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Prolonged-release nicotinic acid for the management of dyslipidemia: an update including results from the NAUTILUS study.

Vogt A, Kassner U, Hostalek U, Steinhagen-Thiessen E - Vasc Health Risk Manag (2007)

Bottom Line: Nicotinic acid (niacin in the US) is the most effective means of increasing HDL-cholesterol available and has been shown to reduce cardiovascular event rates significantly.The most common side-effect of Niaspan is flushing, which infrequently causes treatment discontinuation and which usually subsides over continued treatment.The effect of Niaspan-statin treatment, relative to a statin alone, on clinical cardiovascular outcomes is currently under evaluation.

View Article: PubMed Central - PubMed

Affiliation: Charité-Universitätsmedizin Berlin, Campus Virchow- Klinikum, Interdisziplinäres Stoffwechsel-Centrum, Lipidambulanz,Augustenburger Platz I, 13353 Berlin, Germany. anja.vogt@charite.de

ABSTRACT
Low HDL-cholesterol (<1.02 mmol/L [40 mg/dL] in men or <1.29 mmol/L [50 mg/dL] in women) occurs in about one-third of European patients with dyslipidemia and is an independent cardiovascular risk factor. Simultaneous correction of low HDL-cholesterol and high total-cholesterol and LDL-cholesterol may provide reductions in cardiovascular morbidity and mortality beyond those possible with statins alone. Nicotinic acid (niacin in the US) is the most effective means of increasing HDL-cholesterol available and has been shown to reduce cardiovascular event rates significantly. Niaspan (prolonged-release nicotinic acid) provides a convenient, once-daily means of administering nicotinic acid. Clinical studies with Niaspan have demonstrated marked, long-term increases in HDL-cholesterol with additional useful benefits on triglycerides, LDL-cholesterol, and lipid sub-profiles. The NAUTILUS study demonstrated the beneficial efficacy and tolerability profiles of Niaspan in a usual-care setting. The most common side-effect of Niaspan is flushing, which infrequently causes treatment discontinuation and which usually subsides over continued treatment. The ARBITER 2 and ARBITER 3 studies showed 1-2 years of treatment with Niaspan plus a statin induced regression of atherosclerosis in patients with coronary artery disease. The effect of Niaspan-statin treatment, relative to a statin alone, on clinical cardiovascular outcomes is currently under evaluation. Niaspan represents a practical means of correcting low HDL-cholesterol, an independent risk factor for adverse cardiovascular outcomes.

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Related in: MedlinePlus

Comparison of effects on lipids of combinations of nicotinic acid with a statin in comparison with a combination of a statin with ezetimibe or rosuvastatin monotherapy in a 12-week, open-label, randomized trial in 292 patients indicated for LDL-cholesterol lowering therapy. Patients received rosuvastatin (20–40 mg), rosuvastatin plus Niaspan® (10/1000 mg or 20/1000 mg), atorvastatin plus Niaspan® (20/1000 mg or 40/2000 mg), or simvastatin plus ezetimibe (20/10 mg or 40/10 mg). Significance values are from ANOVA across groups. Drawn from data presented by McKenney et al (2006).
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fig3: Comparison of effects on lipids of combinations of nicotinic acid with a statin in comparison with a combination of a statin with ezetimibe or rosuvastatin monotherapy in a 12-week, open-label, randomized trial in 292 patients indicated for LDL-cholesterol lowering therapy. Patients received rosuvastatin (20–40 mg), rosuvastatin plus Niaspan® (10/1000 mg or 20/1000 mg), atorvastatin plus Niaspan® (20/1000 mg or 40/2000 mg), or simvastatin plus ezetimibe (20/10 mg or 40/10 mg). Significance values are from ANOVA across groups. Drawn from data presented by McKenney et al (2006).

Mentions: Addition of the cholesterol absorption inhibitor, ezetimibe, increases the efficacy of statins on additional lowering of LDL-cholesterol (Robinson and Davidson 2006). The efficacy of this combination was compared with that of Niaspan® – statin combinations in 292 patients indicated for management of LDL-cholesterol according to US cardiovascular management guidelines in a 12-week, randomized trial (McKenney et al 2006). Reductions in LDL-cholesterol were similar between treatments, but Niaspan®-rosuvastatin, and Niaspan® – atorvastatin regimens were more effective in increasing HDL-cholesterol and in reducing triglycerides, compared with simvastatin in combination with ezetimibe or rosuvastatin monotherapy (Figure 3).


Prolonged-release nicotinic acid for the management of dyslipidemia: an update including results from the NAUTILUS study.

Vogt A, Kassner U, Hostalek U, Steinhagen-Thiessen E - Vasc Health Risk Manag (2007)

Comparison of effects on lipids of combinations of nicotinic acid with a statin in comparison with a combination of a statin with ezetimibe or rosuvastatin monotherapy in a 12-week, open-label, randomized trial in 292 patients indicated for LDL-cholesterol lowering therapy. Patients received rosuvastatin (20–40 mg), rosuvastatin plus Niaspan® (10/1000 mg or 20/1000 mg), atorvastatin plus Niaspan® (20/1000 mg or 40/2000 mg), or simvastatin plus ezetimibe (20/10 mg or 40/10 mg). Significance values are from ANOVA across groups. Drawn from data presented by McKenney et al (2006).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2291331&req=5

fig3: Comparison of effects on lipids of combinations of nicotinic acid with a statin in comparison with a combination of a statin with ezetimibe or rosuvastatin monotherapy in a 12-week, open-label, randomized trial in 292 patients indicated for LDL-cholesterol lowering therapy. Patients received rosuvastatin (20–40 mg), rosuvastatin plus Niaspan® (10/1000 mg or 20/1000 mg), atorvastatin plus Niaspan® (20/1000 mg or 40/2000 mg), or simvastatin plus ezetimibe (20/10 mg or 40/10 mg). Significance values are from ANOVA across groups. Drawn from data presented by McKenney et al (2006).
Mentions: Addition of the cholesterol absorption inhibitor, ezetimibe, increases the efficacy of statins on additional lowering of LDL-cholesterol (Robinson and Davidson 2006). The efficacy of this combination was compared with that of Niaspan® – statin combinations in 292 patients indicated for management of LDL-cholesterol according to US cardiovascular management guidelines in a 12-week, randomized trial (McKenney et al 2006). Reductions in LDL-cholesterol were similar between treatments, but Niaspan®-rosuvastatin, and Niaspan® – atorvastatin regimens were more effective in increasing HDL-cholesterol and in reducing triglycerides, compared with simvastatin in combination with ezetimibe or rosuvastatin monotherapy (Figure 3).

Bottom Line: Nicotinic acid (niacin in the US) is the most effective means of increasing HDL-cholesterol available and has been shown to reduce cardiovascular event rates significantly.The most common side-effect of Niaspan is flushing, which infrequently causes treatment discontinuation and which usually subsides over continued treatment.The effect of Niaspan-statin treatment, relative to a statin alone, on clinical cardiovascular outcomes is currently under evaluation.

View Article: PubMed Central - PubMed

Affiliation: Charité-Universitätsmedizin Berlin, Campus Virchow- Klinikum, Interdisziplinäres Stoffwechsel-Centrum, Lipidambulanz,Augustenburger Platz I, 13353 Berlin, Germany. anja.vogt@charite.de

ABSTRACT
Low HDL-cholesterol (<1.02 mmol/L [40 mg/dL] in men or <1.29 mmol/L [50 mg/dL] in women) occurs in about one-third of European patients with dyslipidemia and is an independent cardiovascular risk factor. Simultaneous correction of low HDL-cholesterol and high total-cholesterol and LDL-cholesterol may provide reductions in cardiovascular morbidity and mortality beyond those possible with statins alone. Nicotinic acid (niacin in the US) is the most effective means of increasing HDL-cholesterol available and has been shown to reduce cardiovascular event rates significantly. Niaspan (prolonged-release nicotinic acid) provides a convenient, once-daily means of administering nicotinic acid. Clinical studies with Niaspan have demonstrated marked, long-term increases in HDL-cholesterol with additional useful benefits on triglycerides, LDL-cholesterol, and lipid sub-profiles. The NAUTILUS study demonstrated the beneficial efficacy and tolerability profiles of Niaspan in a usual-care setting. The most common side-effect of Niaspan is flushing, which infrequently causes treatment discontinuation and which usually subsides over continued treatment. The ARBITER 2 and ARBITER 3 studies showed 1-2 years of treatment with Niaspan plus a statin induced regression of atherosclerosis in patients with coronary artery disease. The effect of Niaspan-statin treatment, relative to a statin alone, on clinical cardiovascular outcomes is currently under evaluation. Niaspan represents a practical means of correcting low HDL-cholesterol, an independent risk factor for adverse cardiovascular outcomes.

Show MeSH
Related in: MedlinePlus