Oral nicotinamide safe for renal transplant recipients
Andrew C. Chen, M.B., B.S., from the University of Sydney at Royal Prince Alfred Hospital, and colleagues examined the safety and preliminary efficacy of oral nicotinamide for NMSC prevention in renal transplant recipients. They enrolled patients at least 12 months post-renal transplant, with stable kidney function, and a history of two or more histologically-confirmed NMSCs in the previous 12 months. Twenty-two participants were randomized in a 1:1 ratio to receive six months of nicotinamide 500 mg or placebo twice daily.
The researchers found that within six months, participants taking placebo developed an average of 4.2 new NMSCs, compared with 2.7 among patients taking nicotinamide (rate ratio, 0.65; 95 percent confidence interval, 0.3 to 1.6). One patient with 20 NMSCs highly influenced the rate in the placebo group. There was a nonsignificant, 16 percent reduction in actinic keratoses associated with nicotinamide (95 percent confidence interval, −7 to 34 percent). No significant differences were seen in adverse events, creatinine, or blood pressure.
"A phase 3 study is now warranted to assess the chemopreventive efficacy of nicotinamide in renal transplant recipients," the authors write.
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