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This significant improvement in the inflammatory activity could be because VCN is a phosphodiesterase 1 (PDE1) inhibitor
Wikland KA, Luo ZC, Niklasson A, et al

Alternative treatment options External radiotherapy has proven effective, in cases where surgical treatment is not feasible

doi: 10.1038/s41586-024-07754-w 174 RoldnM
Follow-up tests may also be necessary to check the kidney function following certain infusions, says Allem

The study concluded that B12 deficiency disrupts catecholamine degradation and sympathetic nervous system function, directly contributing to orthostatic intolerance