T Rooimans et al. Gastroentol 2021; 161: 1056-1059. Open Access PDF: Novel Orally Formulated Mixed Micelles Optimize Vitamin K Absorption Under Bile-Deficient Conditions

This study, using a rat animal model, demonstrated how gastro-resistant mixed micelles (MMs) could be used to overcome the limitations of current prophylactic vitamin K formulations which are associated with failures in newborns with unrecognized cholestatic liver diseases (1:2,500 live births).

Key findings:

• Under cholestatic conditions, gastro-resistant formulations greatly improved vitamin K absorption.
• Pathophysiology: “Our data provide an explanation why: unstabilized MMs will aggregate during gastric passage, once aggregated vitamin K will not be sufficiently resolubilized upon a subsequent pH increase”

My take: It is likely that these gastro-resistant MMs would be effective in pediatric patients. If proven in clinical trials, this would reduce bleeding events in infants and lower bleeding risks in those with chronic liver disease while obviating the need for parenteral Vitamin K.

Related blog posts: 

• NY Times: Vitamin K for Newborns is a No-Brainer
• Educated or Misinformed –Leading to Hemorrhagic Disease of the Newborn
• Bleeding due to vitamin K deficiency