Taking nicotinamide, which is vitamin PP, is statistically associated with a reduced probability of developing open-angle glaucoma in individuals with elevated intraocular pressure. This conclusion was reached by American researchers after analyzing data from electronic health records collected from nearly three thousand patients.
Impact on Treatment and Pathogenesis
Furthermore, the vitamin helps decrease the likelihood of needing local treatment aimed at lowering intraocular pressure, and it also reduces the need for laser trabeculoplasty. The results of this study were published in JAMA Ophthalmology.
Open-angle glaucoma is characterized by impaired outflow of intraocular fluid, leading to increased intraocular pressure and subsequent damage to the optic nerve and other eye structures. Ophthalmologists usually prescribe therapy to control pressure, but a significant portion of patients develop optic neuropathy.
Metabolism and Prevention
Recent scientific investigations indicate that a disruption in the metabolism of nicotinamide adenine dinucleotide—one of the key coenzymes in the redox processes of all living cells—may be the cause of this disease. This coenzyme participates in processes such as glycolysis, the tricarboxylic acid cycle, and fatty acid beta-oxidation. For example, a deficiency of this substance in retinal ganglion cells can cause a failure in energy metabolism and metabolism.
Cohort Study at the University of Utah
To test the potential preventive effect of influencing this part of the pathogenesis, a research group led by Iqbal Ayka Ahmed from the University of Utah conducted a cohort study using electronic health records of 2920 patients with elevated intraocular pressure. The researchers studied the effect of systemic nicotinamide intake (vitamin PP, vitamin B3), traditionally used to combat pellagra, on the risk of developing glaucoma. Initially, participant characteristics were carefully balanced across all variables after matching procedures.
During the average observation period of 3.7 years, nicotinamide use correlated with a reduction in the incidence of open-angle glaucoma. Diagnosis was made in 51 patients (3.5 percent) in the treatment group compared to 132 patients (9 percent) in the control group (risk ratio was 0.34; p < 0.001), demonstrating an absolute risk reduction of 5.5 percent. It was also found that fewer patients in the nicotinamide group required local therapy to lower intraocular pressure (risk ratio 0.57; p < 0.001).
The frequency of laser trabeculoplasty, a method to improve the outflow of intraocular fluid through the trabecular meshwork, was also lower in the systemic nicotinamide intervention group (risk ratio 0.38; p = 0.003). Furthermore, refraction indices and the frequency of ophthalmologist visits showed no differences between the studied groups. Sensitivity analyses confirmed the previously identified associations.
Conclusion and Future Steps
The study authors believe that taking nicotinamide may serve as an accessible additional strategy for preventing the development of open-angle glaucoma in people with high intraocular pressure. However, practical implementation of this method requires prospective clinical trials to confirm its safety and efficacy.
Additional Analysis of Global Burden of Disease
It is also worth noting the work of Yuanyuan Du from Chongqing Medical University and her colleagues from China, Singapore, and the UK. They analyzed data from the Global Burden of Disease (GBD) collaboration for the period from 1990 to 2023. Their findings showed a continuous increase in the prevalence of infertility among women aged 35–49, with a projection of nearly a one-and-a-half-fold increase by 2036. The study utilized the GBD 2023 dataset, covering 204 countries and territories, and a forecast up to 2036 was made using multilevel trend analysis and Bayesian modeling. These results were published in The Lancet Obstetrics, Gynaecology, & Women's Health.