title: The effect of pioglitazone and extended-release niacin on HDL-cholesterol in diabetes patients in a real-world setting.
abstract: OBJECTIVE
  This retrospective study was designed to assess the effects of the combination of pioglitazone and extended-release niacin on the lipid panel, particularly HDL-cholesterol, when used in patients with type 2 diabetes in an endocrinology specialty practice.
  
  
  METHODS
  The electronic medical records of 434 adult patients with type 2 diabetes receiving extended-release niacin and pioglitazone were screened for review. Patients with type 2 diabetes and hyperlipidemia were included for review if they received the combination of pioglitazone at doses ≥ 15 mg/day and extended-release niacin (Niaspan) at doses ≥ 1000 mg/day for ≥6 months. Statistical analysis used paired t-tests with p < 0.05 as statistically significant. Both ANOVA and the Tukey-Kramer test for multiple comparisons (α = 0.05) were also used.
  
  
  RESULTS
  A total of 47 patients, 83% were men with average age of 58, met all eligibility criteria for the study. Compared with baseline, a statistically significant increase in HDL-C (+ 25.13%, p < 0.0001) was observed at the conclusion of combination therapy. The HDL-C levels progressively increased with duration of combination treatment, and were not correlated with concomitant statin use. Significant decreases in total cholesterol and triglycerides were detected, and HbA1c decreased 0.84% during combination therapy for all therapies combined.
  
  
  CONCLUSIONS
  The combination of pioglitazone and extended-release niacin in patients with type 2 diabetes and hyperlipidemia, used in commonly prescribed doses for at least 6 months, resulted in statistically significant improvements in HDL-C, total cholesterol, and triglycerides, and did not result in deteriorations in glycemic control.
authors.affiliation: Iowa Diabetes & Endocrinology Research Center, Des Moines, Iowa.
authors.forename: A
authors.initials: A
authors.lastname: Bhargava
authors.forename: S
authors.initials: S
authors.lastname: Gleason
authors.forename: A G
authors.initials: AG
authors.lastname: Vaughan
authors.forename: J F
authors.initials: JF
authors.lastname: Johnson
authors.forename: K V S N
authors.initials: KV
authors.lastname: Yarlagadda
mesh_terms: D000704:Analysis of Variance; D008076:Cholesterol, HDL / Q000187:drug effects* / Q000378:metabolism; D003692:Delayed-Action Preparations; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D018149:Glucose Intolerance / Q000517:prevention & control; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D000960:Hypolipidemic Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009525:Niacin / Q000008:administration & dosage*; D000077205:Pioglitazone; D012189:Retrospective Studies; D045162:Thiazolidinediones / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D008076:Cholesterol, HDL; D003692:Delayed-Action Preparations; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents; D009525:Niacin; D000077205:Pioglitazone; D045162:Thiazolidinediones