Skip to main content

The effect of niacinamide on osteoarthritis: A pilot study



To evaluate the effect of niacinamide, on selected parameters of osteoarthritis using a doubleblind, placebo controlled study design.


Seventy two patients with osteoarthritis were randomized for treatment with niacinamide or an identical placebo for 12 weeks. Outcome measures included global arthritis impact and pain, joint range of motion and flexibility, erythrocyte sedimentation rate, complete blood count, liver function tests, cholesterol, uric acid, and fasting blood sugar. Compliance was monitored with a pill record sheet and interview.


Global arthritis impact improved by 29% (95% confidence interval [CI] 6, 46) in subjects on niacinamide and worsened by 10% in placebo subjects (p=0.04). Pain levels did not change but those on niacinamide reduced their anti-inflammatory medications by 13% (95% CI 9, 94; p=0.01). Niacinamide reduced erythrocyte sedimentation rate by 22% (95% CI 6, 51; p<0.005) and increased joint mobility by 4.5 degrees over controls (8 degrees vs. 3.5 degrees; p=0.04). Side effects were mild but higher in the niacinamide group (40% vs 27%, p=0.003).


This study indicates that niacinamide may have a role in the treatment of osteoarthritis. Niacinamide improved the global impact of osteoarthritis, improved joint flexibility, reduced inflammation, and allowed for reduction in standard anti-inflammatory medications when compared to placebo. More extensive evaluation of niacinamide in arthritis is warranted.

This is a preview of subscription content, access via your institution.


  1. [1]

    Altman RD. Overview of osteoarthritis. Am J Med 1987;83:65–9.

    Google Scholar 

  2. [2]

    Dieppe PA, Frankel SJ, Toth B. Is research into the treatment of osteoarthritis with non-steroidal anti-inflammatory drugs misdirected? Lancet 1993;341:353–4.

    Google Scholar 

  3. [3]

    Kaufman W. Niacinamide therapy for joint mobility: Therapeutic reversal of a common clinical manifestation of the normal aging process. Conn State Med J 1953;17:584–9.

    Google Scholar 

  4. [4]

    Kaufman W. The use of vitamin therapy to reverse certain concomitants of aging. J Am Geriatr Soc 1955;3:927–36.

    Google Scholar 

  5. [5]

    Hoffer A. Treatment of arthritis by nicotinic acid and nicotinamide. Can Med Assoc J 1959;8:235–8.

    Google Scholar 

  6. [6]

    Kaufman W. The common form of joint dysfunction: Its incidence and treatment. Brattleboro, E.L. Hildreth & Company, 1949.

  7. [7]

    DiPalma JR, Thayer WS. Use of niacin as a drug. Ann Rev Nutr 1991;11:169–87.

    Google Scholar 

  8. [8]

    Mosher LR. Nicotinic acid side effects and toxicity: A review. Amer J Psychiat 1970;126:124–9.

    Google Scholar 

  9. [9]

    Altman R, Asch E, Boch D, et al. Development of criteria for classification and reporting of osteoarthritis: classification of osteoarthritis of the knee. Arthr Rheum 1986;29:1039–49.

    Google Scholar 

  10. [10]

    Joint motion measurement. U.S. Army Training Circular TC 8-640 (No. 8-640), 1987:1–3.

  11. [11]

    Meenan RF, Gertman PM, Mason JH. Measuring health status in arthritis: The arthritis impact measurement scales. Arthr Rheum 1980;23:146–52.

    Google Scholar 

  12. [12]

    Drugs for pain. Med Lett 1993;35:1–6.

    Google Scholar 

  13. [13]

    Sackett DL, Haynes RB, Guyatt GH, Tugwell P, editors. Clinical Epidemiology. Boston: Little, Brown & Company, 1991:214–5.

    Google Scholar 

  14. [14]

    Bernstein DS. Studies on glucose metabolism in cartilage in vitro. Proc Soc Exp Biol Med 1961;107:456–9.

    Google Scholar 

  15. [15]

    Hamerman D. The biology of osteoarthritis. NEJM 1989;320:1322–30.

    Google Scholar 

  16. [16]

    Hess EV, Herman JH. Cartilage metabolism and anti-inflammatory drugs in osteoarthritis. Am J Med 1986;81 Suppl 5B:36–43.

    Google Scholar 

Download references

Author information



Corresponding author

Correspondence to W. B. Jonas.

Additional information

accepted by R. O. Day

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Jonas, W.B., Rapoza, C.P. & Blair, W.F. The effect of niacinamide on osteoarthritis: A pilot study. Inflamm Res 45, 330–334 (1996).

Download citation


  • Niacinamide
  • Randomized controlled trial
  • Osteoarthritis