Again, Niacin Proves Ineffective in Statin-Treated Patients with Vascular Disease

In a large randomized trial, niacin was associated with serious adverse effects but no cardiovascular benefit.

In the 2011 AIM-HIGH trial, niacin (added to a statin) failed to improve outcomes in patients with cardiovascular disease (NEJM JW Gen Med Nov 15 2011). We now have results from another randomized niacin trial — the industry-sponsored HPS2-THRIVE study. The study involved nearly 26,000 patients with known vascular disease whose mean LDL and HDL cholesterol levels were 64 mg/dL and 44 mg/dL, respectively, while taking simvastatin (40 mg daily; with ezetimibe in some cases). Patients received either 2 g of extended-release niacin daily or placebo; niacin was combined with laropiprant, a drug that lessens niacin-related flushing.

During median follow-up of 4 years, niacin lowered LDL cholesterol levels by a mean of 10 mg/dL and raised HDL chole…

Reviewing Author

Allan S. Brett, MD

Disclosures

Nothing to disclose

Allan S. Brett, MD

Disclosures

Nothing to disclose

Again, Niacin Proves Ineffective in Statin-Treated Patients with Vascular Disease

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Reviewing Author