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.[0]

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.[0] Participants were randomly assigned to receive 500 mg of nicotinamide or placebo twice daily for 12 months.[0] 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.[1]

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.[1] No significant differences were observed between the two groups in terms of adverse events or alterations in blood or urine laboratory values.[1] This suggests that nicotinamide does not effectively prevent nonmelanoma skin cancers in solid-organ transplant patients.[2]

0. “Oral nicotinamide ineffective in preventing keratinocyte cancers” Healio, 2 Mar. 2023,

1. “Nicotinamide for Skin-Cancer Chemoprevention in Transplant Recipients | NEJM”, 1 Mar. 2023,

2. “Nicotinamide Does Not Prevent Skin Cancer After Organ Transplant” Medscape, 2 Mar. 2023,

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