JAMA

Nicotinamide riboside did not improve early Parkinson disease

In a 52-week randomised trial, disease rating scores rose by 2.45 points with the supplement compared with a 0.27-point fall with placebo.

Figure 1 from JAMA
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Figure 1. Brakedal et al.
Randomised trial in 393 peopleInterventions

52 weeks, double-blind, placebo-controlled, multicentre, registered NCT03568968

Stake: Authors hold patents licensed to Niagen Bioscience, which develops nicotinamide riboside, and take fees from it.

Follow

In a randomised, double-blind, placebo-controlled trial across 11 centres in Norway, researchers assigned 410 patients with early Parkinson disease to receive oral nicotinamide riboside, 500 mg twice daily, or a placebo for 52 weeks. The primary analysis included 393 participants, whose mean age was 65.6 years.

Over 52 weeks, disease rating scores worsened by 2.45 points with nicotinamide riboside and improved by 0.27 points with placebo. Non-motor symptom burden also worsened more with nicotinamide riboside than with placebo. Four other key secondary outcomes showed no significant differences between the groups. Serious adverse events occurred in 8.3% of treated participants and 14.1% of those given placebo.

Why it matters

Parkinson disease is an illness that becomes more common with age. These findings bear on whether oral nicotinamide riboside, a nicotinamide adenine dinucleotide precursor, can act as a disease-modifying treatment in early stages of the disorder.

Caveats

The trial was conducted at 11 centres in Norway and tested a single dose over 52 weeks in patients diagnosed within the prior two years. The findings may not apply to different doses, longer treatment periods, or more advanced disease.