Nicotinamide Riboside for Patients With Early-Stage Parkinson Disease: The NOPARK Randomized Clinical Trial.

Nicotinamide riboside did not improve clinical outcomes and was associated with worse symptoms than placebo in early Parkinson disease patients.

• Why it matters: Determining effective disease-modifying therapies for Parkinson disease is crucial, as current treatments do not alter disease progression, and preclinical studies suggested potential benefits of nicotinamide riboside.
• What they did: A phase 3, randomized, double-blind, placebo-controlled trial enrolled 410 patients aged 35 or older with early Parkinson disease across 11 centers in Norway, comparing 52 weeks of nicotinamide riboside (500 mg twice daily) versus placebo.
• The result: After 52 weeks, the primary outcome showed a 2.72-point greater increase in disease severity with nicotinamide riboside compared to placebo (P = .02), and nonmotor symptoms worsened more with nicotinamide riboside (P = .009), indicating no benefit and potential harm.