NAD+ vs BPC-157 capsules: what the research compares

NAD+ (nicotinamide adenine dinucleotide, oxidised form; synonyms include diphosphopyridine nucleotide and DPN) is a pyridine dinucleotide coenzyme with the formula C21H27N7O14P2 and a molecular weight of approximately 663.43 g/mol. BPC-157 (body protection compound-157, also written as pentadecapeptide BPC 157) is a synthetic pentadecapeptide with the sequence Gly-Glu-Pro-Pro-Pro-Gly-Lys-Pro-Ala-Asp-Asp-Ala-Gly-Leu-Val and a molecular weight of approximately 1419.53 g/mol.

The published work on NAD+ centres on redox cofactor biology and the sirtuin and CD38/NADase enzyme families, while the published work on BPC-157 centres on cytoprotective and angiogenic signalling in gastrointestinal and connective tissue models.

Research Studies

NAD+ and retinal nerve cell layer thickness in primary open-angle glaucoma

A registered clinical trial is evaluating whether high-dose nicotinamide, a vitamin B3 precursor that feeds into NAD+ biosynthesis, can protect retinal nerve cells in adults with primary open-angle glaucoma who are already receiving standard eye drops or laser treatment [1]. The primary question is whether adding nicotinamide to standard therapy slows the rate of thinning of the inner retinal nerve cell layer, measured by a non-invasive eye scan, compared with standard therapy alone over 12 months [1]. Participants are randomised to a treatment group taking nicotinamide tablets by mouth, starting at 1.5 grams per day, or to a comparator group [1].

NAD+ precursor and tryptophan metabolism in post-COVID syndrome

An observational study is examining the use of CICR-NAM, a nicotinamide tablet formulated to release the active substance selectively in the lower intestine, in patients with post-COVID syndrome and documented tryptophan deficiency [2]. The rationale cites earlier nutritional work in which patients with COVID-19 recovered physical performance more quickly when taking nicotinamide, and in which patients who responded to nicotinamide developed post-COVID syndrome less frequently [2]. The study notes that changes in tryptophan metabolism, energy metabolism, and the gut microbiome may occur in post-COVID syndrome [2].

NAD+ and the sirtuin/CD38 axis: what the registered work does not measure

The evidence block for this page does not contain a study that directly measures sirtuin activity, CD38 activity, or tissue NAD+ concentration in humans. Claims about those endpoints are therefore outside what the supplied evidence supports and are not made here.

BPC-157 and gastrointestinal and connective tissue models

The evidence block for this page does not contain a primary study of BPC-157 in any model. No finding on BPC-157 in gastrointestinal, tendon, ligament, or vascular tissue can be reported from the supplied evidence, and none is reported here.

BPC-157 and capsule formulation: what the registered work does not measure

No registered study in the supplied evidence administers BPC-157 by capsule, measures its oral bioavailability, or compares a capsule form against any other route. Those endpoints are not supported by the evidence block and are not asserted here.

Adjacent comparator work: nicotinamide in a non-ocular population

The post-COVID syndrome study described above is the only supplied source in which a nicotinamide product is given to a defined patient population outside ophthalmology [2]. It is observational and its stated population is adults with post-COVID syndrome and documented tryptophan deficiency, so its findings do not transfer to other populations [2].

Adjacent comparator work: injectable agents in cardiometabolic and inflammatory disease

Several registered trials in the supplied evidence test injectable biologics or peptides in cardiovascular and inflammatory populations. Maridebart cafraglutide is being tested for superiority over placebo, as an adjunct to standard of care, on cardiovascular morbidity and mortality in participants with atherosclerotic cardiovascular disease and overweight or obesity [4]. Ziltivekimab is being tested in people admitted to hospital with a heart attack, with participants receiving monthly subcutaneous injections and the study examining whether new heart attacks or strokes are prevented [8]. Afimkibart (RO7790121) is in a Phase III, multicentre, double-blind, placebo-controlled study of induction therapy in participants with moderately to severely active Crohn's disease [5]. These trials define the comparator landscape for injectable agents; they do not test NAD+ or BPC-157.

Adjacent comparator work: injectables and devices in musculoskeletal and wound care

A prospective observational study is comparing perineural 5% dextrose injections with perineural local anaesthetic injections in adults with symptomatic knee osteoarthritis, following participants for six months and assessing pain intensity and functional outcomes at baseline and at 1, 3, and 6 months [3]. A post-market clinical follow-up study is confirming the performance of Debrisoft Duo and collecting safety data within its certified indications under routine use [6]. A separate study examines forward head posture, assessed by craniovertebral angle, in patients with fibromyalgia and its association with symptom severity [7]. None of these involve NAD+ or BPC-157.

Where the two compounds stand against each other in the supplied evidence

Read against each other, the supplied evidence is asymmetric. For NAD+, there are two registered protocols in defined human populations, one interventional with a stated primary endpoint and one observational [1][2]. For BPC-157, the supplied evidence contains no primary study, no registered protocol, and no measured endpoint. That is a statement about the evidence block, not about the compound.

What is simply not known from the supplied evidence

• Whether nicotinamide slows inner retinal nerve cell layer thinning in primary open-angle glaucoma — the trial is registered and its results are not in the supplied material [1].
• Whether CICR-NAM alters tryptophan metabolism, energy metabolism, or the gut microbiome in post-COVID syndrome — the study is observational and its results are not in the supplied material [2].
• Any measured effect of BPC-157 in any model, tissue, or population.
• Any oral bioavailability, pharmacokinetic, or capsule-specific data for BPC-157.
• Any head-to-head study comparing NAD+ and BPC-157.
• Any human NAD+ tissue concentration data in the supplied material.

If you are reading this for personal health reasons

The materials described on this page are sold for laboratory research use only. We do not provide dosing information, medical guidance, or recommendations for human use. Anyone considering a compound for themselves should speak to a licensed clinician.

Sources

• [1] Nicotinamide for Retinal Protection in Primary Open-Angle Glaucoma (NADIR Trial) — https://clinicaltrials.gov/study/NCT07808333
• [2] Observational Study With CICR-NAM as a Food for Special Medicinal Purposes in Post-COVID Syndrome (PCS) — https://clinicaltrials.gov/study/NCT07798570
• [3] Perineural Dextrose Versus Local Anesthetic Injections in Knee Osteoarthritis — https://clinicaltrials.gov/study/NCT07381621
• [4] Evaluating the Impact of Maridebart Cafraglutide on Cardiovascular Outcomes in Participants With Atherosclerotic Cardiovascular Disease and Overweight or Obesity — https://clinicaltrials.gov/study/NCT07037433
• [5] A Study to Assess the Efficacy and Safety of Induction Therapy With Afimkibart (RO7790121) in Participants With Moderately to Severely Active Crohn's Disease — https://clinicaltrials.gov/study/NCT06819891
• [6] Multicenter, Randomized, Non-inferiority Study to Compare the Performance and Safety of Debrisoft Duo With Debrisoft Pad in the Debridement of Wounds — https://clinicaltrials.gov/study/NCT07312513
• [7] Craniovertebral Angle and Fibromyalgia Severity — https://clinicaltrials.gov/study/NCT06957873
• [8] ARTEMIS - A Research Study to Look at How Ziltivekimab Works Compared to Placebo in People With a Heart Attack — https://clinicaltrials.gov/study/NCT06118281
• [9] Guizhi Wuling Decoction alleviates myocardial fibrosis by restoring mitochondrial homeostasis: Evidence from network pharmacology, molecular docking, and multi-omics integration — https://pubmed.ncbi.nlm.nih.gov/42462419/