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In an 8-week open-label trial, a group of researchers evaluated the effect of Clostridium butyricum MIYAIRI 588 (CBM588) in patients with treatment-resistant MMD in an open-label study (Miyaoka et al., 2018)

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Its FDA approval is built on this exact outcome, and the clinical evidence is robust

Results After a mean follow-up period of 7 years, event rates per 1000 person-years were 3.08 for MI, 3.72 for CHD, 1.12 for HF, 0.84 for stroke and 6.25 for cardiovascular mortality

Gabarin N, Gavish H, Muhlrad A, Chen YC, Namdar-Attar M, Nissenson RA, et al

ACMSD: a novel target for modulating NAD(+) homeostasis