Clinical trial of wax-matrix sustained-release niacin in a Russian population with hypercholesterolemia.
OBJECTIVE
To assess the clinical effectiveness and tolerability of wax-matrix, controlled-release nicotinic acid (CNA) in persons with hypercholesterolemia.


METHODS
Randomized, double-blind, placebo controlled, crossover trial.


METHODS
Ambulatory clinic at an academic cardiology center in Moscow, Russia.


METHODS
A volunteer sample of 135 men and women, aged 20 to 70 years, with hypercholesterolemia greater than 5.82 mmol/L (225 mg/dL) (70th-95th percentile for age and sex) who otherwise met study inclusion and exclusion criteria, were initially recruited into the study. Cholesterol levels were reduced to less than 5.82 mmol/L (225 mg/dL) in 46 subjects who participated in the initial diet intervention and were excluded from the drug intervention. Eighty-nine subjects were randomized into the clinical trial; 4 subjects (4.5%) dropped out of the study because of intolerance of CNA.


METHODS
Eight weeks of diet alone (American Heart Association Step I Diet) was followed by randomization to 2 treatment groups (1500 mg/d CNA [ENDURACIN] or placebo) for 2 months followed by a crossover of treatments for 2 months, followed by all subjects taking 2000 mg/d of CNA for 2 months.


METHODS
Significant improvements in baseline measures for total serum cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were observed after initial diet (TC, 6%; LDL-C, 6%; P < .001, t test), after 1500 mg/d CNA (TC, 14%; LDL-C, 18%; P < .001, t test), and after 2000 mg/d CNA (TC, 16%; LDL-C, 21%; P < .001, t test). Triglyceride, high-density lipoprotein cholesterol, and lipoprotein(a) levels also improved. No serious toxic reactions were encountered, and 4 subjects withdrew from the study because of intolerance of cutaneous and gastrointestinal adverse effects.


CONCLUSIONS
Wax-matrix CNA is an effective and well-tolerated pharmacological treatment for hypercholesterolemia.
Aronov
D M
DM
National Research Centre for Preventive Medicine, Moscow, Russia.
Keenan
J M
JM
Akhmedzhanov
N M
NM
Perova
N V
NV
Oganov
R Y
RY
Kiseleva
N Y
NY
D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D002784:Cholesterol / Q000097:blood; D018592:Cross-Over Studies; D003692:Delayed-Action Preparations; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009031:Moscow; D009525:Niacin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D014677:Pharmaceutical Vehicles; D016896:Treatment Outcome
D003692:Delayed-Action Preparations; D008055:Lipids; D014677:Pharmaceutical Vehicles; D009525:Niacin; D002784:Cholesterol