Small, Early Study Suggests Benefit, but Expert Is Skeptical
By Salynn Boyles
WebMD Health News
Latest Digestion News
Reviewed by Louise Chang, MD
July 17, 2012 -- Early research suggests that patients with chronic hepatitis C infections may improve their treatment response by also receiving vitamin B12.
Investigators say adding B12 to standard therapy may boost the body's ability to fight the virus, but an expert who spoke to WebMD remains skeptical.
B12 May Help Drugs Work Better
In the newly reported Italian study, previously untreated patients with hepatitis C virus (HCV) who received vitamin B12 along with the drugs pegylated interferon and ribavirin were more likely to have undetectable levels of virus at 24 weeks after stopping treatment compared to patients who did not receive vitamin B12.
The study was small, with just 94 patients. Of those, 32 were genotype 1 patients treated with the vitamin. Genotype 1 is the most common strain in the U.S., and difficult to treat.
But the findings raise hopes that this inexpensive therapy may help HCV drugs work better in hard-to-treat patients, researcher Gerardo Nardone, MD, of the University of Naples, tells WebMD.
He says his research team hopes to conduct a much larger B12 supplementation study in hepatitis C patients.
3.2 Million in U.S. Infected With HCV
About 3.2 million people in the U.S. have chronic HCV infection, according to the CDC.
Until very recently, pegylated interferon along with ribavirin were the only drugs available to treat HCV.
The recent addition of a new class of drugs for patients with genotype 1 HCV has raised the rate of undetectable viral level to closer to 75%, says David Bernstein, MD, who is chief of hepatology at North Shore University Hospital in Manhasset, N.Y.
The new study, published in the journal Gut, included 94 patients with chronic HCV infections of genotypes 1, 2, and 3. They were treated with either pegylated interferon and ribavirin alone or the two drugs plus vitamin B12, given by injection every four weeks.
Patients with genotype 2 or 3 were treated for 24 weeks and patients with genotype 1 were treated for 48 weeks.
HCV Doctor Questions Study's Relevance
Patients given vitamin B12 along with standard treatment were more likely to achieve undetectable levels of virus at 24 weeks after stopping treatment.
Bernstein tells WebMD that the relevance of the pilot study is far from clear given its small size and the fact that the patients were not treated with other drugs now available.
"This study raises far more questions than it answers," he says. "It may merit further study, but this should be in patients who are on triple-drug therapy."
He adds that new drugs on the horizon are likely to boost ideal treatment response rates for previously hard-to-treat patients even further.
"This is really a very exciting time in the treatment of this disease," he says. "The current therapies are very good and those coming down the pipeline should be even better."
SOURCES: Rocco, A. Gut, July 2012. Gerardo Nardone, MD, department of clinical and experimental medicine, University of Naples, Italy. David Bernstein, chief of the division of hepatology, North Shore University Hospital, Manhasset, New York. News release, BMJ Publications. CDC: "Hepatitis C FAQs for Health Professionals." WebMD Health News: "3-Drug Combo May Treat Hepatitis C."
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