CLINICAL EFFICACY OF INTRAVENOUS PLUS ORAL MECOBALAMIN IN PATIENTS WITH PERIPHERAL NEUROPATHY USING VIBRATION PERCEPTION THRESHOLDS AS AN INDICATOR OF IMPROVEMENT

Mecobalamin has been widely used in the treatment of patients with per ipheral neuropathy. Several studies have investigated oral, intravenou s (IV), or intramuscular administration of mecobalamin, but no studies on the usefulness of a combination of these routes have been reported . In addition, drug efficacy has been evaluated mainly from subjective symptoms, the severity of which is difficult to express numerically. In the present study, the effectiveness of two practical regimens of m ecobalamin was investigated: (1) oral administration of 500 mu g of me cobalamin three times a day for at least 8 weeks (O group); and (2) IV administration of 500 mu g/d of mecobalamin three times a week for 4 weeks followed by oral administration of 500 mu g of mecobalamin three times a day for at least 4 weeks (VO group). Not only were the change s in subjective symptoms and neurologic findings evaluated, but vibrat ion perception thresholds were also monitored to evaluate the efficacy of each regimen as objectively as possible. Overall improvement was e valuated as ''improved'' or ''markedly improved'' in 66.6% of the VO g roup and 39.1% of the O group. Vibration perception thresholds of the lower extremities were significantly improved in patients in the VO gr oup, whereas patients in the O group did not show clear improvement. T he regimen was evaluated as ''useful'' or ''highly useful'' in 71.4% o f the VO group and 43.5% of the O group. The investigators concluded t hat the VO regimen is highly effective, and it is recommended in patie nts who require more rapid and greater improvement of neurologic sympt oms.