Does niacin therapy improve lipid profiles and clinical outcomes in patients with lipid disorders?
Patients with lipid disorders, including metabolic syndrome, diabetes mellitus, isolated low high-density lipoprotein cholesterol, and hypertriglyceridemia
Niacin (nicotinic acid) therapy, including immediate release, extended release, and long acting formulations
This review highlights the comprehensive lipid-modifying benefits of niacin and delineates the distinct safety and efficacy profiles of its three available formulations.
Therapy with niacin (nicotinic acid) is unique in that it improves all lipoprotein abnormalities. It significantly reduces low-density lipoprotein cholesterol, triglyceride, and lipoprotein(a) levels, while increasing high-density lipoprotein cholesterol levels. This makes niacin ideal for treating a wide variety of lipid disorders, including the metabolic syndrome, diabetes mellitus, isolated low high-density lipoprotein cholesterol, and hypertriglyceridemia. Niacin-induced changes in serum lipid levels produce significant improvements in both coronary artery disease and clinical outcomes. Niacin is currently available in 3 formulations (immediate release, extended release, and long acting), which differ significantly with respect to their safety and efficacy profiles. Immediate-release niacin is generally taken 3 times a day and is associated with adverse flushing, gastrointestinal symptoms, and elevations in blood glucose levels. Long-acting niacin can be taken once daily and is associated with significantly reduced flushing, but its metabolism increases the risk of hepatotoxic effects. Extended-release niacin, also given once daily, has an absorption rate intermediate between the other formulations and is associated with fewer flushing and gastrointestinal symptoms without increasing hepatotoxic risk.
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James M. McKenney
Archives of Internal Medicine
Virginia Commonwealth University
National Clinical Research
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James M. McKenney (Mon,) studied this question.
www.synapsesocial.com/papers/69d73420779571b57e48f49a — DOI: https://doi.org/10.1001/archinte.164.7.697