Evidence mapPaperPMID 41903085Full record

Trial reportClinical drug investigation2026

Alternative Dosing Strategies to Enhance the Absorption of N-Acetyl-D-Mannosamine Monohydrate (ManNAc) in Healthy Adult Males.

Tahlia R Meola, Kellie La Fontaine, James Condon, Paul Wabnitz, Gianfranco Fornasini, Allan M Evans, Stephanie E Reuter

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Clinical drug investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Tahlia R MeolaSchool of Pharmacy and Biomedical Science, Adelaide University, Adelaide, SA, Australia.
Kellie La FontaineSchool of Pharmacy and Biomedical Science, Adelaide University, Adelaide, SA, Australia.
James CondonSchool of Pharmacy and Biomedical Science, Adelaide University, Adelaide, SA, Australia.
Paul WabnitzSchool of Pharmacy and Biomedical Science, Adelaide University, Adelaide, SA, Australia.
Gianfranco FornasiniLeadiant Biosciences, Inc., Rockville, MD, USA.
Allan M Evans *School of Pharmacy and Biomedical Science, Adelaide University, Adelaide, SA, Australia.
Stephanie E Reuter *School of Pharmacy and Biomedical Science, Adelaide University, Adelaide, SA, Australia. Stephanie.ReuterLange@adelaide.edu.au.ORCID http://orcid.org/0000-0003-3888-7287

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGNE myopathy is a rare autosomal recessive muscle disease caused by biallelic mutations in GNE, a gene which encodes the bifunctional enzyme that catalyses the rate-limiting step of intracellular sialic acid biosynthesis. Whilst there is no current marketed therapy to treat the disease, current investigations focus on supplementation with N-acetyl-D-mannosamine monohydrate (ManNAc), a precursor in the biosynthesis of N-acetylneuraminic acid (Neu5Ac), the most abundant sialic acid. ManNAc possesses a low oral bioavailability, likely owing to poor absorption, and exhibits non-linearity across the therapeutic range, possibly due to saturation of intestinal transporter systems.

objectivesThe study was conducted to examine if the absorption of ManNAc could be improved by administering a smaller (non-saturating) oral dose, more frequently, or by co-administering ManNAc with dietary salt, which might facilitate carrier-mediated transport.

methodsThis was an open-label, randomised, cross-over study in 12 healthy male participants. Participants were administered 4 x 1 g doses of ManNAc every hour, 4 g ManNAc as a single dose with 1 g dietary salt or 4 g ManNAc alone.

resultsThe pharmacokinetic analysis population comprised 11 participants who received all three study treatments. Administration of ManNAc as split doses, more frequently, resulted in a 1.7-fold increase in ManNAc plasma exposure compared to a single 4 g dose, with a corresponding 1.9-fold increase in systemic Neu5Ac concentrations. In comparison, co-administration of ManNAc with dietary salt had no impact on ManNAc absorption.

conclusionsThis study suggests that strategies to slow down the delivery of ManNAc to the small intestine may significantly improve its overall bioavailability and therefore reduce total daily dose requirements. CLINICAL

trial registrationThe clinical trial was registered on the Australian New Zealand Clinical Trials Registry (ID: ACTRN12620001127998).

Indexed as

HexosaminesIntestinal AbsorptionAdministration, OralAdultBiological AvailabilityCross-Over StudiesDose-Response Relationship, DrugHumansMaleYoung AdultHexosaminesN-acetylmannosamine

Identifiers

PMID41903085
PMCPMC13102927

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.