Oral Cyanocobalamin is Effective in the Treatment of Vitamin B12 Deficiency in Crohn's Disease.
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.
Hospital Clínico Universitario "Lozano Blesa", Avenue San Juan Bosco, 15, Zaragoza 50009, Aragón, Spain. fgomollon@gmail.com.|Aragón Health Research Institute (IIS Aragón), Zaragoza 50009, Aragón, Spain. fgomollon@gmail.com.|University of Zaragoza, Zaragoza 50009, Aragón, Spain. fgomollon@gmail.com.|Centro de Investigación Biomédica en Red, Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid 28029, Spain. fgomollon@gmail.com.
Fernando
F
Gomollón
Hospital Clínico Universitario "Lozano Blesa", Avenue San Juan Bosco, 15, Zaragoza 50009, Aragón, Spain. carlajerusalen@hotmail.com.|Aragón Health Research Institute (IIS Aragón), Zaragoza 50009, Aragón, Spain. carlajerusalen@hotmail.com.
Carla J
CJ
Gargallo
Hospital Universitario de Salamanca, Salamanca 37007, Castilla y León, Spain. jmunozn@gmail.com.
Jose Fernando
JF
Muñoz
Hospital Universitario Miguel Servet, Zaragoza 50009, Aragón, Spain. raquelvicentelidon@gmail.com.
Raquel
R
Vicente
Hospital Clínico Universitario "Lozano Blesa", Avenue San Juan Bosco, 15, Zaragoza 50009, Aragón, Spain. alberto.lue@hotmail.com.|Aragón Health Research Institute (IIS Aragón), Zaragoza 50009, Aragón, Spain. alberto.lue@hotmail.com.
Alberto
A
Lue
Hospital Ernest Lluch Martin, Calatayud, Zaragoza 50299, Aragón, Spain. albertomirsubias@gmail.com.
Alberto
A
Mir
Hospital Virgen de la Concha, Zamora 49022, Castilla y León, Spain. mery_271@hotmail.com.
Marta
M
García-Alvarado
Hospital Universitario Miguel Servet, Zaragoza 50009, Aragón, Spain. tagaru@hotmail.com.
Marta
M
Gracia
Hospital Universitario Miguel Servet, Zaragoza 50009, Aragón, Spain. sgarcia.lopez@gmail.com.
Santiago
S
García-López
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D003424:Crohn Disease / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014805:Vitamin B 12 / Q000008:administration & dosage*; D014806:Vitamin B 12 Deficiency / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D055815:Young Adult
D014805:Vitamin B 12
Crohn’s disease; acute treatment; cobalamin deficiency; ileal resection; maintenance treatment; oral treatment; vitamin B12 deficiency