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Human randomized trial

Oral MIB-626 (β Nicotinamide Mononucleotide) Safely Raises Blood Nicotinamide Adenine Dinucleotide Levels in Hospitalized Patients With COVID-19 and Acute Kidney Injury: A Randomized Controlled Trial

Karol M Pencina, David E Leaf, Rodrigo J Valderrabano, Sushrut S Waikar, Tapan S Mehta, Yili Valentine Shang, Nancy K Latham, Tejossy John, Elena Volpi, Dahlene Fusco, Yusnie Memish-Beleva, Shobana Krishnamurthy, Siva Lavu, Salma Karmi, David J Livingston, Shalender Bhasin

FASEB BioAdvances · 2025 · 7(8):e70011

Original publication PubMed Full text on PMC

Study at a glance

Design
Multicenter, randomized, double-blind, placebo-controlled, parallel-group proof-of-concept trial; 14 days
Population or model
Adults hospitalized with COVID-19 and acute kidney injury
Sample size
42 randomized; 25 MIB-626 and 17 placebo
Intervention
MIB-626 1,000 mg twice daily versus placebo for 14 days
Publication type
Randomized controlled trial
Evidence class
human-study
Research area
Disease-setting NAD pharmacodynamics
Trial registration
NCT05038488

Study endpoints

  • Blood NAD+ and NAD metabolites
  • Serum creatinine primary efficacy outcome
  • Cystatin C, KIM-1 and NGAL
  • CRP, IL-6 and TNF-alpha
  • COVID-19 disease severity
  • Safety

Plain-language summary

This randomized trial tested 2,000 mg/day MIB-626 for 14 days in 42 hospitalized adults with COVID-19 and acute kidney injury.

MIB-626 substantially raised blood NAD+ and several NAD metabolites. However, serum creatinine, cystatin C, other acute-kidney-injury markers, inflammatory markers and disease-severity measures did not significantly differ between groups.

The study therefore provides disease-setting NAD pharmacodynamic and short-term safety evidence, but not evidence that oral MIB-626 improved COVID-19 or acute kidney injury outcomes.

Key findings

  • Blood NAD+ rose substantially with MIB-626 and peaked between days 5 and 14.
  • NAD metabolites 2-PY and MeNAM increased during treatment.
  • Serum creatinine and cystatin C changes did not significantly differ from placebo.
  • Other AKI biomarkers, inflammatory markers and disease-severity indices did not significantly differ between groups.
  • The treatment was reported as safe and well tolerated in this short trial.

Limitations

  • Only 42 randomized participants.
  • Disease-specific hospitalized population with substantial comorbidity burden.
  • Treatment lasted 14 days.
  • Primary and secondary clinical efficacy outcomes were null.
  • Commercial sponsorship and author relationships with Metro International Biotech require transparent interpretation.
  • The proprietary MIB-626 formulation should not be generalized to all NMN products.

Funding and transparency

Funding

The trial was funded by Metro International Biotech LLC; Pencina and Bhasin were also partially supported by the Boston Claude D. Pepper Older Americans Independence Center.

Competing interests

The publication reports Metro International Biotech employees and a consultant among the authors, plus other research, consulting and equity disclosures.

HealthspanX observation

This is a useful example of clear target engagement without demonstrated clinical efficacy on the disease endpoints.

Interpretive weight

Limited

Randomized disease-specific proof-of-concept trial with strong NAD pharmacodynamics but null kidney, inflammation and disease-severity outcomes.

This record summarizes a publication; it is not medical advice or a claim that a HealthspanX product reproduces the study's results. Report a correction.

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