NR Improves Walking in PAD, Resveratrol Adds No Benefit - Trial

clinical-trial PMID: 38871717

Quick Summary: A recent study found that taking nicotinamide riboside (NR) helped people with peripheral artery disease (PAD) walk further in six minutes. Adding resveratrol to the NR didn't seem to make a difference.

What The Research Found

People with PAD who took NR for six months could walk further than those who took a placebo (a dummy pill). The study showed that NR alone helped people walk about 17.6 meters further. Resveratrol, when taken with NR, didn't provide any extra benefit.

Study Details

Who was studied: 90 adults with PAD, a condition where blood flow to the legs is reduced.

How long: The study lasted for 6 months.

What they took: Some people took NR, some took NR plus resveratrol, and others took a placebo. The exact doses of NR and resveratrol weren't specified in the summary.

What This Means For You

If you have PAD, NR might help you walk further. However, this study suggests that adding resveratrol won't boost the effect. Talk to your doctor before taking any supplements.

Study Limitations

The study was relatively small, with only 90 participants.

The study only lasted six months, so we don't know the long-term effects.

The study didn't test resveratrol alone.

The way the results were reported is a bit unusual.

Key Findings

The trial demonstrated that 6 months of nicotinamide riboside (NR) significantly improved 6-minute walk distance (6MWD) in peripheral artery disease (PAD) patients versus placebo (mean difference: +17.6 meters; 90% CI: +1.8, +∞). Resveratrol provided no additional benefit when combined with NR. In high-adherence participants (≥75% pill intake), NR alone increased 6MWD by 31.0 meters and NR + resveratrol by 26.9 meters compared to placebo. The study concluded NR meaningfully enhances walking performance in PAD, while resveratrol did not augment this effect.

Study Design

This was a randomized, double-blind, placebo-controlled clinical trial conducted in 2024. It enrolled 90 adults with lower extremity PAD. Participants were assigned to one of three groups: NR alone, NR + resveratrol, or placebo. The primary outcome was change in 6MWD after 6 months. The trial duration was 6 months, with follow-up at the endpoint.

Dosage & Administration

The summary does not specify exact doses of NR or resveratrol. Supplements were administered orally as daily pills. Participants took their assigned regimen for 6 months, with adherence monitored via pill counts. High adherence was defined as ≥75% pill consumption.

Results & Efficacy

NR significantly improved 6MWD versus placebo: +7.0 meters (NR) vs. -10.6 meters (placebo), yielding a between-group difference of +17.6 meters (90% CI: +1.8, +∞). The one-sided 90% CI indicates statistical significance (p<0.05 for superiority). In high-adherence subgroups, NR increased 6MWD by 31.0 meters and NR + resveratrol by 26.9 meters relative to placebo. Resveratrol showed no additive effect, as the NR-only and NR+resveratrol groups had comparable improvements. No demographic specifics (e.g., age, sex) were provided in the summary.

Limitations

The sample size (n=90) was small, limiting statistical power for subgroup analyses. The 6-month duration may be insufficient to assess long-term outcomes in PAD. The absence of a resveratrol-only arm prevented evaluation of its independent effects. The one-sided confidence interval for the primary outcome deviates from standard two-sided reporting, potentially affecting interpretation. The authors explicitly note the need for a larger confirmatory trial.

Clinical Relevance

For PAD patients, NR supplementation may improve walking capacity, with adherence critical for optimal results. The 17.6-meter improvement exceeds the minimal clinically important difference (10–20 meters) for 6MWD in PAD, suggesting tangible functional benefits. However, adding resveratrol offers no advantage. Patients should not expect resveratrol to enhance NR’s effects based on this trial. Larger studies are required before clinical adoption, and self-administration without medical supervision is not advised.