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Niacin, an old drug with a new twist
- Source :
- Journal of Lipid Research, Vol 54, Iss 10, Pp 2586-2594 (2013)
- Publication Year :
- 2013
- Publisher :
- Elsevier BV, 2013.
-
Abstract
- Niacin (nicotinic acid) has been used for decades as a lipid-lowering drug. The clinical use of niacin to treat dyslipidemic conditions is limited by its side effects. Niacin, along with fibrates, are the only approved drugs which elevate high density lipoprotein cholesterol (HDLc) along with its effects on low density lipoprotein cholesterol (LDLc) and triglycerides. Whether niacin has a beneficial role in lowering cardiovascular risk on the background of well-controlled LDLc has not been established. In fact, it remains unclear whether niacin, either in the setting of well-controlled LDLc or in combination with other lipid-lowering agents, confers any therapeutic benefit and if so, by which mechanism. The results of recent trials reject the hypothesis that simply raising HDLc is cardioprotective. However, in the case of the clinical trials, structural limitations of trial design complicate their interpretation. This is also true of the most recent Heart Protection Study 2-Treatment of HDLc to Reduce the Incidence of Vascular Events (HPS2-THRIVE) trial in which niacin is combined with an antagonist of the D prostanoid (DP) receptor. Human genetic studies have also questioned the relationship between cardiovascular benefit and HDLc. It remains to be determined whether niacin may have clinical utility in particular subgroups, such as statin intolerant patients with hypercholesterolemia or those who cannot achieve a sufficient reduction in LDLc. It also is unclear whether a potentially beneficial effect of niacin is confounded by DP antagonism in HPS2-THRIVE.
- Subjects :
- Drug
Statin
medicine.drug_class
media_common.quotation_subject
QD415-436
Pharmacology
Niacin
Biochemistry
chemistry.chemical_compound
Endocrinology
High-density lipoprotein
Animals
Humans
Medicine
Dyslipidemias
Hypolipidemic Agents
Randomized Controlled Trials as Topic
media_common
business.industry
Cholesterol
cardiovascular
digestive, oral, and skin physiology
Thematic Review
cholesterol
food and beverages
nutritional and metabolic diseases
Cell Biology
Lipoproteins, LDL
Clinical trial
chemistry
prostaglandin
Lipoproteins, HDL
business
Heart Protection Study
Subjects
Details
- ISSN :
- 00222275
- Volume :
- 54
- Database :
- OpenAIRE
- Journal :
- Journal of Lipid Research
- Accession number :
- edsair.doi.dedup.....4ade33bee4e9fa4e78e4a60bc1704a24