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Methods: This study investigates (i) the enzymatic functions of CD38, (ii) the in vitro effects of DARA and ISA on CD38_mediated NAD + degradation in primary MM cells and a representative MM cell line, and (iii) the in vivo dynamics of ADO and its metabolite inosine (INO) in BM and peripheral blood (PB) plasma from MM patients receiving DARA monotherapy

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At the cellular level, NNMT inhibition is typically confirmed through direct enzyme activity assays alongside measurement of intracellular NAD+ and SAM concentrations before and after treatment — verifying that the proposed mechanism is actually happening at the biochemical level, not just inferred from the downstream weight and fat-mass outcomes