We have been made aware that a pharmaceutical company based in Northumberland is about to be granted a licence to produce 1mg tablets of Cyanocobalamin. One of our Pharmacist members immediately contacted the company, which is owned and operated by a GP and was reassured to find out that not only is the medication not going to be used to treat Pernicious Anaemia or other non-dietary causes of B12 Deficiency but that the company wants to work with this society to investigate whether it could be used to treat PA.
Issues around oral tablets
Firstly, there’s the current practice by some GPs of prescribing 50mcg tablets of B12 to treat Pernicious Anaemia instead of injections. The flawed studies that have been carried out in the past (they would never pass strict quality controls for publication today) have found that some patients when given 1,000mcg tablets (1mg) absorbed around 1% of the tablet ‘passively’. Prescribing three 50mcg tablets as treatment is useless – the tablets in the flawed studies in the past used 1,000mcg – three 50mcg tablets is just 150mcg.
Secondly, the practice of some GPs telling patients to visit a Health-food store or internet store to purchase 1mg tablets to treat their Pernicious Anaemia is not only based on the same flawed, small research projects conducted many decades ago, but also the tablets will not be of Pharmaceutical Standard therefore not subject to any stringent quality controls.
When this new 1mg tablet is licenced, it will be of high pharmaceutical quality and therefore address one problem associated with oral supplementation. And it will do more than this – it will offer the opportunity for a robust research project to take place to assess the suitability of oral tablets as a treatment for Pernicious Anaemia.
We know that some of our members already use 1mg tablets daily to treat their Pernicious Anaemia; but we are also aware that other members of this society see their symptoms return and deteriorate when they have tried oral tablets.
Research team to investigate
With this in mind this society is forming a Research Team that will investigate this method of treatment and once and for all find out whether some patients can use oral tablets as a form of treatment. We will be applying for a large research grant to fund this project.
Already we have six clinicians and other health professionals who have agreed to take part in this study, and we will be aiming for a team of eight to ten professionals. One thing is already clear to the team – they will not be simply using serum B12 levels to assess the success of oral treatment; instead the clinical picture of the patient will be used to determine whether oral treatments will work. It will be whether the patient feels any benefit that will form the basis for evaluating tablets as a treatment. This society will be a co-applicant for funding and a core member of the research team.