Prolonged-release nicotinic acid for the management of dyslipidemia: an update including results from the NAUTILUS study.
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.
Vogt
Anja
A
Charité-Universitätsmedizin Berlin, Campus Virchow- Klinikum, Interdisziplinäres Stoffwechsel-Centrum, Lipidambulanz,Augustenburger Platz I, 13353 Berlin, Germany. anja.vogt@charite.de
Kassner
Ursula
U
Hostalek
Ulrike
U
Steinhagen-Thiessen
Elisabeth
E
D000069059:Atorvastatin; D001384:Azetidines / Q000627:therapeutic use; D008076:Cholesterol, HDL / Q000187:drug effects; D003692:Delayed-Action Preparations; D004359:Drug Therapy, Combination; D050171:Dyslipidemias / Q000188:drug therapy*; D000069438:Ezetimibe; D005464:Fluorobenzenes / Q000627:therapeutic use; D006538:Heptanoic Acids / Q000627:therapeutic use; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D009525:Niacin / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use; D011758:Pyrroles / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D000068718:Rosuvastatin Calcium; D019821:Simvastatin / Q000627:therapeutic use; D013449:Sulfonamides / Q000627:therapeutic use
D001384:Azetidines; D008076:Cholesterol, HDL; D003692:Delayed-Action Preparations; D005464:Fluorobenzenes; D006538:Heptanoic Acids; D000960:Hypolipidemic Agents; D011743:Pyrimidines; D011758:Pyrroles; D013449:Sulfonamides; D009525:Niacin; D000068718:Rosuvastatin Calcium; D000069059:Atorvastatin; D019821:Simvastatin; D000069438:Ezetimibe