Key Takeaways

  • Nicotinamide supplementation was associated with reduced risk of primary open angle glaucoma diagnosis (POAG) and delayed need for medical or surgical escalation in patients with ocular hypertension.
  • Over a mean follow-up of 3.7 years, POAG diagnosis occurred in 3.5% of nicotinamide group compared with 9% of the control group (P < .001).
  • The authors concluded that systemic nicotinamide represents a potential adjunctive strategy and warrants further prospective investigation.

A study published in JAMA Ophthalmology sought to determine whether systemic nicotinamide supplementation, with its potential neuroprotective properties, is associated with reduced risk of primary open angle glaucoma (POAG) diagnosis and delayed need for medical or surgical escalation in patients with ocular hypertension (OHT).1

This cohort study evaluated deidentified electronic medical record data from a federated research network of 67 US health care organizations between March 2006 and March 2026. Nicotinamide supplementation was the sole exposure of interest, and propensity score matching (1:1) was used to balance baseline covariates. Patients with a primary diagnosis of OHT and at least one prior health care encounter were included, excluding those with history of open-angle glaucoma, laser therapy, or glaucoma topical therapies.1

The propensity score-matched sample included 2,920 patients (1,460 in each cohort). Over a mean follow-up of 3.7 years, POAG diagnosis occurred in 51 patients in the nicotinamide group (3.5%) compared with 132 patients in the control group (9%) (P < .001), representing an absolute risk reduction of 5.5% in the nicotinamide cohort. Topical IOP therapy was initiated in 198 patients in the nicotinamide group (13.6%) compared with 309 patients in the control group (21.2%) (P < .001). Laser trabeculoplasty was performed in 12 patients in the nicotinamide group (0.8%) vs 28 patients (1.9%) in the control group (P = .003).1

The authors concluded that systemic nicotinamide represents a potential adjunctive strategy complementary to standard therapy and warrants further prospective investigation.1

1. Muayad J, Sallam AB, De Francesco T, De Moraes CG, Ahmed IIK. Nicotinamide supplementation and primary open-angle glaucoma in patients with ocular hypertension. [published online ahead of print.] JAMA Ophthalmol.