Prolonged-release nicotinic acid in patients with atherosclerotic disease in the Netherlands.
OBJECTIVE
High-density lipoprotein (HDL) cholesterol elevation is associated with an improved outcome in patients with atherosclerotic disease. Niaspan, a prolonged-release nicotinic acid, was evaluated during the Niaspan-Induced HDL Elevation for Optimizing Risk Control (NEMO) study in The Netherlands.


METHODS
NEMO was a 6-month, prospective, observational, multicentre, open-label study. Niaspan was prescribed in statin-treated patients with known or suspected atherosclerotic disease. The main outcome measures were treatment-related adverse drug reactions (ADRs) and effects on lipids and cardiovascular-risk score based on the algorithm derived from the Prospective Cardiovascular Münster study.


RESULTS
612 patients were included in The Netherlands. Flushing was the most common ADR (29% of patients during the first month of treatment). The main reasons for treatment discontinuation were flushing (10.5%), patient request (8.0%) and being lost to follow-up (6.0%). About half of all patients (52%) continued treatment after the study. Tolerability was rated 'good' or 'very good' in 54% of these patients. HDL cholesterol increased by 23% from baseline, and triglycerides were reduced by 16%, with little change in low-density lipoprotein or total cholesterol. Cardiovascular risk score was reduced by 3.3 points.


CONCLUSIONS
The use of the prolonged-release nicotinic acid Niaspan in patients with or at risk for atherosclerotic disease showed good tolerability, a marked increase in HDL cholesterol and a reduced cardiovascular risk score.
Poldermans
D
D
Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands. d.poldermans@erasmusmc.nl
Dunkelgrun
M
M
Schouten
O
O
Hostalek
U
U
D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000188:drug therapy*; D002318:Cardiovascular Diseases / Q000517:prevention & control; D008076:Cholesterol, HDL / Q000097:blood; D003692:Delayed-Action Preparations; D005260:Female; D005483:Flushing / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D009525:Niacin / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies
D008076:Cholesterol, HDL; D003692:Delayed-Action Preparations; D009525:Niacin