This study will determine the pharmacokinetics, pharmacodynamics and safety of escalating doses of Basis following twice daily oral administration in patients with acute kidney injury (AKI). Basis is a commercially available nutritional supplement consisting of nicotinamide riboside (NR) and pterostilbene that acts to increase sirtuin activity.
Acute kidney injury (AKI) is common, growing in incidence, and associated with significant morbidity and mortality. Sirtuins are anti-aging enzymes that play a diverse role in cellular energy metabolism and gene regulation. Mice deficient in SIRT1 are more susceptible to developing AKI and sirtuin activation is a potential treatment for AKI. This is a randomized, double-blind, placebo-controlled, stepwise study of escalating doses of Basis (NR/pterostilbene) in patients with AKI. The study will potentially comprise up to four Steps. The purpose of the stepwise approach is to identify the dose of Basis that achieves at least a 50% and up to 100% increase in white blood cell (WBC) content of nicotinamide adenine dinucleotide (NAD+) without side-effects. During each Step, Basis (5 patients) or placebo (1 patient) will be given twice a day for 2 days. Patients will have frequent blood sampling performed for a 24 hour period following dosing on Day 1 and then at 48 hr. The measurements in blood will include NR/pterostilbene blood concentrations and NAD+ and NAAD (nicotinic acid adenine dinucleotide) concentrations in WBCs.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
TRIPLE
Enrollment
24
Massachusetts General Hospital
Boston, Massachusetts, United States
Maximum plasma concentration [Cmax] of NR
Maximum plasma concentration \[Cmax\] of NR after oral administration of Basis
Time frame: 2 days
Maximum plasma concentration [Cmax] of pterostilbene
Maximum plasma concentration \[Cmax\] of pterostilbene after oral administration of Basis
Time frame: 2 days
Area Under the Curve [AUC] of NR
Area Under the Curve \[AUC\] of NR after oral administration of Basis
Time frame: 2 days
Area Under the Curve [AUC] of pterostilbene
Area Under the Curve \[AUC\] of pterostilbene after oral administration of Basis
Time frame: 2 days
Incidence of Treatment-Emergent Adverse Events (Safety)
Subjects will be interviewed to determine onset of nausea, abdominal pain, vomiting, diarrhea, or rash. Adverse events will be characterized as probably related, probably not related, or unknown
Time frame: 2 days
Incidence of Treatment-Emergent Laboratory Abnormalities (Safety)
comprehensive metabolic panel (including liver function tests), complete blood count
Time frame: 2 days
NAD+ levels
To determine the increase in NAD+ levels in white blood cells (WBCs) following twice daily Basis administration
Time frame: 2 days
Dose finding for 50% increase in NAD+ levels in WBCs
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Dose of Basis that leads to 50% increase in NAD+ levels in WBC
Time frame: 2 days
Dose finding for 100% increase in NAD+ levels in WBCs
Dose of Basis that leads to 100% increase in NAD+ levels in WBC
Time frame: 2 days