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 et al. · FASEB BioAdvances · 2025
Evidence type: Human randomized trialInterpretive weight: LimitedResearch area: Disease-setting NAD pharmacodynamics
DesignMulticenter, randomized, double-blind, placebo-controlled, parallel-group proof-of-concept trial; 14 days
PopulationAdults hospitalized with COVID-19 and acute kidney injury
Sample42 randomized; 25 MIB-626 and 17 placebo
InterventionMIB-626 1,000 mg twice daily versus placebo for 14 days
EndpointsBlood 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
What the publication reported
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.
What it cannot establish
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.
HealthspanX claim boundary: This study does not establish NMN or MIB-626 as a treatment for COVID-19, acute kidney injury or systemic inflammation.
