title: Fixed-dose combination of extended-release niacin plus simvastatin for lipid disorders.
abstract: Coronary heart disease (CHD) carries significant morbidity and mortality worldwide. Elevated LDL-cholesterol and reduced HDL-cholesterol levels are well-recognized CHD risk factors. Despite guideline recommendations for intensive therapy among patients at high risk for CHD to lower LDL-cholesterol, such lowering has failed to prevent approximately two-thirds of cardiovascular events. As a result of new data, guidelines have begun to focus on non-HDL-cholesterol, HDL-cholesterol and triglycerides as treatment targets, with the end result being a recommendation for combination therapy, such as niacin plus statin for the treatment of dyslipidemia. Compared with statin monotherapy, a combination of niacin and statin therapy provides beneficial effects on a broad range of lipid particles and some evidence suggests a further reduction in CHD risk. Recent studies have shown that the combination of a fixed dose of extended-release niacin plus simvastatin reduces non-HDL-cholesterol, LDL-cholesterol, triglycerides and total cholesterol:HDL-cholesterol ratio by approximately 50% while increasing HDL-cholesterol by 25%. The safety of this combination is consistent with the safety profiles of each individual component and is well tolerated. A long-term study is currently being conducted to evaluate whether this combination therapy confers an additive impact on clinical end points.
authors.affiliation: Atherosclerosis Research Center, Department of Veteran Affairs Healthcare System, 5901 E. Seventh Street, Long Beach, CA 90822, USA. anthony.vo@med.va.gov
authors.forename: Anthony N
authors.initials: AN
authors.lastname: Vo
authors.forename: Moti L
authors.initials: ML
authors.lastname: Kashyap
mesh_terms: D000818:Animals; D002784:Cholesterol / Q000097:blood; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D003692:Delayed-Action Preparations; D004338:Drug Combinations; D050171:Dyslipidemias / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D000960:Hypolipidemic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D009525:Niacin / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D019821:Simvastatin / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D014280:Triglycerides / Q000097:blood
chemical_list: D003692:Delayed-Action Preparations; D004338:Drug Combinations; D000960:Hypolipidemic Agents; D014280:Triglycerides; D009525:Niacin; D002784:Cholesterol; D019821:Simvastatin