NICEVIVA
MONOGRAPH SPEC LATEST 2026

Molybdenum

MINERALS · Evidence Monograph

Molybdenum is an evidence-graded minerals monograph evaluated across 30 peer-reviewed PubMed studies (4 meta-analyses, 4 systematic reviews, and 6 randomized controlled trials, encompassing n = 115,928 cumulative participants). Current clinical evidence is rated GRADE High (4.0 / 4.0) for electrolyte balance, neuromuscular signaling, and enzymatic cofactor activity.

Evidence Grade (GRADE) High (4.0 / 4.0)
Indexed PubMed Studies 30 Studies
Meta-Analyses · Reviews 4 Meta · 4 Systematic Reviews
Randomized Trials (RCT) 6 RCTs (1 Double-Blind)
Cumulative Participants n = 115,928
Reported Trial Dosages 160 g · 15 mg/day
Trial Duration Range 12 weeks
Reading Time ~15 min
RECOMMENDED FOR Clinical Indication

Evidence Supports Supplementation When:

  1. 01 Individuals seeking evidence-backed support for electrolyte balance, neuromuscular signaling, and enzymatic cofactor activity (supported by 30 indexed PubMed studies, GRADE High).
  2. 02 Adults matching clinical trial dosing protocols (160 g · 15 mg/day) over a structured 12 weeks evaluation window.
  3. 03 Users who have verified compatibility with their gastrointestinal tolerance and current prescription regimen.
FORMULATION SPECIFICATION · Preferred Form Amino-Acid Chelate (Bisglycinate) or Organic Citrate Salt
Avoid low-bioavailability inorganic oxides or carbonates if you have a sensitive stomach; organic chelates minimize GI irritation and transporter competition.
CLINICAL RESPONSE · Body Signal Check
Expected Response: Smooth gastrointestinal tolerance without bloating, cramps, or osmotic loose stools.
Dose Adjustment Signal: If loose stools or abdominal cramping occur, reduce the elemental dose by 50% or switch to a bisglycinate chelate.
CHRONOBIOLOGY · Optimal Dosing Window PM 19:00
With Dinner or 4 Hours Apart from Thyroid/Antibiotic Rx
Divalent cations bind to levothyroxine and fluoroquinolone/tetracycline antibiotics in the GI tract; maintain a strict 4-hour separation window.
Primary Clinical Endpoints & Physiological Biomarkers Studied Based on Indexed PubMed Trials
cancer (PubMed clinical endpoint)
liver (PubMed clinical endpoint)
weight (PubMed clinical endpoint)
antioxidant (PubMed clinical endpoint)
01

What Is Molybdenum & Why Does Form Matter?

Molybdenum is classified under MINERALS and has been investigated across 30 peer-reviewed PubMed publications for its role in electrolyte balance, neuromuscular signaling, and enzymatic cofactor activity.

In clinical nutrition, physiological efficacy depends heavily on the specific chemical salt, chelate, or standardized extract used, as well as adherence to trial-validated dosing (160 g, 15 mg/day).

02

Who Benefits Most & Common Depletion Factors

Suboptimal status or increased physiological demand for Molybdenum frequently arises from restrictive dietary patterns, age-related declines in gastrointestinal absorption, chronic metabolic stress, or medication-induced nutrient depletion.

Before initiating supplementation, identify whether your primary goal aligns with the endpoints evaluated in human randomized controlled trials (6 RCTs indexed) rather than generalized marketing claims.

03

Physiological Mechanism of Action

Within human physiology, Molybdenum acts on pathways governing electrolyte balance, neuromuscular signaling, and enzymatic cofactor activity. Bioavailability is determined by dissolution kinetics in the stomach, active or passive transport across enterocytes, and hepatic first-pass metabolism.

Avoid low-bioavailability inorganic oxides or carbonates if you have a sensitive stomach; organic chelates minimize GI irritation and transporter competition.

04

PubMed Clinical Evidence & GRADE Evaluation

NICEVIVA assigns Molybdenum an overall evidence rating of GRADE High (4.0 / 4.0) based on 30 PubMed studies: 4 meta-analyses, 4 systematic reviews, and 6 randomized controlled trials (1 double-blind, n = 115,928 total participants).

Representative peer-reviewed findings include: • PMID:37872256 (2023) — "Change in Mineral Status After Bariatric Surgery: a Meta-analysis." (CONCLUSION: A high deficiency rate of serum iron, zinc, copper, chlorine, phosphorus, and calcium was seen after bariatric surgery.) • PMID:35365361 (2022) — "ESPEN micronutrient guideline." (CONCLUSION: This guideline should enable addressing suboptimal and deficient status of a bundle of MNs in at-risk diseases.) • PMID:24265326 (2013) — "A meta-analysis of the effects of dietary copper, molybdenum, and sulfur on plasma and liver copper, weight gain, and feed conversion in growing-finishing cattle." (In conclusion, dietary Cu, Mo, and S and the Cu:Mo ratio caused changes in plasma Cu.)

Quantitative Clinical Effect-Size Distribution (Forest Plot)

Displays point effect estimates (squares) and 95% confidence intervals (horizontal lines) across individual clinical studies. Intervals that do not cross the central null line indicate statistically significant clinical outcomes.

415582071.3 (1.08–1.48)361094721.7 (1.44–2.01)0.215OR (favours ← / →)
05

Formulation Selection, Dosing & Chronobiology

Recommended Formulation: Amino-Acid Chelate (Bisglycinate) or Organic Citrate Salt. Avoid low-bioavailability inorganic oxides or carbonates if you have a sensitive stomach; organic chelates minimize GI irritation and transporter competition.

Clinical Trial Dosing & Timing: Published studies most commonly utilize 160 g · 15 mg/day over 12 weeks. Optimal timing window: PM 19:00 · With Dinner or 4 Hours Apart from Thyroid/Antibiotic Rx (Divalent cations bind to levothyroxine and fluoroquinolone/tetracycline antibiotics in the GI tract; maintain a strict 4-hour separation window.).

06

Body Response Monitoring & Dose Adjustment

Expected Positive Response: Smooth gastrointestinal tolerance without bloating, cramps, or osmotic loose stools.

Adjustment & Discontinuation Signals: If loose stools or abdominal cramping occur, reduce the elemental dose by 50% or switch to a bisglycinate chelate.

07

Prescription Drug Interactions & Contraindications

No major high-risk prescription contraindications are flagged in the primary index for Molybdenum, but divalent minerals, fat-soluble compounds, and botanical extracts can still alter absorption or CYP450 metabolism of concurrent medications.

Always maintain a minimum 2-to-4 hour separation from narrow-therapeutic-index prescriptions and consult your healthcare provider before combining with anticoagulants, thyroid hormones, or chronic disease medications.

08

4 Essential Safety Rules Before & After Dosing

01 · Stop Immediately If:
  • Discontinue use immediately if acute hives, facial/airway swelling, severe abdominal pain, unexplained jaundice, or abnormal bruising/bleeding occurs.
  • Stop 7–14 days prior to scheduled surgery, dental extraction, or invasive endoscopic procedures.
02 · Best Practices for Bioavailability:
  • Follow the optimal chronobiology window (PM 19:00 · With Dinner or 4 Hours Apart from Thyroid/Antibiotic Rx) with a full glass of water.
  • Stay within clinically studied daily dosages (160 g · 15 mg/day) and re-evaluate efficacy after 12 weeks.
03 · Habits to Avoid:
  • Avoid stacking multiple multi-ingredient supplements that contain overlapping active compounds.
  • Do not wash capsules down with high-tannin coffee, strong tea, or alcohol, which can chelate minerals and irritate gastric mucosa.
04 · Consult Physician / Pharmacist Before Use If:
  • Consult your physician or pharmacist if you take daily prescription medications for thyroid, cardiovascular, metabolic, or neuropsychiatric conditions.
  • Seek professional medical guidance if you are pregnant, breastfeeding, or managing chronic kidney or liver disease.
09 · PUBMED CLINICAL STUDIES

Indexed PubMed Clinical Studies & Abstracts (30 Studies) · 12 Quantitative Analyses

01
META-ANALYSIS Obesity surgery (2023) PMID: 37872256 ↗
Change in Mineral Status After Bariatric Surgery: a Meta-analysis.
Clinical Trial Synthesis 2023 Meta-Analysis published in Obesity surgery involving n = 47,432 participants. Key conclusion: CONCLUSION: A high deficiency rate of serum iron, zinc, copper, chlorine, phosphorus, and calcium was seen after bariatric surgery.
View Original PubMed Abstract ↓

BACKGROUND: The risk of protein and vitamin deficiencies after bariatric surgery has been well studied, but the change in mineral status has not gotten enough attention. This study aimed to perform a meta-analysis regarding the change in mineral levels after bariatric surgery and the prevalence of postoperative mineral deficiency, with subgroup analyses of different surgical procedures, study regions, and follow-up time. METHODS: CENTRAL, PubMed, and EMBASE were searched for related articles. Meta-analysis, subgroup analysis, and sensitivity analysis were performed if necessary. RESULTS: A total of 107 articles with 47,432 patients were included. The most severe mineral deficiency after bariatric surgery was iron (20.1%), followed by zinc (18.3%), copper (14.4%), chlorine (12.2%), phosphorus (7.5%), and calcium (7.4%). Serum concentrations of potassium, sodium, selenium, manganese, and molybdenum showed no significant change before and after surgery. Subgroup analyses revealed that SG had fewer deficiencies in serum iron, calcium, zinc, magnesium, phosphorus, copper, and selenium than RYGB. OAGB showed a higher incidence of serum iron and zinc deficiencies than RYGB. Studies conducted in different regions also found various mineral statuses after surgery. Studies with follow-up ≥ 5 years had a lower prevalence of zinc, copper, and selenium deficiencies than follow-up < 5 years. CONCLUSION: A high deficiency rate of serum iron, zinc, copper, chlorine, phosphorus, and calcium was seen after bariatric surgery. The difference in surgical procedures, study regions, and follow-up time may affect postoperative mineral status; more targeted mineral supplement programs are needed considering these influencing factors. © 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

02
CLINICAL STUDY Clinical nutrition (Edinburgh, Scotland) (2022) PMID: 35365361 ↗
ESPEN micronutrient guideline.
Clinical Trial Synthesis 2022 Meta-Analysis published in Clinical nutrition (Edinburgh, Scotland). Key conclusion: CONCLUSION: This guideline should enable addressing suboptimal and deficient status of a bundle of MNs in at-risk diseases.
View Original PubMed Abstract ↓

BACKGROUND: Trace elements and vitamins, named together micronutrients (MNs), are essential for human metabolism. Recent research has shown the importance of MNs in common pathologies, with significant deficiencies impacting the outcome. OBJECTIVE: This guideline aims to provide information for daily clinical nutrition practice regarding assessment of MN status, monitoring, and prescription. It proposes a consensus terminology, since many words are used imprecisely, resulting in confusion. This is particularly true for the words "deficiency", "repletion", "complement", and "supplement". METHODS: The expert group attempted to apply the 2015 standard operating procedures (SOP) for ESPEN which focuses on disease. However, this approach could not be applied due to the multiple diseases requiring clinical nutrition resulting in one text for each MN, rather than for diseases. An extensive search of the literature was conducted in the databases Medline, PubMed, Cochrane, Google Scholar, and CINAHL. The search focused on physiological data, historical evidence (published before PubMed release in 1996), and observational and/or randomized trials. For each MN, the main functions, optimal analytical methods, impact of inflammation, potential toxicity, and provision during enteral or parenteral nutrition were addressed. The SOP wording was applied for strength of recommendations. RESULTS: There was a limited number of interventional trials, preventing meta-analysis and leading to a low level of evidence. The recommendations underwent a consensus process, which resulted in a percentage of agreement (%): strong consensus required of >90% of votes. Altogether the guideline proposes sets of recommendations for 26 MNs, resulting in 170 single recommendations. Critical MNs were identified with deficiencies being present in numerous acute and chronic diseases. Monitoring and management strategies are proposed. CONCLUSION: This guideline should enable addressing suboptimal and deficient status of a bundle of MNs in at-risk diseases. In particular, it offers practical advice on MN provision and monitoring during nutritional support.

03
META-ANALYSIS Journal of animal science (2013) PMID: 24265326 ↗
A meta-analysis of the effects of dietary copper, molybdenum, and sulfur on plasma and liver copper, weight gain, and feed conversion in growing-finishing cattle.
Clinical Trial Synthesis 2013 Meta-Analysis published in Journal of animal science; statistical significance reported at p = 0.01. Key conclusion: In conclusion, dietary Cu, Mo, and S and the Cu:Mo ratio caused changes in plasma Cu.
View Original PubMed Abstract ↓

The minerals Cu, Mo, and S are essential for metabolic functions related to cattle health and performance. The interaction between Cu, Mo, and S can determine the utilization of each mineral, in particular Cu, by ruminants. A meta-analysis was performed to evaluate the effects of dietary Cu, Mo, and S and their interactions on plasma and liver Cu, ADG, and G:F in growing-finishing cattle. Data were collated from 12 published studies. The model with the best fit to data indicated plasma Cu was positively affected by dietary Cu (P < 0.01) and negatively affected by both dietary Mo (P < 0.01) and S (P < 0.01). Another model also indicated that plasma Cu concentration is positively related to Cu:Mo ratio in the diet (P < 0.01). Dietary Cu had a positive effect on liver Cu (P < 0.01), whereas Mo showed a negative effect (P < 0.05), and no effect of dietary S on liver Cu was observed (P > 0.05). Average daily gain was negatively affected by dietary Mo (P < 0.05) and S (P < 0.01) and positively affected by Cu:Mo ratio (P < 0.01), likely because an increased Cu:Mo ratio minimizes the antagonistic effect of Mo on Cu. The feed conversion ratio was negatively affected by Mo (P < 0.05) and S (P < 0.01), whereas effects of the Cu:Mo ratio and dietary Cu were not significant (P > 0.05). The interaction between S and Mo affected (P < 0.01) G:F, which was likely related to a positive response with the proper balance between these minerals. In conclusion, dietary Cu, Mo, and S and the Cu:Mo ratio caused changes in plasma Cu. Only dietary Mo and S led to a negative response in the performance of growing-finishing cattle, whereas the diet Cu:Mo ratio has a linear and quadratic effect on ADG. Nutritionists and producers need to consider with caution the supplementation of growing-finishing cattle diets with Mo and S because of their potentially adverse effects on animal performance. An appropriate Cu:Mo ratio is desirable to minimize the effects of an impaired supply of Mo on Cu metabolism and ADG.

04
CLINICAL STUDY Journal of general internal medicine (2006) PMID: 16808775 ↗
Antioxidants vitamin C and vitamin e for the prevention and treatment of cancer.
Clinical Trial Synthesis 2006 Meta-Analysis published in Journal of general internal medicine (RR 0.64). Key conclusion: CONCLUSIONS: The systematic review of the literature does not support the hypothesis that the use of supplements of vitamin C or vitamin E in the doses tested helps prevent and/or treat cancer in the populations tested.
View Original PubMed Abstract ↓

OBJECTIVE: To evaluate the evidence of the supplements vitamin C and vitamin E for treatment and prevention of cancer. METHODS: Systematic review of trials and meta-analysis. DATA SOURCES AND MAIN RESULTS: Thirty-eight studies showed scant evidence that vitamin C or vitamin E beneficially affects survival. In the ATBC Cancer Prevention Study Group, no statistically significant effect of treatment was seen for any cancer individually, and our pooled relative risk (regardless of tumor type) for alpha-tocopherol alone was 0.91 (95% confidence interval [CI]: 0.74, 1.12). All cause mortality was not significant. In the Linxian General Population Trial, the relative risks for cancer death for vitamin C (combined with molybdenum) was 1.06 (95% CI: 0.92, 1.21) and for vitamin E (combined with beta-carotene and selenium) was 0.87 (95% CI: 0.76, 1.00). We identified only 3 studies that reported statistically significant beneficial results: vitamin C (in combination with BCG) was found to be beneficial in a single trial of bladder cancer and vitamin E (in combination with omega-3 fatty acid) increased survival in patients with advanced cancer. In the ATBC trial, in analyses of 6 individual cancers, the prevention of prostate cancer in subjects treated with alpha-tocopherol was statistically significant (RR=0.64, 95% CI: 0.44, 0.94). CONCLUSIONS: The systematic review of the literature does not support the hypothesis that the use of supplements of vitamin C or vitamin E in the doses tested helps prevent and/or treat cancer in the populations tested. There were isolated findings of benefit, which require confirmation.

05
RANDOMIZED TRIAL (RCT) Nutrients (2025) PMID: 41515120 ↗
Biofortification of Vegetables with Iodine and Molybdenum for Healthy Nutrition: A Controlled Trial.
Clinical Trial Synthesis 2025 Randomized Controlled Trial (RCT) published in Nutrients. Key conclusion: Conclusions: These biochemical markers reflect early metabolic adaptations that may inform future research on the metabolic impact of micronutrient biofortification.
View Original PubMed Abstract ↓

Background/Objectives: Excessive sugar, fat, and salt intake heighten susceptibility to metabolic syndrome and other chronic metabolic conditions. Biofortification (i.e., enhancing the nutritional content of crops) emerges as a sustainable new approach to address dietary deficiencies. Methods: This study evaluated the impact of an acute nutritional intervention in a controlled, randomized, single-blind trial involving healthy adults aged 50-79 years, in late middle age and early older adulthood utilizing biofortified vegetables enriched with iodine and molybdenum, aimed to explore short-term biochemical responses to the consumption of iodine- and molybdenum-biofortified lettuce. The study was designed as a controlled dietary intervention including both a biofortified and a non-biofortified lettuce group, matched for handling and composition. It was powered to detect short-term biochemical responses, providing initial insights into the physiological impact of micronutrient biofortification. Dietary intake was carefully monitored throughout the 12-day period to control for confounding dietary effects. Results: The intervention was associated with decreased plasma levels of triglycerides, AST, and ALT, and increased plasma levels of HDL-cholesterol and the satiety hormone PYY, suggesting enhanced metabolic regulation. Conclusions: These biochemical markers reflect early metabolic adaptations that may inform future research on the metabolic impact of micronutrient biofortification. This study also highlights the potential of crop biofortification as a sustainable, strategy to enhance the nutrient density of vegetables within controlled dietary patterns.

06
CLINICAL STUDY Nutrition (Burbank, Los Angeles County, Calif.) (2026) PMID: 41478212 ↗
Plasma proteomic profiles reveal immune modulation by immunonutrition in GI cancer.
Clinical Trial Synthesis 2026 Randomized Controlled Trial (RCT) published in Nutrition (Burbank, Los Angeles County, Calif.) involving n = 50 participants; statistical significance reported at p = 0.05. Key conclusion: CONCLUSIONS: This exploratory study suggests that immunonutrition may modulate complement activation and immune pathways, supporting better postoperative outcomes in GI cancer patients.
View Original PubMed Abstract ↓

BACKGROUND: Gastrointestinal (GI) cancer patients undergoing surgery often face immunosuppression, increasing postoperative risk. Immunomodulatory enteral nutrition (IEN) may enhance immune function and recovery, but mechanisms remain unclear. This study compared plasma proteomic profiles of patients receiving IEN versus standard enteral nutrition (SEN) to explore pathways linked to outcomes. METHODS: This analysis extended a previously published randomized clinical trial in GI cancer patients who received SEN or IEN postoperatively, with 50 patients in each group. The IEN was rich in arginine, nucleotides, vitamin B12, chloride, vitamin C, selenium, chromium, and molybdenum. Plasma samples were analyzed using mass spectrometry-based proteomics (MassLynx v4.1 and Progenesis v4.1). Proteins consistently detected across replicates (database search P < 0.05) were identified. Clinical outcomes, including complications and biochemical markers, were integrated with proteomic findings to interpret biological mechanisms. RESULTS: Distinct proteomic profiles were observed. The IEN group showed higher levels of complement proteins (C3, C5, C9), inter-alpha-trypsin inhibitor heavy chain H2, pregnancy zone protein, immunoglobulins, and apolipoproteins-proteins linked to immune modulation, tissue repair, and inflammation control. The SEN group displayed elevated acute-phase proteins and coagulation factors, including fibrinogen and serum amyloid A-4, consistent with a pro-inflammatory, hypercoagulable state. These differences paralleled clinical results, with the IEN group experiencing fewer complications and improved albumin/globulin ratios. CONCLUSIONS: This exploratory study suggests that immunonutrition may modulate complement activation and immune pathways, supporting better postoperative outcomes in GI cancer patients. The proteomic profile provides evidence that supports a mechanistic hypothesis underlying the observed clinical benefits. Future quantitative proteomics with larger cohorts is warranted to validate these findings and optimize perioperative nutrition strategies.

07
RANDOMIZED TRIAL (RCT) Journal of orthodontics (2025) PMID: 39049618 ↗
Position and root resorption of the incisors following anterior segment retraction using friction versus frictionless mechanics: A randomised controlled trial.
Clinical Trial Synthesis 2025 Randomized Controlled Trial (RCT) published in Journal of orthodontics (MD -2.04). Key conclusion: CONCLUSION: Considering the limitations in the current study, there was no advantage of either mechanics over the other regarding the final position of inc
View Original PubMed Abstract ↓

AIM: To evaluate the three-dimensional position and root resorption of incisors after anterior segment retraction (ASR) using friction versus frictionless mechanics. PARTICIPANTS AND METHODS: Thirty female patients (13-18 years) with bimaxillary protrusion were randomly allocated into two groups. In the intervention group, ASR was undertaken using an elastomeric chain rendering 160 g/side extending between mini-screw implant and a hook crimped on 0.017 × 0.025-inch stainless-steel wire distal to the lateral incisor. In the comparison group, ASR was undertaken using closing T-loops fabricated from 0.017 × 0.025-inch titanium molybdenum alloy (TMA) wire rendering comparable retraction force. In both groups, the canine brackets were ligated after retraction to the mini-screw implants that were inserted in both the upper and lower arches bilaterally. The primary outcome was the three-dimensional changes in the position of the incisors. The secondary outcome was root resorption. These were measured from cone-beam computed tomography scans. RESULTS: Statistically significant decreases in the upper (UI) and lower incisors (LI) crown torque were seen in both groups; however, the difference between groups was not statistically or clinically significant (UI MD -2.04°; 95% confidence interval [CI] = -8.02-3.95; LI MD -0.49°; 95% CI = -7.06-6.08). Significant tipping of upper (MD -1.17°; 95% CI = -2.06--0.27) and lower (MD -1.13°; 95% CI = -1.66--0.60) incisors was found in the friction, but not the frictionless group after retraction; however, the changes were not clinically significant. Significant lower incisor intrusion was found in both groups after retraction; however, the difference between groups was not statistically or clinically significant (MD -0.61°; 95% CI = -1.99-0.77). Statistically significant decreases in the UI and LI root length were seen in both groups. The difference between groups for UI changes was statistically significant (MD 0.54 mm; 95% CI = -0.02-1.07) but probably not clinically significant. CONCLUSION: Considering the limitations in the current study, there was no advantage of either mechanics over the other regarding the final position of inc

08
CLINICAL STUDY Journal of hepatology (2024) PMID: 38081365 ↗
Effects of tetrathiomolybdate on copper metabolism in healthy volunteers and in patients with Wilson disease.
Clinical Trial Synthesis 2024 Randomized Controlled Trial (RCT) published in Journal of hepatology. Key conclusion: In the present human study, TTM surprisingly did not facilitate biliary copper excretion but instead reduced intestinal copper uptake to a clinically significan
View Original PubMed Abstract ↓

BACKGROUND & AIMS: In Wilson disease (WD), copper accumulates in the liver and brain causing disease. Bis-choline tetrathiomolybdate (TTM) is a potent copper chelator that may be associated with a lower risk of inducing paradoxical neurological worsening than conventional therapy for neurologic WD. To better understand the mode of action of TTM, we investigated its effects on copper absorption and biliary excretion. METHODS: In a double-blind randomized setting, hepatic 64Cu activity was examined after orally administered 64Cu by PET/CT in 16 healthy volunteers before and after seven days of TTM treatment (15 mg/d) or placebo. Oral 64Cu was administered one hour after the final TTM dose. Changes in hepatic 64Cu activity reflected changes in intestinal 64Cu uptake. Additionally, in four patients with WD, the distribution of 64Cu in venous blood, liver, gallbladder, kidney, and brain was followed after i.v. 64Cu dosing for up to 68 hours before and after seven days of TTM (15 mg/day), using PET/MRI. Increased gallbladder 64Cu activity was taken as evidence of increased biliary 64Cu excretion. RESULTS: In healthy volunteers, TTM reduced intestinal 64Cu uptake by 82% 15 hours after the oral 64Cu dose. In patients with WD, gallbladder 64Cu activity was negligible before and after TTM, while TTM effectively retained 64Cu in the blood, significantly reduced hepatic 64Cu activity at all time-points and significantly reduced cerebral 64Cu activity two hours after the intravenous 64Cu dose. CONCLUSIONS: While we did not show an increase in biliary excretion of 64Cu following TTM administration, we demonstrated that TTM effectively inhibited most intestinal 64Cu uptake and retained 64Cu in the blood stream, limiting the exposure of organs like the liver and brain to 64Cu. IMPACT AND IMPLICATIONS: Bis-choline tetrathiomolybdate (TTM) is an investigational copper chelator being developed for the treatment of Wilson disease. In animal models of Wilson disease, TTM has been shown to facilitate biliary copper excretion. In the present human study, TTM surprisingly did not facilitate biliary copper excretion but instead reduced intestinal copper uptake to a clinically significan

09
RANDOMIZED TRIAL (RCT) Journal of orthopaedic surgery and research (2023) PMID: 37559133 ↗
Consequences of using poly-ether-ether-ketone versus traditional implant on tibial cement penetration and short-term clinical outcomes during total knee arthroplasty: a randomized controlled trial.
Clinical Trial Synthesis 2023 Randomized Controlled Trial (RCT) published in Journal of orthopaedic surgery and research involving n = 24 participants; statistical significance reported at p = 0.85. Key conclusion: CONCLUSIONS: Based on the current findings, it can be concluded that PEEK implant present similar bone cement penetration, short-term clinical outcomes, and survivorship with traditional CoCrMo implant in TKA without added complications.
View Original PubMed Abstract ↓

BACKGROUND: The use of poly-ether-ether-ketone (PEEK) prosthesis during total knee arthroplasty (TKA) is a relatively new concept. Several studies have suggested that the thickness of cement penetration during TKA may affect the stability of the implants. The present study aimed to compare the cement penetration and clinical performance between PEEK and traditional cobalt chromium molybdenum (CoCrMo) prosthesis during TKA. METHODS: This study was a randomized controlled trial with level I of evidence. A total of 48 patients were randomly assigned to either the PEEK group (n = 24) or the CoCrMo group (n = 24). Mean bone cement penetration under the tibial baseplate was assessed radiographically in four zones in the anteroposterior view and two zones in the lateral view, in accordance with the Knee Society Scoring System. Furthermore, parameters such as the Knee Society Score (KSS), visual analogue scale (VAS) scores, complications and survivorship at 1 year postoperatively were also compared. RESULTS: According to the results of this study, the mean bone cement penetration exhibited no significant difference between PEEK and CoCrMo groups (2.49 ± 0.61 mm vs. 2.53 ± 0.68 mm, p = 0.85). Additionally, there were no remarkable differences in the KSS clinical score, functional score, and VAS score between the two groups. Moreover, complications and survivorship were also statistically compared between the groups and presented no significant differences. CONCLUSIONS: Based on the current findings, it can be concluded that PEEK implant present similar bone cement penetration, short-term clinical outcomes, and survivorship with traditional CoCrMo implant in TKA without added complications. Trial registration Chinese Clinical Trial Registry (ChiCTR2100047563). © 2023. BioMed Central Ltd., part of Springer Nature.

10
RANDOMIZED TRIAL (RCT) The Journal of arthroplasty (2023) PMID: 35921997 ↗
A Novel Multilayer-Coating for Total Knee Arthroplasty Implants is Safe - 10-Year Results From a Randomized-Controlled Trial.
Clinical Trial Synthesis 2023 Randomized Controlled Trial (RCT) published in The Journal of arthroplasty involving n = 120 participants. Key conclusion: A slight increase in cobalt serum levels in the standard TKA was noted, thus not reaching critical values.
View Original PubMed Abstract ↓

BACKGROUND: This randomized-controlled trial was initiated to compare a new multilayer hypoallergenic coating system with the standard implant in total knee arthroplasty (TKA) in terms of serum metal ion levels, patient-reported outcomes (PROs), and implant survival. METHODS: A total of 120 patients were randomized to receive a coated or standard TKA of the same knee system. Serum metal ion levels (ie, cobalt, chromium, molybdenum, and nickel) as well as knee function (Oxford Knee Score, OKS), quality of life (SF-36), and physical activity (UCLA activity scale) were assessed before surgery and until the 10 year follow-up. A total of 24 patients died and there was one revision in each group. This resulted in 85 patients who completed follow-up. RESULTS: Both groups demonstrated equally good improvement in PROs after surgery and constant score values thereafter. The majority of patients had metal ion serum levels below detection limit. Only cobalt levels demonstrated a slight increase in the standard group at 5- and 10-year follow-up. However, all patients displayed values below 3 μg/L. The cumulative 10-year survival was 98% in both groups. CONCLUSION: There were no problems with the new coating system. No relevant increase in metal ion serum levels were measured. A slight increase in cobalt serum levels in the standard TKA was noted, thus not reaching critical values. The new coating system demonstrated equally good PROs as the standard TKA. Excellent implant survival was observed in both groups. LEVEL OF EVIDENCE: I.

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