In Search for New Antipsoriatic Agents: NAD⁺ Topical Composition

Abstract

The aim of the study was to examine the effectiveness of the oxidized form of nicotinamide adenine dinucleotide (NAD⁺), adenosine precursor, in 37 patients suffering from psoriasis. As NAD⁺ is known to be relatively unstable, the second goal was to establish the proper conditions for the satisfactory stability of topical NAD⁺ composition. In each patient, two matching plaques were selected for the study. Topical treatment with 1 or 0.3% NAD⁺ in Vaseline ointment administered twice daily was compared with overnight therapy with 0.1% anthralin applied for 12 h and placebo. The enzymatic method was applied to determine the stability of NAD⁺ in Vaseline ointment. After a 4-week application, the reduction in erythema, infiltration and desquamation caused by 1 or 0.3% topical NAD⁺ composition was similar to the reduction caused by 0.1% anthralin. It was demonstrated that NAD⁺ underwent a considerable decomposition at room temperature, while it was sufficiently stable at 5°C; thus, for a longer use the agent should be stored at fridge temperature. NAD⁺ therapy combines good efficacy, cosmetic acceptability and convenient twice-daily application.

1-Methylnicotinamide and nicotinamide: two related anti-inflammatory agents that differentially affect the functions of activated macrophages

“…1-Methylnicotinamide (MNA), a major metabolite of nicotinamide (NA), has been shown recently to act in vivo as a very efficient anti-inflammatory agent [ 9 ]. After topical application of MNA, a remarkable therapeutic effect was observed in such inflammatory skin diseases as rosacea and acne vulgaris as well as in skin burns and wound healing [ 22 , 23 ]. On the other hand, MNA therapy was not effective in cases with accompanying bacterial infection, which indicates that MNA’s therapeutic effectiveness is related to its anti-inflammatory, but not anti-bacterial, properties [ 1 ].…”

Methotrexate use and NAD+/NADH metabolism in psoriatic keratinocytes

“…An opposite hypothesis links increased cellular metabolism to the increased NADH/NAD + ratio. In line with that, Wozniacka et al demonstrated that after a 4-week application of topical NAD + in Vaseline ointment administered twice daily resulted in the reduction in erythema, infiltration, and desquamation of psoriatic lesions, and was similar to the effectiveness of 0.1% anthralin [16]. However, there is a lack of comprehensive studies on real-time, in vivo non-invasive monitoring of NADH in psoriatic skin.…”

Pilot, multicenter, double-blind, randomized placebo-controlled bilateral comparative study of a combination of calcipotriene and nicotinamide for the treatment of psoriasis

“…As a result of these mechanisms, it has been proposed that nicotinamide may prove a useful addition to the antipsoriatic repertoire and may enhance the efficacy of calcipotriene therapy when used in combination. 5 A new medication, which consists of a macrogel, polyethylene glycol-based ointment that contains calcipotriene 0.005% and nicotinamide at different concentrations (0.05%, 0.1%, 0.7%, and 1.4%), has been found to be highly stable for 24 months. In preclinical studies, the combination drug was shown to induce a significantly larger granular layer in scaly areas of mouse tail skin with abnormal maturation (95% orthokeratosis in the 0.21% nicotinamide plus 0.005% calcipotriene group vs 68% in the control group) (Dermipsor, unpublished data).…”