Nicotinamide in Glaucoma (NAMinG): A Randomised, Placebo-controlled, Multi-centre, Phase III Trial

Inclusion Criteria:

1. Patients who have been recently diagnosed (within the last 12 months) with early tomoderate open-angle glaucoma (OAG) in at least one eye (including primary OAG, normaltension glaucoma (NTG) and pseudoexfoliation glaucoma)
2. Open angle on gonioscopy
3. Adults aged 18 years or over
4. Snellen visual acuity 6/12 or better in at least one eye meeting the visual field (VF)criteria
5. Visual Field (VF) mean deviation (MD) no worse than -12dB in either eye
6. A negative pregnancy test result at the screening and baseline visit prior torandomisation for women of childbearing potential
7. Ability to provide informed consent to participate
8. Able and willing to attend trial visits and comply with trial procedures for theduration of the trial

Exclusion Criteria:

1. Pigment dispersion glaucoma
2. Pregnancy (or planned pregnancy during the trial) and/or breastfeeding
3. Women of childbearing potential and male participants with a partner of childbearingpotential not willing to use highly effective contraception for the duration of thetrial treatment and for the time period specified following last trial treatmentadministration.
4. Current treatment with either isoniazid, pyrazinamide, carbamazepine, phenobarbital orprimidone
5. Current liver disease or laboratory results with elevated levels of livertransaminases (AST or ALT >3 x ULN) at screening visit.
6. Renal failure (eGFR <30mL/min/1.73m²) at screening visit.
7. Conditions affecting both eyes which may affect the Visual Field test result:
8. Diabetic retinopathy or any other retinal disease causing VF loss
9. Clinically relevant cataract (likely to require cataract surgery within the next 2 years)
10. Dementia or other non-glaucomatous neurological disease causing VF loss
11. Adnexal conditions causing VF loss (including but not limited toblepharochalasis)
12. Diagnosed with cancer in the last 5 years (with exception of non-melanoma skincancer).
13. Any clinical condition that, in the investigator's opinion would make the participantunsuitable for the trial.
14. Concurrently enrolled in any other interventional trial or participation in previousclinical trial of glaucoma.
15. Current use of, and unwilling to abstain from, over-the-counter additional vitaminB3/NAM oral supplements (including skin preparations such as ointments/emulsions),Ginkgo Biloba and/or Coenzyme Q10 supplements, throughout the duration of theirparticipation in the trial.