Topical nicotinamide in combination with calcipotriol for the treatment of mild to moderate psoriasis: A double-blind, randomized, comparative study

Siadat, Amir Hossein; Iraji, Fariba; Khodadadi, Mehdi; Jary, Maryam Kalateh

doi:10.4103/2277-9175.122520

Cited by 10 publications

(3 citation statements)

References 17 publications

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“…This has been also confirmed by the Medical Investigator who considered that for nearly all patients, DENI gel was a helpful and convenient addition to their treatment regime. These observations are in line with published studies attesting to the effectiveness of topically applied nicotinamide in inflammatory skin conditions including AE and psoriasis 15–18. The limitation of the study is that patients received samples labelled, but unblinded, as they would normally do in real-life settings when they get their emollient product(s) on prescription.…”

Section: Discussionsupporting

confidence: 83%

<p>Steroid-sparing effects and acceptability of a new skin gel containing the anti-inflammatory medicinal substance-nicotinamide</p>

Djokic-Gallagher¹,

Rosher²,

Hart³

et al. 2019

CCID

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Background/aim: Adex gel (DENI) is a leave-on emollient, containing an ancillary anti-inflammatory medicinal substance, nicotinamide, for use in the treatment and management of dry skin conditions prone to inflammation. The aim of the study was to obtain patients’ and a Medical Investigator’s feedback on the clinical performance and acceptability of the product, and to assess the product’s potential for reducing patients’ reliance on topical corticosteroids and immunomodulators. Methods: Forty-eight patients were enrolled with 43 patients completing the study. These patients used the product on its own, or as adjunctive therapy, for two weeks instead of their usual emollient, applying it three times daily or more often if necessary. Using a questionnaire, subjects then indicated whether they were in agreement or not with various statements about the clinical performance and acceptability of the product. In the second part of the study, twenty patients used the product for four weeks, this time using it as often as they liked. The Medical Investigator looked at both the performance and the acceptability of the treatment. Patients completed a questionnaire again to indicate how they used it and whether their use of topical corticosteroids and/or immunomodulator treatments had changed. Results: Patient’s responses were very positive, ranging from 81% to 100% agreement with each performance statement in relation to beneficial effects on the skin. The Medical Investigator considered that for nearly all patients, DENI gel was a helpful and convenient addition to their treatment regime. When questioned on steroid-sparing effects, more than half reported that they needed to use less of their other anti-inflammatory treatments, and nearly 95% reported that they felt their skin condition had benefited from using DENI gel. Conclusion: This new anti-inflammatory emollient appears to be a helpful addition to the treatment armamentarium for eczema and psoriasis that may reduce reliance on topical corticosteroids and immunomodulators.

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Section: Discussionsupporting

confidence: 83%

<p>Steroid-sparing effects and acceptability of a new skin gel containing the anti-inflammatory medicinal substance-nicotinamide</p>

Djokic-Gallagher¹,

Rosher²,

Hart³

et al. 2019

CCID

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“…Nicotinamide has been widely used to treat diseases such as diabetes, schizophrenia, Alzheimer's disease, psoriasis, obesity, and cancer (Aisen et al., 2008, Bagcchi, 2015, Chase et al., 1992, Chen et al., 2015, Gale, 2004, Knip et al., 2000, Siadat et al., 2013, Smythies, 1973). High dosage of nicotinamide is often required in clinical treatment, and the concentration in serum could reach the millimolar range (Dragovic et al., 1995).…”

Section: Introductionmentioning

confidence: 99%

Nicotinamide Promotes Cell Survival and Differentiation as Kinase Inhibitor in Human Pluripotent Stem Cells

Yang

Ren

et al. 2018

Stem Cell Reports

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SummaryNicotinamide, the amide form of vitamin B3, is widely used in disease treatments and stem cell applications. However, nicotinamide's impact often cannot be attributed to its nutritional functions. In a vitamin screen, we find that nicotinamide promotes cell survival and differentiation in human pluripotent stem cells. Nicotinamide inhibits the phosphorylation of myosin light chain, suppresses actomyosin contraction, and leads to improved cell survival after individualization. Further analysis demonstrates that nicotinamide is an inhibitor of multiple kinases, including ROCK and casein kinase 1. We demonstrate that nicotinamide affects human embryonic stem cell pluripotency and differentiation as a selective kinase inhibitor. The findings in this report may help researchers design better strategies to develop nicotinamide-related stem cell applications and disease treatments.

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“…Viceversa, a previous in vitro study demonstrated that total NAD content is significantly increased by about 30% in both subcorneal and basal epidermal layers of psoriatic skin lesions, compared to uninvolved or healthy skin biopsies [32]. Although previous studies showed that the combination of NAM with calcipotriene may provide additional benefit in the topical treatment for patients with psoriasis [33,34], the effective efficacy of NAM in psoriasis management remains to be established.…”

Section: Introductionmentioning

confidence: 99%

Enhanced NAMPT-Mediated NAD Salvage Pathway Contributes to Psoriasis Pathogenesis by Amplifying Epithelial Auto-Inflammatory Circuits

Mercurio

Morelli

Scarponi

et al. 2021

IJMS

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Dysregulated cross-talk between immune cells and epithelial compartments is responsible for the onset and amplification of pathogenic auto-inflammatory circuits occurring in psoriasis. NAMPT-mediated NAD salvage pathway has been recently described as an immunometabolic route having inflammatory function in several disorders, including arthritis and inflammatory bowel diseases. To date, the role of NAD salvage pathway has not been explored in the skin of patients affected by psoriasis. Here, we show that NAD content is enhanced in lesional skin of psoriatic patients and is associated to high NAMPT transcriptional levels. The latter are drastically reduced in psoriatic skin following treatment with the anti-IL-17A biologics secukinumab. We provide evidence that NAMPT-mediated NAD+ metabolism fuels the immune responses executed by resident skin cells in psoriatic skin. In particular, intracellular NAMPT, strongly induced by Th1/Th17-cytokines, acts on keratinocytes by inducing hyper-proliferation and impairing their terminal differentiation. Furthermore, NAMPT-mediated NAD+ boosting synergizes with psoriasis-related cytokines in the upregulation of inflammatory chemokines important for neutrophil and Th1/Th17 cell recruitment. In addition, extracellular NAMPT, abundantly released by keratinocytes and dermal fibroblasts, acts in a paracrine manner on endothelial cells by inducing their proliferation and migration, as well as the expression of ICAM-1 membrane molecule and chemokines important for leukocyte recruitment into inflamed skin. In conclusion, our results showed that NAMPT-mediated NAD salvage pathway contributes to psoriasis pathogenic processes by amplifying epithelial auto-inflammatory responses in psoriasis.

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Topical nicotinamide in combination with calcipotriol for the treatment of mild to moderate psoriasis: A double-blind, randomized, comparative study

Cited by 10 publications

References 17 publications

<p>Steroid-sparing effects and acceptability of a new skin gel containing the anti-inflammatory medicinal substance-nicotinamide</p>

<p>Steroid-sparing effects and acceptability of a new skin gel containing the anti-inflammatory medicinal substance-nicotinamide</p>

Nicotinamide Promotes Cell Survival and Differentiation as Kinase Inhibitor in Human Pluripotent Stem Cells

Enhanced NAMPT-Mediated NAD Salvage Pathway Contributes to Psoriasis Pathogenesis by Amplifying Epithelial Auto-Inflammatory Circuits

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