Nicotinamide for Glaucoma

(NADIR Trial)

This trial aims to determine if a vitamin B3 supplement, nicotinamide, can protect the eye's nerve cells in individuals with primary open-angle glaucoma (POAG). Participants will either continue their usual glaucoma treatment or add nicotinamide, and researchers will compare the eye health of both groups over 12 months. The study seeks individuals diagnosed with POAG who are already using eye drops or have undergone laser treatment to manage their glaucoma. As a Phase 2 trial, this research focuses on assessing the treatment's effectiveness in an initial, smaller group.

Research has shown that high-dose nicotinamide, a type of vitamin B3, is usually safe for people. Studies have found that taking up to 1 gram per day is often safe for long-term use. In this trial, participants will start with 1.5 grams and may increase to 3 grams per day.

A review of high-dose nicotinamide found it to be safe, with most people not experiencing serious side effects. Some might encounter mild issues like an upset stomach. Before increasing the dose, the trial will check for any liver problems to ensure participants can handle the dose without major issues.

Unlike the standard glaucoma treatments, which primarily focus on lowering intraocular pressure with medications like prostaglandin analogs or using laser therapy, high-dose oral nicotinamide takes a different approach. This treatment uses nicotinamide, a form of vitamin B3, which may protect the cells in your eyes from damage by boosting their energy levels and resilience. Researchers are excited because this method could provide a new layer of protection for the optic nerve, potentially slowing the progression of glaucoma more effectively than current options.

Research has shown that nicotinamide, a type of vitamin B3, might help protect against glaucoma. In this trial, one group of participants will receive high-dose oral nicotinamide along with standard glaucoma care. One study found that patients taking high doses of nicotinamide experienced noticeable vision improvements over 12 weeks. Another study found that 93% of eyes in mice did not develop glaucoma when given nicotinamide. Research on humans also suggests that it can reduce the risk of glaucoma in people with high eye pressure. These findings indicate that nicotinamide might slow the progression of glaucoma by protecting the nerve cells in the eye.⁶⁷⁸⁹¹⁰