Effect of Nicotinamide in Skin Cancer and Actinic Keratoses Chemoprophylaxis, and Adverse Effects Related to Nicotinamide: A Systematic Review and Meta-Analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 35134311 · doi:10.1177/12034754221078201
What was done
A systematic review and meta-analysis of randomized controlled trials (RCTs) evaluated the effect of oral nicotinamide on skin cancer prevention. Searches across Medline, EMBASE, CENTRAL, and Web of Science were conducted from inception to October 2020. Screening and data extraction were performed in duplicate. The primary outcome was skin cancers (all types); secondary outcomes included basal cell carcinomas (BCCs), cutaneous squamous cell carcinomas (cSCCs), actinic keratoses, melanomas, and adverse effects.
What was found
Of 4,730 citations screened, 29 trials (3,039 patients) met inclusion criteria. Nicotinamide significantly reduced total skin cancers compared to control (rate ratio 0.50, 95% CI 0.29–0.85; I² = 64%; 5 trials, 552 patients; moderate strength of evidence). Nicotinamide was also reported to significantly reduce BCCs and cSCCs, and increase digestive adverse effects, but the abstract did not report exact numbers or effect sizes for these secondary outcomes.
Why it matters
This review synthesizes trial evidence supporting oral nicotinamide as chemoprophylaxis against non-melanoma skin cancer in patients with a history of skin cancer, including organ transplant recipients.
Limits
The primary outcome analysis was limited to 5 trials (552 patients) out of the 29 included studies and showed substantial statistical heterogeneity (I² = 64%), attributed to risk of bias. Effect estimates and confidence intervals for BCCs, cSCCs, actinic keratoses, melanomas, and specific adverse effects were not reported in the abstract.
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- supports Oral nicotinamide supplementation significantly lowers the risk of skin cancer in prospective clinical trials in Australia.