Vitamin A
| Evidence Level: L5 | Predicted Indications: 10 |
Table of Contents
Vitamin A: From Vitamin Deficiency Disorder to Congenital Prothrombin Deficiency
One-Sentence Summary
Vitamin A is an essential nutrient, originally used to treat vitamin deficiency disorders, including vitamin A deficiency. The TxGNN model predicts it may be effective for congenital prothrombin deficiency, but there are currently 0 clinical trials and 0 publications supporting this direction, so the prediction rests on the model alone.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Vitamin deficiency disorder / vitamin A deficiency (from the knowledge graph; the Singapore licence records contain no indication text) |
| Predicted New Indication | Congenital prothrombin deficiency |
| TxGNN Prediction Score | 99.97% |
| Evidence Level | L5 |
| Singapore Market Status | ✓ Marketed |
| Number of Registrations | 3 |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Currently, detailed mechanism of action data is not available. Vitamin A is a fat-soluble vitamin, and its efficacy in correcting vitamin A deficiency is well established. Its active metabolites, the retinoids, act mainly through nuclear receptors that regulate epithelial differentiation, vision, and immunity.
Congenital prothrombin (factor II) deficiency is a genetic coagulation disorder. Vitamin A has no established role in prothrombin synthesis. That role belongs to vitamin K, which is needed for the production of several clotting factors. The review of the prediction found no clear mechanistic link. The very high model score most likely reflects generic "vitamin or nutrient" associations in the knowledge graph rather than a real therapeutic relationship.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
Currently no related literature available.
Singapore Market Information
| Authorization Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| SIN05207P | VITALIPID N INFANT INJECTION | Injection | Not stated in the licence record |
| SIN05208P | VITALIPID N ADULT INJECTION | Injection | Not stated in the licence record |
| SIN11975P | CERNEVIT FOR INJECTION | Injection, powder, for solution | Not stated in the licence record |
All three licences are currently valid and for injectable products. No cancelled registrations were found.
Safety Considerations
- Contraindications (knowledge-graph associations, not label text): The drug is linked to contraindication or caution signals in the following conditions:
- Kidney and urinary: kidney disease, nephrolithiasis, nephrocalcinosis, acute urate nephropathy
- Liver and digestive: liver disease, gallbladder disease, peptic ulcer disease, ulcerative colitis, inflammatory bowel disease, gastroenteritis
- Mineral and iron metabolism: hypercalcemia, phosphorus metabolism disease, hyperphosphatemia, hereditary hemochromatosis, hemosiderosis, iron metabolism disease, Wilson disease
- Blood disorders: sickle cell anemia, hemolytic anemia, hereditary persistence of fetal hemoglobin
- Other: sarcoidosis, primary hyperoxaluria, hypervitaminosis, arteriosclerosis obliterans
- Drug Interactions: 68 interactions were recorded. The main ones are:
- Major: other retinoids (isotretinoin, acitretin, tretinoin) and tetracycline-class antibiotics (doxycycline, tetracycline, minocycline, omadacycline, demeclocycline, eravacycline, oxytetracycline, sarecycline)
- Moderate: bile acid sequestrants (cholestyramine, colesevelam, colestipol), sevelamer, bexarotene, selpercatinib
- Minor: orlistat
Please refer to the package insert for label warnings and contraindications.
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction has a very high model score but no supporting trials or literature, and no plausible mechanism. Vitamin A plays no known role in prothrombin synthesis, so this is a graph-based artefact rather than a credible repurposing signal.
To proceed, the following is needed:
- Mechanism of action data for vitamin A
- Any biological or clinical evidence linking vitamin A to prothrombin or coagulation-factor function
- Package insert warnings and contraindications for the registered Singapore products
- Consideration of other predicted indications for vitamin A with more evidence behind them. One example is perinatal disease, where systematic reviews of vitamin A in very-low-birth-weight infants exist. This is a separate question and would need its own evaluation.
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.