Nicotinamide riboside for peripheral artery disease: the NICE randomized clinical trial
What this study found
NR alone was associated with improved walking performance, while adding resveratrol did not provide clear additional benefit. At 6 months, NR versus placebo increased 6-minute walk distance by +17.6 meters (90% CI: +1.77, +∞; P = 0.08), whereas NR plus resveratrol versus placebo changed it by +3.65 meters (90% CI: -11.2, +∞; P = 0.38). At 3 months, both active arms improved versus placebo: NR alone +22.4 meters (90% CI: +7.3, +∞; P = 0.029) and NR plus resveratrol +20.6 meters (90% CI: +6.3, +∞; P = 0.034). In a post hoc adherence analysis (≥75%), benefits were larger for NR alone (+31.0…
- Study & population
- Randomized, placebo-controlled, 3-arm clinical trial in adults with lower-extremity peripheral artery disease and walking impairment.
- Intervention
- Oral nicotinamide riboside (NR) 1000 mg daily for 6 months, given as two 250 mg pills twice daily.
- Key limitation
- The active arms were small, and the 6-month primary comparison for NR versus placebo did not reach conventional statistical significance (P = 0.08).
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Open PDFOriginal abstract
People with lower extremity peripheral artery disease (PAD) have increased oxidative stress, impaired mitochondrial activity, and poor walking performance. NAD+ reduces oxidative stress and is an essential cofactor for mitochondrial respiration. Oral nicotinamide riboside (NR) increases bioavailability of NAD+ in humans. Among 90 people with PAD, this randomized double-blind clinical trial assessed whether 6-months of NR, with and without resveratrol, improves 6-min walk distance, compared to placebo, at 6-month follow-up. At 6-month follow-up, compared to placebo, NR significantly improved 6-min walk (+7.0 vs. −10.6 meters, between group difference: +17.6 (90% CI: + 1.8,+∞). Among participants who took at least 75% of study pills, compared to placebo, NR improved 6-min walk by 31.0 meters and NR + resveratrol improved 6-min walk by 26.9 meters. In this work, NR meaningfully improved 6-min walk, and resveratrol did not add benefit to NR alone in PAD. A larger clinical trial to confirm these findings is needed. Clinical Trials.gov registration: NCT03743636. In peripheral artery disease (PAD), this randomized trial assessed whether nicotinamide riboside (NR), with and without resveratrol, improved walking, compared to placebo. Here, the authors show that NR meaningfully improves 6-min walk, and resveratrol did not add benefit to NR alone.