A new study has revealed that nicotinamide supplementation reduced the risk of progression to glaucoma by two-thirds in patients with raised ocular pressures.
The cohort study, published in JAMA Ophthalmology,1 used electronic medical record data from a network of United States healthcare companies over a 20-year period between 2006 and 2026.
They observed patients who had been diagnosed with ocular hypertension (OHT) and had received at least one healthcare visit. They didn’t include any patients who had open-angle glaucoma, had received laser eye surgery, or were receiving any therapy to reduce eye pressure.
Nicotinamide supplementation was the sole exposure of interest.
Study authors concluded systemic nicotinamide exposure was associated with a reduced risk of disease development in patients with OHT.
Propensity score matching was used to create two groups of 1,460 patients, controlling for age, sex, and baseline health. The exposure group received documented nicotinamide supplementation; the control group did not.
Over a mean follow-up of 3.7 years, primary open angle glaucoma (POAG) diagnosis occurred in 51 patients in the nicotinamide group (3.5%) compared with 132 patients in the control group (9.0%) (HR, 0.34; 95% CI, 0.25–0.47; P<.001), representing an absolute risk reduction of 5.5% in the nicotinamide cohort (95% CI, 3.8–7.3).
Topical intraocular pressure-lowering therapy was initiated in 198 patients in the nicotinamide group (13.6%) compared with 309 patients in the control group (21.2%) (HR, 0.57; 95% CI, 0.48–0.68; P<.001).
Laser trabeculoplasty was performed in 12 patients in the nicotinamide group (0.8%) vs 28 patients (1.9%) in the control group (HR, 0.38; 95% CI, 0.19–0.74; P=.003).
Study authors concluded systemic nicotinamide exposure was associated with a reduced risk of disease development in patients with OHT.
“By potentially delaying POAG diagnosis and decreasing the rate of subsequent prescribed interventions, nicotinamide represents a potential adjunctive strategy complementary to standard therapy, warranting further prospective investigation,” study authors wrote.
Reference
- Muayad J, Sallam AB, Ahmed IIK, et al. Nicotinamide supplementation and primary open-angle glaucoma in patients with ocular hypertension. JAMA Ophthalmol. 2026 Aug 1;144(8):724-730. doi: 10.1001/jamaophthalmol.2026.2472.
