Advanced or Resistant Cases: For patients with stubborn or dermal melasma unresponsive to standard treatments (approximately 1520% of cases), supplements may be considered a last resort intervention
others are supported primarily by observational data and patient-reported outcomes rather than large controlled trials
In the pediatric population, certain genetic variants have been linked to a higher risk of developing various types of toxicity, including gastrointestinal, hematological, neurological, endocrine, and cardiotoxic effects [69]
One randomized pilot study looked at total neuropathy score evaluated by a neurologist and patient-reported neuropathy in 71 newly diagnosed cancer patients receiving taxane, vincristine, or oxaliplatin chemotherapy who received B vitamins or placebo as an adjunct to therapy
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