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Therapeutic Response to Sublingual Methylcobalamin in Children With Vitamin B12 Deficiency Anemia
Chahat Saxena1, Sweta Kumari1, Pooja Dewan2
1Department of Pediatrics, University College of Medical Sciences and GTB Hospital, Delhi.
Insights
Sublingual methylcobalamin effectively treats vitamin B12 deficiency anemia in children, improving key blood markers. Longer treatment duration may be needed for complete anemia resolution.
Area of Science:
- Pediatric Hematology
- Nutritional Science
- Pharmacology
Background:
- Vitamin B12 deficiency anemia is a significant concern in pediatric populations.
- Sublingual administration offers a potentially convenient alternative to parenteral routes for vitamin B12 supplementation.
Purpose of the Study:
- To assess the efficacy and safety of sublingual methylcobalamin in treating vitamin B12 deficiency anemia in children.
- To evaluate changes in serum cobalamin, plasma homocysteine, hemoglobin, and MCV levels following treatment.
Main Methods:
- A single-arm study involving 37 children (aged 1-12 years) with diagnosed vitamin B12 deficiency anemia.
- Children received varying doses of sublingual methylcobalamin based on age, followed by weekly maintenance doses for 6 weeks.
- Prospective follow-up included biochemical and hematological parameter monitoring.
Main Results:
- Significant increases in serum cobalamin (P<0.001) and hemoglobin (P<0.001) were observed.
- Significant decreases in plasma homocysteine (P<0.001) and MCV (P<0.001) were noted.
- No adverse events were reported, and no rescue therapy was required, indicating good tolerability and initial efficacy.
Conclusions:
- Sublingual methylcobalamin demonstrates efficacy in treating vitamin B12 deficiency anemia in children.
- While effective, a treatment duration longer than six weeks may be necessary to fully resolve anemia in all pediatric patients.
Objective:
To evaluate the efficacy and safety of sublingual methylcobalamin for the treatment of vitamin B12 deficiency anemia in children.
Methods:
A single arm intervention study was conducted between November, 2020 and April, 2022 in children aged 1-12 years with vitamin B12 deficiency anemia. Children aged 1-6 years received a tablet of methylcobalamin (1500 mcg) by sublingual route every alternate day (three doses) while those aged 7-12 years received five such doses. Thereafter, one such sublingual tablet was given weekly and all participants were followed-up for 6 weeks.
Results:
37 children with a mean (SD) age of 8.2 (4.1) years were treated and followed up prospectively. On day 10, no child needed rescue therapy with parenteral methylcobalamin. After 6 weeks, the mean (SD) serum cobalamin (mL) increased from 123.3 (35.5) pg/mL to 507.3 (274.2) pg/mL (P<0.001), plasma homocysteine (L) decreased from 48.9 (17.8) pg/mL to 16.3 (8.5) µmol/L (P<0.001), the mean (SD) hemoglobin increased by 2.3 (1.1) g/dL (P<0.001), and MCV decreased by 12.9 (6.8) fL (P<0.001). 67.6% children persisted to have anemia, albeit majority of them had mild or moderate anemia. There were no unsolicited side-effect reported.
Conclusion:
Sublingual methylcobalamin is effective for the treatment of vitamin B12 deficiency anemia in children; although, the duration of treatment needs to be longer than six weeks.
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