What's the deal with niacin development: is laropiprant add-on therapy a winning strategy to beat a straight flush?
OBJECTIVE
Niacin is a B-complex vitamin used as a lipid-altering drug since the 1950s. Niacin improves multiple lipid parameters. Atherosclerotic coronary heart disease outcome studies support niacin's efficacy in reducing coronary heart disease events, either as monotherapy or when used in combination with other lipid-altering drugs. The most commonly reported reason for the lack of its more widespread clinical use is niacin-induced flushing.


RESULTS
Laropiprant is a highly selective prostaglandin D2 receptor 1 antagonist that mitigates niacin-induced flushing.


CONCLUSIONS
This review examines the history and provides a perspective regarding the extended-release niacin/laropiprant development program, which was designed to better allow patients to achieve a more therapeutic niacin dose of 2 g/day, without the need for titration. Ongoing coronary heart disease outcome studies will provide better insight as to the benefits of niacin in general, and the safety and efficacy of extended-release niacin/laropiprant specifically.
Bays
Harold E
HE
L-MARC Research Center, 3288 Illinois Avenue, Louisville, KY 40213, USA. hbaysmd@aol.com
Ballantyne
Christie
C
D003327:Coronary Disease / Q000097:blood / Q000188:drug therapy; D003692:Delayed-Action Preparations; D004338:Drug Combinations; D005483:Flushing / Q000139:chemically induced / Q000517:prevention & control*; D006801:Humans; D000960:Hypolipidemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007211:Indoles / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood; D009525:Niacin / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D003692:Delayed-Action Preparations; D004338:Drug Combinations; D000960:Hypolipidemic Agents; D007211:Indoles; D008055:Lipids; C518174:MK-0524; D009525:Niacin