ARBITER 6-HALTS: A Surprise Knockout

To compare the effects of niacin versus ezetimibe when added to statin treatment, investigators conducted a randomized, open-label trial with blinded adjudication of endpoints. All patients were already taking a statin and had LDL levels <100 mg/dL, HDL levels <55 mg/dL, and coronary heart disease or a risk equivalent (e.g., diabetes or a 10-year Framingham risk score of ≥20%). The primary endpoint was change in carotid intima–media thickness (CIMT) after 14 months. The industry-funded, investigator-initiated trial was terminated early on the basis of results from a prespecified interim analysis.

A total of 208 participants (mean age, 65; 80% men) had 14-month endpoint data. At baseline, mean levels of LDL and HDL were 82 mg/dL and 42 mg/dL,…