Tier 2 — strong

Nicotinamide Riboside for Patients With Early-Stage Parkinson Disease: The NOPARK Randomized Clinical Trial

Brakedal B, Skeie GO, Derad C, Alstadhaug KB, Anundskås I, Berven H, Biermann M, Bjørnarå KA, Torres Cleuren YN, Dalbro SEJ, Eidelberg D, Foldnes K, Fortes G, Haugarvoll K, Herlofson K, Hustad E, HogenEsch RI, Johanson GAS, Johnsen SH, Kunszt K, Kverneng S, Labusau A, Lie IH, Lilleng H, Lundervold K, Lundqvist C, Ma Y, McCann A, Njølstad TH, Pihlstrøm L, Riemer F, Rognerud AK, Sheard E, Simonsen AM, Storm E, Svensen M, Toker L, Tunold JA, Dölle C, Friede T, Tzoulis C
JAMA 2026

Bibliography

PubMed
PMID 42848371
Funding
Funding details are not specified in the accessible publication information.
Competing interests
Disclosures include pharmaceutical fees and research support, and NR-related patents held by investigators. Individual declarations are detailed in the publication.

Study snapshot

DesignMulticenter double-blind randomized placebo-controlled phase III trial
ModelHuman participants
Sample410 randomized; 393 in the primary analysis
InterventionNR 500 mg twice daily versus placebo
Duration52 weeks
EndpointsMDS-UPDRS I–III; nonmotor symptoms; adverse events

What the study showed, in plain terms

The phase III NOPARK trial did not support NR as a disease-modifying treatment for early Parkinson’s disease. Clinical outcomes favored placebo on the primary scale.

Key findings

The adjusted MDS-UPDRS I–III difference was 2.72 points in favor of placebo.

What this study can and cannot tell us

The primary between-group difference was statistically significant but below the stated clinically important threshold. Findings apply to this population and regimen, not every indication.

Citation network

Articles citing this research paper

7 articles

Biohack Blueprint analyses that reference this study in their evidence base.

Editorial review

Reviewed by the Biohack Blueprint research team

Last verified