Observational Study With CICR-NAM as a Food for Special Medicinal Purposes in Post-COVID Syndrome (PCS) (CICR-NAM-PCS)
In patients with post-COVID syndrome, changes in tryptophan metabolism, energy metabolism, and the gut microbiome may occur. In an earlier nutritional study, patients with COVID-19 recovered their physical performance more quickly when taking nicotinamide (vitamin B3). Patients who responded to nicotinamide also developed post-COVID syndrome less frequently. At the University Hospital Schleswig-Holstein in Kiel, special nicotinamide tablets (CICR-NAM) were developed that release the active substance selectively in the lower intestine and have been shown to be very well tolerated in several studies.
Patients with post-COVID syndrome and documented tryptophan deficiency may therefore take one tablet (500 mg) of CICR-NAM daily for up to approximately 4 months as a food for special medicinal purposes within the therapy groups of the outpatient clinic for patients with post-COVID syndrome at the University Hospital Schleswig-Holstein in Kiel. This intake is far below the Upper Level defined by the European Food Safety Authority for lifelong daily intake (900 mg per day). Therefore, there are no safety concerns. CICR-NAM intake is intended to complement the therapy group programme by supporting energy metabolism.
A tanulmány áttekintése
Állapot
Körülmények
Beavatkozás / kezelés
Részletes leírás
In the COVit-2 study (DRKS00021214), daily intake of two tablets containing a total of 1,000 mg nicotinamide (500 mg conventional nicotinamide and 500 mg controlled-ileocolonic-release nicotinamide, CICR-NAM) in patients with acute COVID-19 was associated with a significantly faster improvement in physical performance after two weeks compared with placebo. Parallel effects on the gut metagenome suggested that specifically the ileocolonically released nicotinamide from CICR-NAM tablets could counteract COVID-19-associated disturbances in the metabolism of the essential amino acid tryptophan and in the gut microbiome. In the placebo group, gene expression related to the microbial tryptophan biosynthesis pathway as well as redox and salvage pathways of the central metabolic coenzyme nicotinamide adenine dinucleotide (NAD+) was significantly increased at week 2, whereas these deviations in the metagenome were not observed in patients receiving nicotinamide supplementation.
At the 6-month follow-up of COVit-2 participants, patients who benefited from nicotinamide administration (responders) developed post-COVID syndrome significantly less frequently. Because disturbances in tryptophan metabolism are well described in both COVID-19 and PCS, a low tryptophan level may serve as an easily measurable surrogate parameter for an increased nicotinamide requirement in these conditions.
There is currently no satisfactory treatment for patients with PCS. They experience significant distress and often have a permanent disability. Given the disturbances in tryptophan metabolism and the gut microbiome observed in PCS, supplementation with CICR-NAM may help restore physical performance. Therefore, a nutritional observational study offering 500 mg/day CICR-NAM as a food for special medicinal purposes for up to approximately 4 months will be conducted within the therapy groups of the PCS outpatient clinic at UKSH Campus Kiel for patients with documented tryptophan deficiency. A placebo-controlled clinical trial with CICR-NAM in PCS is planned, but it will not be available for recruitment in the near future. The present observational study is intended as an interim option until the clinical trial begins and is also expected to provide insights into the feasibility of such an intervention.
Tanulmány típusa
Beiratkozás (Becsült)
Fázis
- Nem alkalmazható
Kapcsolatok és helyek
Tanulmányi kapcsolat
- Név: Lennart Reinke, Dr. med.
- Telefonszám: +49 431 500-22200
- E-mail: lennartmichel.reinke@uksh.de
Részvételi kritériumok
Jogosultsági kritériumok
Tanulmányozható életkorok
- Felnőtt
- Idősebb felnőtt
Egészséges önkénteseket fogad
Leírás
Inclusion Criteria:
- all sexes;
- minimum age 18 years; no upper age limit;
- post-COVID syndrome (PCS)
- serum tryptophan <55 µmol/L (UKSH reference range: 48-109 µmol/L);
- participation in the therapy groups of the PCS outpatient clinic at UKSH Campus Kiel.
Exclusion Criteria:
- Known allergies or intolerances to any component of CICR-NAM;
- inability to provide informed consent;
- pregnancy or breastfeeding;
- severe comorbid disease (especially renal insufficiency, uncontrolled autoimmune diseases, liver disease, or malignancy);
- long-term use of higher doses of medications that raise gastric pH (for example proton pump inhibitors, H2 receptor antagonists, or antacids), as an increase in pH toward approximately 7 may cause premature release of nicotinamide from CICR-NAM;
- use of supplements containing more than 20 mg nicotinamide, nicotinamide riboside, nicotinamide mononucleotide, nicotinic acid, or NAD+ per daily dose.
Tanulási terv
Hogyan készül a tanulmány?
Tervezési részletek
- Elsődleges cél: Támogató gondoskodás
- Kiosztás: N/A
- Beavatkozó modell: Egyetlen csoportos hozzárendelés
- Maszkolás: Nincs (Open Label)
Fegyverek és beavatkozások
Résztvevő csoport / kar |
Beavatkozás / kezelés |
|---|---|
|
Kísérleti: CICR-NAM Administration
Oral administration of CICR-NAM (controlled-ileocolonic-release nicotinamide) as a food for special medical purposes, one film-coated tablet (500 mg) daily for up to approximately 4 months, embedded in the therapy groups of the PCS outpatient clinic at UKSH Campus Kiel.
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Oral administration of CICR-NAM (controlled-ileocolonic-release nicotinamide) as a food for special medical purposes, one film-coated tablet (500 mg) daily for up to approximately 4 months, embedded in the therapy groups of the PCS outpatient clinic at UKSH Campus Kiel
|
Mit mér a tanulmány?
Elsődleges eredményintézkedések
Eredménymérő |
Intézkedés leírása |
Időkeret |
|---|---|---|
|
Serum tryptophan level
Időkeret: From T1 (start of participation, screening for reduced serum tryptophan) to T6 (end of the therapy group) approximately 5 month.
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Serum tryptophan level (µmol/L) as a longitudinal marker of tryptophan and NAD+ metabolism during CICR-NAM supplementation.
Assessment time points: therapy group session 1 (start of participation, screening for reduced serum tryptophan, T1), session 2 (start of supplementation, T2), session 3 (after approximately 1 month of supplementation, T3), and session 6 (end of the therapy group, after approximately 4 months, T4).
Method: quantitative determination of serum tryptophan (UKSH laboratory diagnostics)
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From T1 (start of participation, screening for reduced serum tryptophan) to T6 (end of the therapy group) approximately 5 month.
|
Együttműködők és nyomozók
Tanulmányi rekorddátumok
Tanulmány főbb dátumok
Tanulmány kezdete (Becsült)
Elsődleges befejezés (Becsült)
A tanulmány befejezése (Becsült)
Tanulmányi regisztráció dátumai
Először benyújtva
Először nyújtották be, amely megfelel a minőségbiztosítási kritériumoknak
Első közzététel (Tényleges)
Tanulmányi rekordok frissítései
Utolsó frissítés közzétéve (Tényleges)
Az utolsó frissítés elküldve, amely megfelel a minőségbiztosítási kritériumoknak
Utolsó ellenőrzés
Több információ
A tanulmányhoz kapcsolódó kifejezések
Egyéb vizsgálati azonosító számok
- CICR-NAM-PCS_V01_2026
Terv az egyéni résztvevői adatokhoz (IPD)
Tervezi megosztani az egyéni résztvevői adatokat (IPD)?
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