Thursday, March 14, 2013
Is it the end of the line for niacin?
No, but a new study presented at ACC raises concerns. Before jumping to conclusions about niacin note the following:
The results do not permit a distinction between niacin and the antiflushing agent laropiprant in attribution of the negative outcomes.
The patients were studied without regard to LDL particle density, ignoring previous findings that niacin has a powerful niche in patients with low LDL particle density (LDL pattern B).
In the trial, niacin was combined with a statin with a higher toxicity profile.
In the Coronary Drug Project, an example of comparative effectiveness research done decades before the term was co-opted for political ends, niacin was the first lipid modifying agent found to favorably impact significant clinical outcomes.