobalamin, one of the coenzyme forms of vitamin B(12), acts as an important cofactor in the activities of B(12)-dependent methyltransferases. Since the discovery of mecobalamin, it has been applied mainly in the treatment of hyperhomocysteinaemia and peripheral neuropathy. However, there is still lack of a systemic review on the clinical administration of mecobalamin and its potential mechanism.


OBJECTIVE
To review the mechanism, clinical efficacy and safety of mecobalamin in the treatment of hyperhomocysteinaemia and peripheral neuropathy.


METHODS
First, the potential mechanism, pharmacokinetics and metabolism of mecobalamin were clarified. In addition, the clinical administration including efficacy, safety and tolerability of mecobalamin as monotherapy or combined therapy in the treatment of hyperhomocysteinaemia and peripheral neuropathy were also detailed.


CONCLUSIONS
Although both monotherapy and combined therapy can lower plasma/serum homocysteine levels and improve the neuropathic symptoms, combined therapy with other B vitamins seems to be more effective. However, more precise, double-blind and randomised control studies are necessary to confirm the efficacy of mecobalamin on hyperhomocysteinaemia, peripheral neuropathy interaction, and cardiovascular, neurological and osteoporotic mortality or morbidity.
Zhang
Yi-Fei
YF
Shanghai Institute of Endocrinology and Metabolism, Division of Endocrine and Metabolic Diseases of E-Institute of Shanghai Universities, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, PR China.
Ning
Guang
G
D000368:Aged; D000527:Alprostadil / Q000008:administration & dosage / Q000627:therapeutic use; D000818:Animals; D003038:Cobamides / Q000502:physiology; D003067:Coenzymes / Q000502:physiology; D003929:Diabetic Neuropathies / Q000188:drug therapy / Q000517:prevention & control; D004333:Drug Administration Routes; D004359:Drug Therapy, Combination; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000009:adverse effects; D007676:Kidney Failure, Chronic / Q000188:drug therapy / Q000628:therapy; D008297:Male; D008687:Metformin / Q000009:adverse effects; D008715:Methionine / Q000378:metabolism; D008780:Methyltransferases / Q000378:metabolism; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D006435:Renal Dialysis / Q000009:adverse effects; D014805:Vitamin B 12 / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use; D014806:Vitamin B 12 Deficiency / Q000139:chemically induced / Q000150:complications / Q000188:drug therapy; D025101:Vitamin B 6 / Q000008:administration & dosage / Q000627:therapeutic use
D003038:Cobamides; D003067:Coenzymes; D007004:Hypoglycemic Agents; D025101:Vitamin B 6; D008687:Metformin; D005492:Folic Acid; D008715:Methionine; C019476:mecobalamin; D008780:Methyltransferases; D000527:Alprostadil; D014805:Vitamin B 12