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These benefits were highlighted in 2019 when the Lancet published a meta-analysis of seven clinical trials showing that these treatments reduced hospital admission by 9%, all-cause mortality by 12% and deaths associated with kidney disease by 17% ( While these data are astoundingwith yearly progress in efficacy, we should consider that around 9% of patients receiving these game-changer treatments (Table 1)

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Vitamin B 12 also acts as a co-factor in the conversion of methylmalonyl-CoA into succinyl-CoA by methylmalonyl-CoA mutase

The bar for compassionate use isnt high