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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Curr+Atheroscler+Rep
2016 ; 18
(2
): 11
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gab.com Text
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Niacin Alternatives for Dyslipidemia: Fool s Gold or Gold Mine? Part I:
Alternative Niacin Regimens
#MMPMID26876225
Dunbar RL
; Goel H
Curr Atheroscler Rep
2016[Feb]; 18
(2
): 11
PMID26876225
show ga
Niacin was the first drug demonstrating lowered cholesterol prevents coronary
heart disease (CHD) events, with two clinical CHD outcome studies establishing a
cardioprotective niacin regimen: 1 g thrice daily with meals. Though
cardioprotective, skin toxicity limits niacin's use, fostering several variations
to improve tolerability. One of these, an extended-release (ER) alternative,
proved immensely successful commercially, dominating clinical practice despite
departing from the established regimen in several critical ways. Hence, improved
tolerability may have come at the cost of diminished efficacy, posing a
conundrum: Does it still help the population at risk for CHD to broaden a drug's
acceptance by "watering it down"? This question is crucial at this stage now that
the ER alternative failed to recapitulate the benefits of the established
cardioprotective niacin regimen in two trials of the alternative approach:
AIM-HIGH and HPS2-THRIVE. Part I of this review discusses how vastly the ER
alternative departs from the established cardioprotective regimen, why that is
important physiologically, and how it may explain the findings of AIM-HIGH and
HPS2-THRIVE. Given important gaps left by statin therapy, the established
cardioprotective niacin regimen remains an important evidence-based therapy for
the statin intolerant or statin averse.
|Clinical Trials as Topic
[MESH]
|Coronary Disease/prevention & control
[MESH]
|Dyslipidemias/*drug therapy
[MESH]
|Humans
[MESH]
|Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use
[MESH]