Nicotinamide riboside for peripheral artery disease: the NICE randomized clinical trial.
Level 2 - randomized trial
Individual randomized, double-blind, placebo-controlled trial
PubMed 38871717 · doi:10.1038/s41467-024-49092-5
What was done
A randomized, double-blind clinical trial evaluated 90 patients with lower extremity peripheral artery disease (PAD). Participants were randomized to receive 6 months of oral nicotinamide riboside (NR), NR combined with resveratrol, or placebo. The primary outcome was change in 6-minute walk distance at 6-month follow-up.
What was found
At 6 months, NR significantly improved 6-minute walk distance compared to placebo (+7.0 m vs. -10.6 m; between-group difference: +17.6 m, 90% CI: +1.8, +∞). In adherent participants taking at least 75% of study pills, NR improved 6-minute walk distance by 31.0 meters versus placebo, while NR plus resveratrol improved it by 26.9 meters versus placebo. Resveratrol added no benefit to NR alone.
Why it matters
Targeting NAD+ bioavailability via oral nicotinamide riboside represents a potential therapeutic strategy to improve functional walking performance in PAD, an area with limited pharmacotherapy options.
Limits
The sample size was modest (n = 90) split across three groups, and the main effect reported a one-sided 90% confidence interval. Long-term durability beyond 6 months, safety data, and clinical cardiovascular endpoints were not reported in the abstract.
Cited by
- supports Nicotinamide riboside supplementation demonstrated positive clinical trial results in patients with peripheral artery disease.
- contradicts In a three-arm trial by McDermott et al., NR improved 6-minute walk test distance in peripheral artery disease patients, while placebo and NR plus resveratrol resulted in degraded walk performance.