Prolonged-release nicotinic acid for the management of dyslipidemia: an update including results from the NAUTILUS study

Vasc Health Risk Manag. 2007;3(4):467-79. doi: 10.2147/vhrm.s1023.

Abstract

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.

Publication types

  • Review

MeSH terms

  • Atorvastatin
  • Azetidines / therapeutic use
  • Cholesterol, HDL / drug effects
  • Delayed-Action Preparations
  • Drug Therapy, Combination
  • Dyslipidemias / drug therapy*
  • Ezetimibe
  • Fluorobenzenes / therapeutic use
  • Heptanoic Acids / therapeutic use
  • Humans
  • Hypolipidemic Agents / therapeutic use*
  • Niacin / therapeutic use*
  • Pyrimidines / therapeutic use
  • Pyrroles / therapeutic use
  • Randomized Controlled Trials as Topic
  • Rosuvastatin Calcium
  • Simvastatin / therapeutic use
  • Sulfonamides / therapeutic use

Substances

  • Azetidines
  • Cholesterol, HDL
  • Delayed-Action Preparations
  • Fluorobenzenes
  • Heptanoic Acids
  • Hypolipidemic Agents
  • Pyrimidines
  • Pyrroles
  • Sulfonamides
  • Niacin
  • Rosuvastatin Calcium
  • Atorvastatin
  • Simvastatin
  • Ezetimibe