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New research · Ophthalmology
JAMA ophthalmology · 5d
Cohort studyJAMA ophthalmology · 2026

Nicotinamide Supplementation and Primary Open-Angle Glaucoma in Patients With Ocular Hypertension.

Jawad Muayad, Ahmed B Sallam, Ticiana De Francesco … Iqbal Ike K Ahmed
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OphthalmologyCohort study

Nicotinamide use was associated with lower risk of glaucoma diagnosis in ocular hypertension.

Nicotinamide Supplementation and Primary Open-Angle Glaucoma in Patients With Ocular Hypertension.

Jawad Muayad … Iqbal Ike K Ahmed
JAMA ophthalmology · 2026
Purpose

To determine whether systemic nicotinamide supplementation, with potential neuroprotective properties, is associated with reduced risk of primary open-angle glaucoma diagnosis and delayed need for medical or surgical escalation in patients with ocular hypertension.

Methods

DESIGN, SETTING, AND PARTICIPANTS: This cohort study evaluated deidentified electronic medical record data from a federated research network of 67 US health care organizations between March 2006 and March 2026.

n = 2920 patients
Results

people taking nicotinamide were far less likely to be diagnosed with glaucoma

HR 0.34 (95% CI 0.25 to 0.47)
null = 10.250.47
CI excludes the null - significant
More results

The propensity score-matched sample included 2920 patients (1460 in each cohort; nicotinamide group: mean [SD] age, 54.4 [19.6] years, 846 [57.9%] female; control group: mean [SD] age, 54.9 [18.8] years, 869 [59.5%] female).

More results

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).

“
Conclusion · 1 of 2

In this cohort study, systemic nicotinamide exposure was associated with a reduced risk of disease development in patients with ocular hypertension.

Conclusion · 2 of 2

By potentially delaying primary open-angle glaucoma diagnosis and decreasing the rate of subsequent prescribed interventions, nicotinamide represents a potential adjunctive strategy complementary to standard therapy, warranting further prospective investigation.

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