Trial Outcomes & Findings for Nicotinamide Riboside in Systolic Heart Failure (NCT NCT03423342)

NCT ID: NCT03423342

Last Updated: 2022-11-16

Results Overview

Adverse Events

Recruitment status

COMPLETED

Study phase

PHASE1/PHASE2

Target enrollment

30 participants

Primary outcome timeframe

up to 12 weeks

Results posted on

2022-11-16

Participant Flow

Participant milestones

Participant milestones
Measure
Nicotinamide Riboside
Nicotinamide riboside will be supplied as 250mg capsules, to be administered orally. The initial dose will be 1 capsule twice daily, followed by weekly up-titration by 1 capsule/dose to a final dose of 4 capsules (1000mg) twice daily at the end of Week 4. Participants will be continued on the final dose up to the final follow up visit (week 12). If, at any step, a dose increase is not tolerated, the maximum previously-tolerated dose will be continued through to week 12. nicotinamide riboside: nicotinamide riboside capsule
Placebo
Matching placebo will be supplied as 250mg capsules, to be administered orally. The initial dose will be 1 capsule twice daily, followed by weekly up-titration by 1 capsule/dose to a final dose of 4 capsules (1000mg) twice daily at the end of Week 4. Participants will be continued on the final dose up to the final follow up visit (week 12). If, at any step, a dose increase is not tolerated, the maximum previously-tolerated dose will be continued through to week 12. Placebo: matching placebo capsule
Overall Study
STARTED
20
10
Overall Study
COMPLETED
20
10
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Nicotinamide Riboside in Systolic Heart Failure

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Nicotinamide Riboside
n=20 Participants
Nicotinamide riboside will be supplied as 250mg capsules, to be administered orally. The initial dose will be 1 capsule twice daily, followed by weekly up-titration by 1 capsule/dose to a final dose of 4 capsules (1000mg) twice daily at the end of Week 4. Participants will be continued on the final dose up to the final follow up visit (week 12). If, at any step, a dose increase is not tolerated, the maximum previously-tolerated dose will be continued through to week 12. nicotinamide riboside: nicotinamide riboside capsule
Placebo
n=10 Participants
Matching placebo will be supplied as 250mg capsules, to be administered orally. The initial dose will be 1 capsule twice daily, followed by weekly up-titration by 1 capsule/dose to a final dose of 4 capsules (1000mg) twice daily at the end of Week 4. Participants will be continued on the final dose up to the final follow up visit (week 12). If, at any step, a dose increase is not tolerated, the maximum previously-tolerated dose will be continued through to week 12. Placebo: matching placebo capsule
Total
n=30 Participants
Total of all reporting groups
Age, Continuous
58 years
n=99 Participants
60 years
n=107 Participants
59 years
n=206 Participants
Sex: Female, Male
Female
5 Participants
n=99 Participants
2 Participants
n=107 Participants
7 Participants
n=206 Participants
Sex: Female, Male
Male
15 Participants
n=99 Participants
8 Participants
n=107 Participants
23 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=99 Participants
1 Participants
n=107 Participants
2 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
19 Participants
n=99 Participants
9 Participants
n=107 Participants
28 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Asian
2 Participants
n=99 Participants
0 Participants
n=107 Participants
2 Participants
n=206 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=99 Participants
0 Participants
n=107 Participants
1 Participants
n=206 Participants
Race (NIH/OMB)
White
17 Participants
n=99 Participants
10 Participants
n=107 Participants
27 Participants
n=206 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Region of Enrollment
United States
20 participants
n=99 Participants
10 participants
n=107 Participants
30 participants
n=206 Participants
Sitting Blood Pressure Systolic
106 mmHg
n=99 Participants
106 mmHg
n=107 Participants
106 mmHg
n=206 Participants
Sitting Blood Pressure Diastolic
67 mmHg
n=99 Participants
64 mmHg
n=107 Participants
66 mmHg
n=206 Participants
Heart rate
67 beats/min
n=99 Participants
66 beats/min
n=107 Participants
67 beats/min
n=206 Participants
Weight
95 kg
n=99 Participants
96 kg
n=107 Participants
95 kg
n=206 Participants
Height
170 cm
n=99 Participants
176 cm
n=107 Participants
172 cm
n=206 Participants
Smoking: Never
8 Participants
n=99 Participants
4 Participants
n=107 Participants
12 Participants
n=206 Participants
Alcohol: Never
3 Participants
n=99 Participants
3 Participants
n=107 Participants
6 Participants
n=206 Participants
Non-ischemic heart failure
13 Participants
n=99 Participants
6 Participants
n=107 Participants
19 Participants
n=206 Participants
Left ventricular (LV) ejection fraction [LV stroke volume (SV)/LV end-diastolic volume (LVEDV)]
28 percentage of ejection fraction
n=99 Participants
28 percentage of ejection fraction
n=107 Participants
28 percentage of ejection fraction
n=206 Participants
Previous myocardial infarction
7 Participants
n=99 Participants
4 Participants
n=107 Participants
11 Participants
n=206 Participants
Previous coronary artery bypass surgery
2 Participants
n=99 Participants
4 Participants
n=107 Participants
6 Participants
n=206 Participants
Previous percutaneous coronary intervention
4 Participants
n=99 Participants
1 Participants
n=107 Participants
5 Participants
n=206 Participants
History of hypertension
7 Participants
n=99 Participants
2 Participants
n=107 Participants
9 Participants
n=206 Participants
History of dyslipidemia
11 Participants
n=99 Participants
6 Participants
n=107 Participants
17 Participants
n=206 Participants
History of atherosclerotic disease (coronary, peripheral or carotid)
8 Participants
n=99 Participants
4 Participants
n=107 Participants
12 Participants
n=206 Participants
History of atrial fibrillation
6 Participants
n=99 Participants
7 Participants
n=107 Participants
13 Participants
n=206 Participants
History of atrial flutter
0 Participants
n=99 Participants
3 Participants
n=107 Participants
3 Participants
n=206 Participants
History of diabetes
8 Participants
n=99 Participants
1 Participants
n=107 Participants
9 Participants
n=206 Participants
Liver disease
1 Participants
n=99 Participants
0 Participants
n=107 Participants
1 Participants
n=206 Participants
Emphysema
1 Participants
n=99 Participants
0 Participants
n=107 Participants
1 Participants
n=206 Participants
Serum potassium
4.2 mEq/L
n=99 Participants
4.3 mEq/L
n=107 Participants
4.2 mEq/L
n=206 Participants
Serum glucose
131.7 mg/dL
n=99 Participants
114.1 mg/dL
n=107 Participants
125.8 mg/dL
n=206 Participants
Serum creatinine
1.1 mg/dL
n=99 Participants
1.2 mg/dL
n=107 Participants
1.1 mg/dL
n=206 Participants
Alanine aminotransferase, U/L
19.9 U/L
n=99 Participants
27.3 U/L
n=107 Participants
22.4 U/L
n=206 Participants
Body temperature
37 degrees Celsius
n=99 Participants
36 degrees Celsius
n=107 Participants
37 degrees Celsius
n=206 Participants
White blood count
6.8 cells x 1000/uL
n=99 Participants
6.4 cells x 1000/uL
n=107 Participants
6.7 cells x 1000/uL
n=206 Participants
Hematocrit
41 %
n=99 Participants
42 %
n=107 Participants
41 %
n=206 Participants
Hemoglobin
13.5 g/dL
n=99 Participants
13.8 g/dL
n=107 Participants
13.6 g/dL
n=206 Participants
Platelet count, thousand/uL
194 cells x 1000/uL
n=99 Participants
194 cells x 1000/uL
n=107 Participants
194 cells x 1000/uL
n=206 Participants
Aspartate aminotransferase
19.2 U/L
n=99 Participants
24.9 U/L
n=107 Participants
21.1 U/L
n=206 Participants
Insulin resistance (homeostasis model assessment)
7.0 units
n=99 Participants
4.4 units
n=107 Participants
6.1 units
n=206 Participants
Estimated glomerular filtration rate
71 mL/min/1.73_m2
n=99 Participants
67 mL/min/1.73_m2
n=107 Participants
70 mL/min/1.73_m2
n=206 Participants

PRIMARY outcome

Timeframe: up to 12 weeks

Population: Total Adverse Events, per participant

Adverse Events

Outcome measures

Outcome measures
Measure
Nicotinamide Riboside
n=20 Participants
Nicotinamide riboside will be supplied as 250mg capsules, to be administered orally. The initial dose will be 1 capsule twice daily, followed by weekly up-titration by 1 capsule/dose to a final dose of 4 capsules (1000mg) twice daily at the end of Week 4. Participants will be continued on the final dose up to the final follow up visit (week 12). If, at any step, a dose increase is not tolerated, the maximum previously-tolerated dose will be continued through to week 12. nicotinamide riboside: nicotinamide riboside capsule
Placebo
n=10 Participants
Matching placebo will be supplied as 250mg capsules, to be administered orally. The initial dose will be 1 capsule twice daily, followed by weekly up-titration by 1 capsule/dose to a final dose of 4 capsules (1000mg) twice daily at the end of Week 4. Participants will be continued on the final dose up to the final follow up visit (week 12). If, at any step, a dose increase is not tolerated, the maximum previously-tolerated dose will be continued through to week 12. Placebo: matching placebo capsule
Incidence of Treatment-Emergent Adverse Events (Safety and Tolerability)
3.1 events/participant
Interval 0.0 to 9.0
3.2 events/participant
Interval 1.0 to 7.0

SECONDARY outcome

Timeframe: Week 12-Week 0

Population: Post enrollment, one of the study participants randomized to NR withdraw before the study drug was dispensed.

Between-group comparison of On-Trial Change in Whole Blood NAD+ Levels

Outcome measures

Outcome measures
Measure
Nicotinamide Riboside
n=19 Participants
Nicotinamide riboside will be supplied as 250mg capsules, to be administered orally. The initial dose will be 1 capsule twice daily, followed by weekly up-titration by 1 capsule/dose to a final dose of 4 capsules (1000mg) twice daily at the end of Week 4. Participants will be continued on the final dose up to the final follow up visit (week 12). If, at any step, a dose increase is not tolerated, the maximum previously-tolerated dose will be continued through to week 12. nicotinamide riboside: nicotinamide riboside capsule
Placebo
n=10 Participants
Matching placebo will be supplied as 250mg capsules, to be administered orally. The initial dose will be 1 capsule twice daily, followed by weekly up-titration by 1 capsule/dose to a final dose of 4 capsules (1000mg) twice daily at the end of Week 4. Participants will be continued on the final dose up to the final follow up visit (week 12). If, at any step, a dose increase is not tolerated, the maximum previously-tolerated dose will be continued through to week 12. Placebo: matching placebo capsule
On-Trial Change in Whole Blood NAD+ Levels
29.0 uM
Standard Error 3.2
-0.3 uM
Standard Error 0.6

SECONDARY outcome

Timeframe: 16 weeks

Incidence of On-Trial Abnormal Laboratory Values and/or Adverse Events that Are Related to Treatment

Outcome measures

Outcome measures
Measure
Nicotinamide Riboside
n=20 Participants
Nicotinamide riboside will be supplied as 250mg capsules, to be administered orally. The initial dose will be 1 capsule twice daily, followed by weekly up-titration by 1 capsule/dose to a final dose of 4 capsules (1000mg) twice daily at the end of Week 4. Participants will be continued on the final dose up to the final follow up visit (week 12). If, at any step, a dose increase is not tolerated, the maximum previously-tolerated dose will be continued through to week 12. nicotinamide riboside: nicotinamide riboside capsule
Placebo
n=10 Participants
Matching placebo will be supplied as 250mg capsules, to be administered orally. The initial dose will be 1 capsule twice daily, followed by weekly up-titration by 1 capsule/dose to a final dose of 4 capsules (1000mg) twice daily at the end of Week 4. Participants will be continued on the final dose up to the final follow up visit (week 12). If, at any step, a dose increase is not tolerated, the maximum previously-tolerated dose will be continued through to week 12. Placebo: matching placebo capsule
Number of Participants With Abnormal Laboratory Values and/or Adverse Events That Are Related to Treatment
0 participants
0 participants

SECONDARY outcome

Timeframe: Week 12 - Week 0

Population: One study subject randomized to NR withdrew post enrollment.

Mitochondrial Respiration in Isolated Peripheral Blood Mononuclear Cells by the Seahorse (R) Assay

Outcome measures

Outcome measures
Measure
Nicotinamide Riboside
n=19 Participants
Nicotinamide riboside will be supplied as 250mg capsules, to be administered orally. The initial dose will be 1 capsule twice daily, followed by weekly up-titration by 1 capsule/dose to a final dose of 4 capsules (1000mg) twice daily at the end of Week 4. Participants will be continued on the final dose up to the final follow up visit (week 12). If, at any step, a dose increase is not tolerated, the maximum previously-tolerated dose will be continued through to week 12. nicotinamide riboside: nicotinamide riboside capsule
Placebo
n=10 Participants
Matching placebo will be supplied as 250mg capsules, to be administered orally. The initial dose will be 1 capsule twice daily, followed by weekly up-titration by 1 capsule/dose to a final dose of 4 capsules (1000mg) twice daily at the end of Week 4. Participants will be continued on the final dose up to the final follow up visit (week 12). If, at any step, a dose increase is not tolerated, the maximum previously-tolerated dose will be continued through to week 12. Placebo: matching placebo capsule
Effect of NR on Change in Mitochondrial Function (Maximal Oxygen Consumption Rate)
21 pmol/min/1,000,000 cells
Standard Error 42
2 pmol/min/1,000,000 cells
Standard Error 23

OTHER_PRE_SPECIFIED outcome

Timeframe: Week 12 - Week 0

Change in Six Minute Walk Distance

Outcome measures

Outcome measures
Measure
Nicotinamide Riboside
n=17 Participants
Nicotinamide riboside will be supplied as 250mg capsules, to be administered orally. The initial dose will be 1 capsule twice daily, followed by weekly up-titration by 1 capsule/dose to a final dose of 4 capsules (1000mg) twice daily at the end of Week 4. Participants will be continued on the final dose up to the final follow up visit (week 12). If, at any step, a dose increase is not tolerated, the maximum previously-tolerated dose will be continued through to week 12. nicotinamide riboside: nicotinamide riboside capsule
Placebo
n=9 Participants
Matching placebo will be supplied as 250mg capsules, to be administered orally. The initial dose will be 1 capsule twice daily, followed by weekly up-titration by 1 capsule/dose to a final dose of 4 capsules (1000mg) twice daily at the end of Week 4. Participants will be continued on the final dose up to the final follow up visit (week 12). If, at any step, a dose increase is not tolerated, the maximum previously-tolerated dose will be continued through to week 12. Placebo: matching placebo capsule
Exploratory Endpoint: Effect of NR on Functional Capacity
6 meters
Standard Error 8
1 meters
Standard Error 15

OTHER_PRE_SPECIFIED outcome

Timeframe: Week 12 - Week 0

Population: One study subject randomized to NR withdrew post-enrollment. We were unable to obtain the LVEF for one of the enrolled patient randomized to NR.

Change in Left Ventricular Ejection Fraction by 3D-Transthoracic Echocardiography

Outcome measures

Outcome measures
Measure
Nicotinamide Riboside
n=18 Participants
Nicotinamide riboside will be supplied as 250mg capsules, to be administered orally. The initial dose will be 1 capsule twice daily, followed by weekly up-titration by 1 capsule/dose to a final dose of 4 capsules (1000mg) twice daily at the end of Week 4. Participants will be continued on the final dose up to the final follow up visit (week 12). If, at any step, a dose increase is not tolerated, the maximum previously-tolerated dose will be continued through to week 12. nicotinamide riboside: nicotinamide riboside capsule
Placebo
n=10 Participants
Matching placebo will be supplied as 250mg capsules, to be administered orally. The initial dose will be 1 capsule twice daily, followed by weekly up-titration by 1 capsule/dose to a final dose of 4 capsules (1000mg) twice daily at the end of Week 4. Participants will be continued on the final dose up to the final follow up visit (week 12). If, at any step, a dose increase is not tolerated, the maximum previously-tolerated dose will be continued through to week 12. Placebo: matching placebo capsule
Exploratory Endpoint: Effect of NR on Change in Left Ventricular Systolic Function
0.0 percentage of ejection fraction
Standard Error 2.2
0.3 percentage of ejection fraction
Standard Error 2.2

OTHER_PRE_SPECIFIED outcome

Timeframe: Week 12 - Week 0

Tissue Doppler Imaging, e'

Outcome measures

Outcome measures
Measure
Nicotinamide Riboside
n=17 Participants
Nicotinamide riboside will be supplied as 250mg capsules, to be administered orally. The initial dose will be 1 capsule twice daily, followed by weekly up-titration by 1 capsule/dose to a final dose of 4 capsules (1000mg) twice daily at the end of Week 4. Participants will be continued on the final dose up to the final follow up visit (week 12). If, at any step, a dose increase is not tolerated, the maximum previously-tolerated dose will be continued through to week 12. nicotinamide riboside: nicotinamide riboside capsule
Placebo
n=9 Participants
Matching placebo will be supplied as 250mg capsules, to be administered orally. The initial dose will be 1 capsule twice daily, followed by weekly up-titration by 1 capsule/dose to a final dose of 4 capsules (1000mg) twice daily at the end of Week 4. Participants will be continued on the final dose up to the final follow up visit (week 12). If, at any step, a dose increase is not tolerated, the maximum previously-tolerated dose will be continued through to week 12. Placebo: matching placebo capsule
Exploratory Endpoint: Effect of NR on Left Ventricular Diastolic Function
0.37 cm/sec
Standard Error 0.54
-0.44 cm/sec
Standard Error 0.39

Adverse Events

Nicotinamide Riboside

Serious events: 1 serious events
Other events: 19 other events
Deaths: 0 deaths

Placebo

Serious events: 2 serious events
Other events: 9 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Nicotinamide Riboside
n=20 participants at risk
Nicotinamide riboside will be supplied as 250mg capsules, to be administered orally. The initial dose will be 1 capsule twice daily, followed by weekly up-titration by 1 capsule/dose to a final dose of 4 capsules (1000mg) twice daily at the end of Week 4. Participants will be continued on the final dose up to the final follow up visit (week 12). If, at any step, a dose increase is not tolerated, the maximum previously-tolerated dose will be continued through to week 12. nicotinamide riboside: nicotinamide riboside capsule
Placebo
n=10 participants at risk
Matching placebo will be supplied as 250mg capsules, to be administered orally. The initial dose will be 1 capsule twice daily, followed by weekly up-titration by 1 capsule/dose to a final dose of 4 capsules (1000mg) twice daily at the end of Week 4. Participants will be continued on the final dose up to the final follow up visit (week 12). If, at any step, a dose increase is not tolerated, the maximum previously-tolerated dose will be continued through to week 12. Placebo: matching placebo capsule
Musculoskeletal and connective tissue disorders
Myalgia, severe
5.0%
1/20 • Number of events 1 • 16 weeks
0.00%
0/10 • 16 weeks
Respiratory, thoracic and mediastinal disorders
Acute pulmonary edema
0.00%
0/20 • 16 weeks
10.0%
1/10 • Number of events 1 • 16 weeks
Cardiac disorders
Heart failure
0.00%
0/20 • 16 weeks
10.0%
1/10 • Number of events 1 • 16 weeks

Other adverse events

Other adverse events
Measure
Nicotinamide Riboside
n=20 participants at risk
Nicotinamide riboside will be supplied as 250mg capsules, to be administered orally. The initial dose will be 1 capsule twice daily, followed by weekly up-titration by 1 capsule/dose to a final dose of 4 capsules (1000mg) twice daily at the end of Week 4. Participants will be continued on the final dose up to the final follow up visit (week 12). If, at any step, a dose increase is not tolerated, the maximum previously-tolerated dose will be continued through to week 12. nicotinamide riboside: nicotinamide riboside capsule
Placebo
n=10 participants at risk
Matching placebo will be supplied as 250mg capsules, to be administered orally. The initial dose will be 1 capsule twice daily, followed by weekly up-titration by 1 capsule/dose to a final dose of 4 capsules (1000mg) twice daily at the end of Week 4. Participants will be continued on the final dose up to the final follow up visit (week 12). If, at any step, a dose increase is not tolerated, the maximum previously-tolerated dose will be continued through to week 12. Placebo: matching placebo capsule
Nervous system disorders
Nervous system disorders
30.0%
6/20 • Number of events 12 • 16 weeks
50.0%
5/10 • Number of events 5 • 16 weeks
Infections and infestations
Infections and infestations
30.0%
6/20 • Number of events 12 • 16 weeks
50.0%
5/10 • Number of events 5 • 16 weeks
Renal and urinary disorders
Renal and urinary disorders
5.0%
1/20 • Number of events 1 • 16 weeks
10.0%
1/10 • Number of events 1 • 16 weeks
Musculoskeletal and connective tissue disorders
Musculoskeletal and connective tissue disorders
25.0%
5/20 • Number of events 6 • 16 weeks
10.0%
1/10 • Number of events 1 • 16 weeks
General disorders
General disorders and administration site conditions
45.0%
9/20 • Number of events 12 • 16 weeks
40.0%
4/10 • Number of events 5 • 16 weeks
Gastrointestinal disorders
Gastrointestinal disorders
15.0%
3/20 • Number of events 4 • 16 weeks
20.0%
2/10 • Number of events 3 • 16 weeks
Respiratory, thoracic and mediastinal disorders
Respiratory, thoracic and mediastinal disorders
15.0%
3/20 • Number of events 4 • 16 weeks
30.0%
3/10 • Number of events 8 • 16 weeks
Skin and subcutaneous tissue disorders
Skin and subcutaneous tissue disorders
5.0%
1/20 • Number of events 1 • 16 weeks
10.0%
1/10 • Number of events 1 • 16 weeks
Metabolism and nutrition disorders
Metabolism and nutrition disorders
10.0%
2/20 • Number of events 2 • 16 weeks
10.0%
1/10 • Number of events 1 • 16 weeks
Cardiac disorders
Cardiac disorders
15.0%
3/20 • Number of events 3 • 16 weeks
10.0%
1/10 • Number of events 1 • 16 weeks

Additional Information

Dr. Kevin O'Brien, Study PI

University of Washington

Phone: 206-529-7802

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place