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It is effective for patients who are unresponsive to biologics and can be combined with biologics or systemic therapies (e.g., methotrexate), offering synergy and a better safety profile

If vitamin B 12 intake ceases, deficiency would usually not develop for at least 1-2 years, sometimes even longer

The most comprehensive review to date, published in JAAOS Global Research & Reviews , reached the same conclusion: Although preclinical studies are promising, there is a current lack of clinical trials (Rahman et al., 2026)

[DOI] [PMC free article] [PubMed] [Google Scholar] 63.Nassar N.T., Kim H., Frenzel M., Moats M.S., Hayes S.M

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Intestinal Cobalamin Malabsorption : Certain dog breeds cannot absorb vitamin B12