A Study to See if a Combination of Vitamins That is Injected Into a Muscle is as Good and Safe as a Vitamin That is Taken by Mouth

Phase 4

Recruiting

• Conditions: Vitamin B12 Deficiency
• Interventions: Drug: Vitamin B12, Vitamin B6, Folic acid; Drug: Vitamin B12 (Cyanocobalamin)

• Registration Number: NCT07029698
• Lead Sponsor: Medice Arzneimittel Pütter GmbH & Co KG

Brief Summary

Primary efficacy objective:

To investigate the effects of a parenterally vitamin B12 combination treatment versus an oral vitamin B12 mono therapy on the vitamin B12 status in female and male patients as determined by the change from baseline in serum vitamin B12 concentration after 4 weeks (28 days) of treatment.

Secondary efficacy objectives:

To evaluate the effects of a parenterally vitamin B12 combination versus an oral vitamin B12 mono therapy after 4 weeks of treatment on:

* Serum holotranscobalamin

* Serum homocysteine

* Serum methylmalonic acid

* Combined vitamin B12 markers (cB12)

* Serum folic acid

* Serum vitamin B6

* Serum S-adenosylmethione (SAM)

* Serum S-adenosylhomocysteine (SAH)

* SAM/SAH ratio

* WHO-5 Well-Being Index

* Medical Outcomes Study Questionnaire Short Form 36 Health Survey (SF-36)

* Visual analogue scale (VAS) EQ-5D.

Safety objectives:

To evaluate the safety and tolerability of oral vitamin B12 mono therapy versus intramuscular vitamin B12 combination.

Detailed Description

Not available

Study Timeline

• Study Start: 2025-04-16
• Status Verified: 2025-05
• Study First Submitted: 2025-05-01
• Study First Submitted QC: 2025-06-18
• Last Update Submitted: 2025-06-18
• Study First Posted: 2025-06-19
• Last Update Posted: 2025-06-19
• Primary Completion: 2025-12
• Study Completion: 2026-12

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 46

Inclusion Criteria

1. Provision of written informed consent to participate in the study (according to Order of the Ministry of Health of Ukraine No. 690 (with amendments)).
2. Female and male patients aged ≥18.
3. Vitamin B12 deficiency, defined as serum vitamin B12 < 350 pmol/L.
4. Female patients of childbearing potential (WOCBP) must be using two acceptable methods of contraception, (e.g., intra-uterine device plus condom, spermicidal gel plus condom, diaphragm plus condom, etc., with the exception of oral contraceptives), from the time of screening and for the duration of the study, through study completion and for 1 month following study completion. Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods) and withdrawal are not acceptable methods of contraception. Postmenopausal females must have had no regular menstrual bleeding for at least one (1) year prior to initial dosing. Female patients who report surgical sterilization must have had the procedure at least six (6) months prior to initial dosing. Surgical sterilization procedures should be supported with clinical documentation made available to the sponsor and noted in the Relevant Medical History / Current Medical Conditions section of the CRF. All female patients of childbearing potential must have negative pregnancy test results at screening. An additional pregnancy test will be performed on Days 0, 28, 56.
5. Able to communicate well with the investigator and able to understand and comply with the requirements of the study.
6. Patients are otherwise in relatively good health as determined by past medical history, physical examination, vital signs, and laboratory tests at screening (V -1).

Exclusion Criteria

1. Active or recent vitamin B12, folic acid, B6 intake (the subject must not receive vitamin B12, folic acid, B6 drugs or food supplements for at least 6 months).
2. Participation in a previous clinical study with vitamin B12 within the 6 months prior to screening.
3. Any contraindication to one of the study drugs.
4. Pregnant or nursing (lactating) women.
5. Donation or loss of 400 mL or more of blood within 8 weeks prior to first dosing, or longer if required by local regulation.
6. Subjects with anemia (hemoglobin < 10 mg/dL) or significant neurological symptoms due to vitamin B12 deficiency.
7. Any diseases that prevent intrinsic-factor independent passive diffusion in the small intestine (e.g. ileum resection)
8. Current drug addiction and/or alcohol abuse as evidenced by patient history and/or as determined by the investigator at V-1.
9. Cognitive or behavioural abnormalities that could impair the capacity to give informed consent or carry out protocol-specified procedures.
10. Inability to take oral medication.
11. Inability or unwillingness to comply with the study protocol.
12. Previous (last 6 months) or current participation in another clinical study.
13. Other medical, neuropsychiatric, or social conditions that, in the opinion of the investigator, are likely to adversely affect the risk-benefit of study participation, interfere with study compliance, or confound the study results.
14. Subjects who are in a dependent relationship with the Investigator or the Sponsor.
15. Subjects unwilling to give written informed consent to saving and/or propagation of anonymised medical data

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Vitamin injection	Vitamin B12, Vitamin B6, Folic acid	1 injection twice weekly at the clinical site. Totally 8 injections through 4 week treatment period
Vitamin B12 tablet	Vitamin B12 (Cyanocobalamin)	1 oral tablet once daily in the morning. Totally 28 tablets at approximately the same time each day through 4 week treatment period

Primary Outcome Measures

Name	Time	Method
Vitamin B12	Change from baseline at day 28	Effects of treatment on serum vitamin B12

Secondary Outcome Measures

Name	Time	Method
Holotranscobalamin	Change from baseline at day 28 and at follow up at day 56	Effects of treatment on serum holotranscobalamin
Methylmalonic acid	Change from baseline at day 28 and at follow up at day 56	Effects of treatment on serum methylmalonic acid
Homocystein	Change from baseline at day 28 and at follow up at day 56	Effects of treatment on serum homocystein
Combined vitamin B12 marker (cB12)	Change from baseline at day 28 and at follow up at day 56	Effects of treatment on cB12. Combined vitamin B12 markers (cB12) will be statistically calculated using the levels of Serum holotranscobalamin, Serum homocysteine, Serum methylmalonic acid. cB12 (cB12=log10\[(holoTC x B12)/(MMA x Hcy)\]-(age factor).
Serum S-adenosylmethione (SAM)	Change from baseline at day 28 and at follow up at day 56	Effects of treatment on serum S-adenosylmethione (SAM)
Serum S-adenosylhomocysteine (SAH)	Change from baseline at day 28 and at follow up at day 56	Effects of treatment on serum S-adenosylhomocysteine (SAH)
SAM/SAH ratio	Change from baseline at day 28 and at follow up at day 56	The change of the ratio will be assessed statistically using the levels of Serum S-adenosylmethione (SAM) and Serum S-adenosylhomocysteine (SAH)
Quality of life assessed with SF-36	Change from baseline at day 28 and at follow up at day 56	Effects of treatment on SF-36 questionnaire (from 0 to 100 points in each of the eight subscales, where the higher score means the higher quality of patient's life in each domain)
Quality of life assessed with WHO-5 questionnaire	Change from baseline at day 28 and at follow up at day 56	Effects of treatment on WHO-5 questionnaire (from 0 to 25, where the higher score means the higher quality of patient's life)
Quality of life assessed with VAS EQ-5D	From baseline to day 28 and at follow up at day 56	Effects of treatment on visual analogue scale EQ-5D (from 0 "the worst possible quality of life" to 10 "the best possible quality of life")

Trial Locations

Locations (2)

State institution "V. Danilevsky Institute for Endocrine Pathology Problems of the NAMS of Ukraine"; 🇺🇦 Kharkiv, Ukraine

Private Enterprise Private Manufacturing Company "Acinus"; 🇺🇦 Kropyvnytskyi, Ukraine