Key Takeaways
- Systemic nicotinamide exposure was associated with a lower risk of primary open-angle glaucoma diagnosis in patients with ocular hypertension in a propensity score-matched real-world cohort.
- Nicotinamide exposure was also linked to lower rates of topical therapy initiation and laser trabeculoplasty, suggesting less need for treatment escalation.
Systemic nicotinamide supplementation was associated with a lower risk of progression from ocular hypertension to primary open-angle glaucoma and a reduced need for treatment escalation in a large real-world cohort study.
Investigators compared patients with ocular hypertension who had systemic nicotinamide exposure with matched controls without nicotinamide or niacin use, including 2,920 patients total and a mean follow-up of 3.7 years.
Primary open-angle glaucoma was diagnosed less often in the nicotinamide group than in controls (3.5% vs 9.0%), corresponding to a 66% lower risk of diagnosis and a 5.5% absolute risk reduction with nicotinamide exposure (P < 0.001). Nicotinamide exposure was also associated with lower rates of treatment escalation, with fewer patients starting topical intraocular pressure-lowering therapy (13.6% vs 21.2%; P < 0.001) or undergoing laser trabeculoplasty (P = 0.003).
Reference
Muayad J, Sallam AB, De Francesco T, et al. Nicotinamide Supplementation and Primary Open-Angle Glaucoma in Patients With Ocular Hypertension. JAMA Ophthalmol. 2026;doi: 10.1001/jamaophthalmol.2026.2472. Epub ahead of print. PMID: 42424069.
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