2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T598,There were 12 287 patients (mean [SD] age, 77.2 [8.9] years; 241 women [2.0%]; 31 [0.3%] American Indian or Alaska Native, 3 [<0.1%] Asian, 13 [0.1%] Black or African American, 59 [0.5%] Native Hawaiian or other Pacific Islander, and 11 662 [94.9%] White individuals) exposed to oral nicotinamide, 500 mg, twice daily for longer than 30 days who were matched to 21 479 unexposed patients (mean [SD] age, 76.9 [8.7] years; 374 women [2.0%]; 49 [0.2%] American Indian or Alaska Native, 3 [<0.1%] Asian, 16 [0.1%] Black or African American, 88 [0.4%] Native Hawaiian or other Pacific Islander, and 20 517 [95.3%] White individuals). Within the matched dataset, there were 10 994 instances of basal cell carcinoma after nicotinamide exposure and 12 551 cutaneous squamous cell carcinoma (cSCC). A total of 1334 (3.9%) in the matched cohort were solid organ transplant recipients. Overall, there was a significant 14% reduction in skin cancer risk. When nicotinamide was initiated after a first skin cancer, the risk reduction rose to 54%, although this benefit declined with initiation following subsequent skin cancers. This risk reduction was seen for skin cancers overall, basal cell carcinoma, and cSCC, with the greatest risk reduction seen for cSCC. Among solid organ transplant recipients, no overall significant risk reduction was observed, although early nicotinamide use was associated with reduced cSCC incidence.31:Tb42,Nicotinamide supplementation has been studied as a chemopreventive medication for reducing skin cancer risk, but large-scale data are limited. To determine the clinical efficacy of nicotinamide supplementation for skin cancer prevention in the general population and among solid organ transplant recipients. A retrospective cohort study was conducted using electronic health record data (October 1, 1999, to December 31, 2024) from the Veterans Affairs Corporate Data Warehouse (CDW) of 33 822 patients. Analyses were conducted from January 17, 2025, to May 9, 2025. Patients who were exposed to nicotinamide were propensity score matched based on the number and year of skin cancers after which treatment with nicotinamide was initiated, age, sex, self-reported race, exposure to acitretin, exposure to field therapy, history of chronic lymphocytic leukemia, and history of solid organ transplant. The index date was the first prescription of nicotinamide filled within the VA system. Stratified Cox models were used to investigate the association of nicotinamide with skin cancer development. Nicotinamide, 500 mg, twice daily for longer than 30 days as documented in the electronic health record. Time to the next skin cancer after baseline. There were 12 287 patients (mean [SD] age, 77.2 [8.9] years; 241 women [2.0%]; 31 [0.3%] American Indian or Alaska Native, 3 [<0.1%] Asian, 13 [0.1%] Black or African American, 59 [0.5%] Native Hawaiian or other Pacific Islander, and 11 662 [94.9%] White individuals) exposed to oral nicotinamide, 500 mg, twice daily for longer than 30 days who were matched to 21 479 unexposed patients (mean [SD] age, 76.9 [8.7] years; 374 women [2.0%]; 49 [0.2%] American Indian or Alaska Native, 3 [<0.1%] Asian, 16 [0.1%] Black or African American, 88 [0.4%] Native Hawaiian or other Pacific Islander, and 20 517 [95.3%] White individuals). Within the matched dataset, there were 10 994 instances of basal cell carcinoma after nicotinamide exposure and 12 551 cutaneous squamous cell carcinoma (cSCC). A total of 1334 (3.9%) in the matched cohort were solid organ transplant recipients. Overall, there was a significant 14% reduction in skin cancer risk. When nicotinamide was initiated after a first skin cancer, the risk reduction rose to 54%, although this benefit declined with initiation following subsequent skin cancers. This risk reduction was seen for skin cancers overall, basal cell carcinoma, and cSCC, with the greatest risk reduction seen for cSCC. Among solid organ transplant recipients, no overall significant risk reduction was observed, although early nicotinamide use was associated with reduced cSCC incidence. The results of this cohort study suggest that there is a decreased risk of skin cancer among patients treated with nicotinamide, with the greatest effect seen when initiated after the first skin cancer.32:T102c, Importance Nicotinamide supplementation has been studied as a chemopreventive medication for reducing skin cancer risk, but large-scale data are limited. Objective To determine the clinical efficacy of nicotinamide supplementation for skin cancer prevention in the general population and among solid organ transplant recipients. Design, Setting, and Participants A retrospective cohort study was conducted using electronic health record data (October 1, 1999, to December 31, 2024) from the Veterans Affairs Corporate Data Warehouse (CDW) of 33 822 patients. Analyses were conducted from January 17, 2025, to May 9, 2025. Patients who were exposed to nicotinamide were propensity score matched based on the number and year of skin cancers after which treatment with nicotinamide was initiated, age, sex, self-reported race, exposure to acitretin, exposure to field therapy, history of chronic lymphocytic leukemia, and history of solid organ transplant. The index date was the first prescription of nicotinamide filled within the VA system. Stratified Cox models were used to investigate the association of nicotinamide with skin cancer development. Exposures Nicotinamide, 500 mg, twice daily for longer than 30 days as documented in the electronic health record. Main Outcomes and Measures Time to the next skin cancer after baseline. Results There were 12 287 patients (mean [SD] age, 77.2 [8.9] years; 241 women [2.0%]; 31 [0.3%] American Indian or Alaska Native, 3 [&lt;0.1%] Asian, 13 [0.1%] Black or African American, 59 [0.5%] Native Hawaiian or other Pacific Islander, and 11 662 [94.9%] White individuals) exposed to oral nicotinamide, 500 mg, twice daily for longer than 30 days who were matched to 21 479 unexposed patients (mean [SD] age, 76.9 [8.7] years; 374 women [2.0%]; 49 [0.2%] American Indian or Alaska Native, 3 [&lt;0.1%] Asian, 16 [0.1%] Black or African American, 88 [0.4%] Native Hawaiian or other Pacific Islander, and 20 517 [95.3%] White individuals). Within the matched dataset, there were 10 994 instances of basal cell carcinoma after nicotinamide exposure and 12 551 cutaneous squamous cell carcinoma (cSCC). A total of 1334 (3.9%) in the matched cohort were solid organ transplant recipients. Overall, there was a significant 14% reduction in skin cancer risk. When nicotinamide was initiated after a first skin cancer, the risk reduction rose to 54%, although this benefit declined with initiation following subsequent skin cancers. This risk reduction was seen for skin cancers overall, basal cell carcinoma, and cSCC, with the greatest risk reduction seen for cSCC. Among solid organ transplant recipients, no overall significant risk reduction was observed, although early nicotinamide use was associated with reduced cSCC incidence. Conclusions and Relevance The results of this cohort study suggest that there is a decreased risk of skin cancer among patients treated with nicotinamide, with the greatest effect seen when initiated after the first skin cancer. 33:T57b,Yellow nail syndrome (YNS) is a rare syndrome with unknown pathogenesis characterized by a clinical triad of respiratory disease, lymphedema, and xanthonychia. Diagnosis is challenging as clinical manifestations often do not occur concurrently. Due to disease rarity, few studies to date have characterized YNS or assessed therapeutics. We aimed to characterize clinical findings of YNS and compare therapeutic regimens to provide diagnostic and management recommendations. An international multi-institutional retrospective cohort study of YNS patients was conducted by a panel of nail experts. We included 111 YNS patients. Xanthonychia, increased transverse curvature, thickening, nail growth arrest, and a history of respiratory disease or lymphedema were highly suggestive of YNS. The therapeutic regimen with highest complete response rate was oral vitamin E combined with oral azole antifungals. Limitations include nonrandomized and retrospective design. Clinical details were inconsistently reported. Some treatments discussed are expert opinions and based on hypothetical and/or minimal data. We provide the largest study to date characterizing YNS. We suggest that patients with suspected YNS undergo mycologic examination and referral to pulmonology. We recommend oral vitamin E with oral azole antifungal as the first-line therapy for YNS. Reassurance/no treatment could also be considered.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Vitamin Supplement: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Vitamin Supplement (modality). Clinician-written summaries and actionable practice insights. 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pooling across brands was not performed but both appear in the analysis.","value_numeric":null},{"paper_doi":"10.1038/s41380-026-03759-1","tag_type":"warning","value":"The network includes 137 distinct compound combinations across 163 trials, making many node comparisons sparse and indirect; transitivity assumptions may not fully hold.","value_numeric":null}],"summaries":{"what_studied":"A systematic review and network meta-analysis of 163 RCTs (n = 15,757) evaluated nutraceuticals and phytoceuticals vs. placebo or antidepressants (TAU) for major depressive disorder (MDD), examining depressive symptoms, treatment response, remission, anxiety, tolerability, and acceptability.","key_result":"After restricting to high-quality evidence (≥2 RCTs, low risk of bias, non-sponsored, non-outlier), EPA (SMD = −1.67), vitamin D3 (SMD = −1.59), and St. John's wort extract ZE117 (SMD = −1.02) showed the largest effect sizes vs. placebo for depressive symptoms — but these effect sizes were deemed higher-than-expected or unrealistic. Curcumin showed a moderate benefit for anxiety (SMD = −0.58). Citicoline was linked to significantly more dropouts. Overall confidence in evidence was **low to very low**, and larger effect sizes correlated with lower study quality (meta-regression).","limitations":"- Substantial heterogeneity (I² = 85.3%) and significant global inconsistency limit pooled estimates.\n- Confidence in all evidence rated low to very low (CINeMA/AMSTAR-Plus).\n- Even filtered analyses produced effect sizes judged unrealistically large, suggesting residual bias.","practice_takeaway":"Clinicians should be cautious about recommending nutraceuticals or phytoceuticals for MDD — current evidence is low quality, and apparent large benefits (especially for EPA, vitamin D3, and St. John's wort) are likely inflated by poor study design. Rigorous, well-powered RCTs are needed before routine use can be supported."}},{"doi":"10.1161/circulationaha.126.082363","pmid":"42661461","title":"Vitamin K\n ₂\n and D\n ₃\n Supplementation in Patients With Severe Coronary Artery Calcification: The DANCODE Trial","journal_title":"Circulation","journal_issn":"0009-7322","published_at":"2026-08-28T00:00:00.000Z","url":"https://doi.org/10.1161/circulationaha.126.082363","source_score":51,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-03T06:20:00.007Z","updated_at":"2026-09-03T06:20:00.007Z","tags":[{"paper_doi":"10.1161/circulationaha.126.082363","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.082363","tag_type":"category","value":"Cardiac & Cardiovascular Systems","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.082363","tag_type":"condition","value":"Coronary Artery Calcification","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.082363","tag_type":"condition","value":"Coronary Artery Disease","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.082363","tag_type":"generic","value":"cholecalciferol","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.082363","tag_type":"generic","value":"menaquinone-7","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.082363","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.082363","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.082363","tag_type":"modality","value":"Vitamin Supplement","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.082363","tag_type":"sample_size","value":"n=398","value_numeric":398},{"paper_doi":"10.1161/circulationaha.126.082363","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.082363","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.082363","tag_type":"warning","value":"The coronary CTA substudy (n=143) is a subset analysis and may not fully represent the overall trial population, particularly those with CAC ≥1000 AU.","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.082363","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously — while results are statistically significant, the trial was not powered for hard clinical endpoints (MI, stroke, death), so evidence of patient-level benefit remains indirect.","value_numeric":null},{"paper_doi":"10.1161/circulationaha.126.082363","tag_type":"warning","value":"Vitamin K2 formulation used (720 μg/d) is substantially higher than typical dietary or over-the-counter supplement doses; direct translation to standard supplement products requires caution.","value_numeric":null}],"summaries":{"what_studied":"This multicenter, double-blind, placebo-controlled RCT (DANCODE) evaluated whether daily vitamin K2 (720 μg) plus vitamin D3 (25 μg) vs. placebo reduces coronary artery calcification (CAC) progression over 24 months in 398 patients with severe CAC (score ≥400 Agatston units).","key_result":"Vitamin K2 + D3 significantly slowed CAC progression vs. placebo: mean increase of 196 AU vs. 248 AU (between-group difference −52 AU [95% CI, −79 to −24]). In the 143-participant coronary CTA substudy, calcified plaque volume progression was also attenuated (−8 mm³ [95% CI, −13 to −2]), with no compensatory increase in noncalcified plaque volume.","limitations":"- The trial was not powered for hard cardiovascular endpoints (e.g., MI, death), so clinical benefit remains unproven.\n- The coronary CTA substudy was limited to participants with CAC <1000 AU (n=143), reducing generalizability to the most severe subgroup.\n- Median follow-up was only 24 months; longer-term effects and durability are unknown.","practice_takeaway":"In patients with severe coronary calcification (CAC ≥400 AU), vitamin K2 + D3 supplementation modestly but significantly slowed CAC progression over 2 years without increasing noncalcified plaque. Clinicians should note this does not yet translate to proven reduction in cardiovascular events and larger outcomes trials are needed before routine prescribing."}},{"doi":"10.1001/jamadermatol.2025.3238","pmid":"40960808","title":"Nicotinamide for Skin Cancer Chemoprevention","journal_title":"JAMA Dermatology","journal_issn":"2168-6068","published_at":"2025-09-17T00:00:00.000Z","url":"https://doi.org/10.1001/jamadermatol.2025.3238","source_score":1041,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2025-11-21","doi":"10.1001/jamadermatol.2025.3238","days":"14","issn":"2168-6068","rank":"1","field":"Clinical Medicine","score":"1041","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.1001/jamadermatol.2025.3238","title":"Nicotinamide for Skin Cancer Chemoprevention.","journal":"JAMA dermatology","methods":"","results":"$30","abstract":"$31","keywords":[],"pubmed_id":"40960808","conclusions":"","publication_date":"2025-09-17T00:00:00"},"crossref":{"DOI":"10.1001/jamadermatol.2025.3238","URL":"https://doi.org/10.1001/jamadermatol.2025.3238","ISSN":["2168-6068"],"link":[{"URL":"https://jamanetwork.com/journals/jamadermatology/articlepdf/2838591/jamadermatology_breglio_2025_oi_250045_1762976594.09017.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"1140","type":"journal-article","issue":"11","score":1,"title":["Nicotinamide for Skin Cancer Chemoprevention"],"author":[{"given":"Kimberly F.","family":"Breglio","sequence":"first","affiliation":[{"name":"Dermatology Division, Durham VA Medical Center, Durham, North Carolina"},{"name":"Cutaneous Surgery and Oncology, Department of Dermatology, University of Michigan, Ann Arbor"}]},{"given":"Katlyn M.","family":"Knox","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, Tennessee"}]},{"given":"Jonathan","family":"Hwang","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania"},{"name":"Department of Dermatology, Brigham and Women’s Hospital, Boston, Massachusetts"},{"name":"Dermatology Section, VA Boston Healthcare System, Boston, Massachusetts"}]},{"given":"Rachel","family":"Weiss","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee"}]},{"given":"Kyle","family":"Maas","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, Tennessee"}]},{"given":"Siwei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee"}]},{"given":"Lydia","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee"}]},{"given":"Chris","family":"Madden","sequence":"additional","affiliation":[{"name":"State University of New York Downstate College of Medicine, Brooklyn"}]},{"given":"Yaomin","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee"}]},{"given":"Rebecca I.","family":"Hartman","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Brigham and Women’s Hospital, Boston, Massachusetts"},{"name":"Dermatology Section, VA Boston Healthcare System, Boston, Massachusetts"}]},{"given":"Lee","family":"Wheless","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Tennessee Valley Healthcare System VA Medical Center, Murfreesboro, Tennessee"},{"name":"Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee"}]}],"issued":{"date-parts":[[2025,11,1]]},"member":"10","prefix":"10.1001","source":"Crossref","volume":"161","created":{"date-time":"2025-09-17T15:00:42Z","timestamp":1758121242000,"date-parts":[[2025,9,17]]},"indexed":{"date-time":"2025-11-19T17:20:10Z","timestamp":1763572810229,"date-parts":[[2025,11,19]]},"subject":[],"abstract":"$32","language":"en","relation":{},"resource":{"primary":{"URL":"https://jamanetwork.com/journals/jamadermatology/fullarticle/2838591"}},"subtitle":[],"deposited":{"date-time":"2025-11-19T16:00:42Z","timestamp":1763568042000,"date-parts":[[2025,11,19]]},"issn-type":[{"type":"print","value":"2168-6068"}],"published":{"date-parts":[[2025,11,1]]},"publisher":"American Medical Association 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Xanthonychia, increased transverse curvature, thickening, nail growth arrest, and a history of respiratory disease or lymphedema were highly suggestive of YNS. The therapeutic regimen with highest complete response rate was oral vitamin E combined with oral azole antifungals.","abstract":"$33","keywords":["chronic cough","diagnosis","fluconazole","itraconazole","lymphedema","management","minoxidil","nail growth","sinusitis","vitamin E","xanthonychia","yellow nail syndrome","yellow nails"],"pubmed_id":"40692045","conclusions":"We provide the largest study to date characterizing YNS. We suggest that patients with suspected YNS undergo mycologic examination and referral to pulmonology. We recommend oral vitamin E with oral azole antifungal as the first-line therapy for YNS. 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panel","updated":"2025-10-21T16:47:13+00:00","published_date":"2025-07-19","best_oa_location":null}},"created_at":"2025-10-27T13:37:43.000Z","updated_at":"2025-10-28T07:03:19.517Z","tags":[{"paper_doi":"10.1016/j.jaad.2025.07.039","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.1016/j.jaad.2025.07.039","tag_type":"condition","value":"Yellow Nail Syndrome","value_numeric":null},{"paper_doi":"10.1016/j.jaad.2025.07.039","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1016/j.jaad.2025.07.039","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.jaad.2025.07.039","tag_type":"modality","value":"Azole Antifungal","value_numeric":null},{"paper_doi":"10.1016/j.jaad.2025.07.039","tag_type":"modality","value":"Vitamin 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regimens.","key_result":"Xanthonychia, increased transverse curvature, thickening, nail growth arrest, and a history of respiratory disease or lymphedema were highly suggestive of yellow nail syndrome. The regimen with the highest complete response rate was oral vitamin E combined with an oral azole antifungal.","limitations":"Nonrandomized, retrospective design with inconsistent clinical detail reporting. Some treatments reflect expert opinion with hypothetical or minimal supporting data.","practice_takeaway":"For suspected yellow nail syndrome, obtain mycologic testing and refer to pulmonology. Consider oral vitamin E plus an oral azole antifungal as first-line therapy; reassurance or no treatment is also reasonable."}}],"initialOffset":4,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Vitamin Supplement"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Vitamin Supplement"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Vitamin Supplement"}}}]]

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