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The people with SPMS treated with natalizumab in the phase 3 ASCEND in SPMS trial (NCT01416181) had a decrease in their Multiple Sclerosis Impact Scale mean psychological scores from 39.1 at baseline to 36.7 at week 96, 21 which, although it was nonsignificant, was disconnected from longitudinal PROM changes with a steady decline in EDSS scores and the T25-FW

In such scenarios, vitamin B12 injections can be a game-changer

Conclusion In recent years, research has unearthed a number of vitamin B12 side effects, including positive effects, such as its ability to improve energy levels, enhance mood and keep your heart healthy, and negative effects that may occur when theres too much in the body

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Identifying immune cell infiltration and effective diagnostic biomarkers in rheumatoid arthritis by bioinformatics analysis

However, a 2025 review noted only 3 RCTs, calling for larger trials (Nguyen et al., 2025)