Study Finds Nicotinamide Does Not Prevent Nonmelanoma Skin Cancers in Organ Transplant Patients
Organ transplant recipients are at a dramatically increased risk of developing nonmelanoma skin cancers due to their immunosuppressed state. In an effort to reduce the incidence of these cancers, a randomized phase 3 trial was conducted to assess the impact of oral nicotinamide on the prevention of keratinocyte cancers.
The multicenter, double-blind, placebo-controlled trial included 158 participants who had undergone kidney, liver, heart or lung transplantation at least 12 months prior to the study. Participants were randomly assigned to receive 500 mg of nicotinamide or placebo twice daily for 12 months. The main objective was to record the number of newly developed keratinocyte cancers within the 12-month period of the intervention. The secondary objectives of the study included assessing the number of squamous-cell and basal-cell carcinomas over a 12-month period, the amount of actinic keratoses up to 6 months after randomization, evaluating safety, and determining quality of life.
Nicotinamide group participants had 207 new keratinocyte cancers after 12 months, compared to 210 in the placebo group (rate ratio, 1.0; 95% confidence interval, 0.8 to 1.3; P=0.96). No significant differences in squamous-cell and basal-cell carcinoma counts, actinic keratosis counts, or quality-of-life scores were noticed between the groups. No significant differences were observed between the two groups in terms of adverse events or alterations in blood or urine laboratory values. This suggests that nicotinamide does not effectively prevent nonmelanoma skin cancers in solid-organ transplant patients.
0. “Oral nicotinamide ineffective in preventing keratinocyte cancers” Healio, 2 Mar. 2023, https://www.healio.com/news/dermatology/20230302/oral-nicotinamide-ineffective-in-preventing-keratinocyte-cancers
1. “Nicotinamide for Skin-Cancer Chemoprevention in Transplant Recipients | NEJM” nejm.org, 1 Mar. 2023, https://www.nejm.org/doi/full/10.1056/NEJMoa2203086
2. “Nicotinamide Does Not Prevent Skin Cancer After Organ Transplant” Medscape, 2 Mar. 2023, https://www.medscape.com/viewarticle/988992