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Effectiveness of once-nightly dosing of extended-release niacin alone and in combination for hypercholesterolemia.

Publication ,  Journal Article
Guyton, JR; Goldberg, AC; Kreisberg, RA; Sprecher, DL; Superko, HR; O'Connor, CM
Published in: Am J Cardiol
September 15, 1998

We performed a multicenter, open-label study to determine the long-term safety and efficacy of a new extended-release once-a-night niacin preparation, Niaspan, in the treatment of hypercholesterolemia. Niaspan, 0.5 to 3.0 g once a night at bedtime, was used alone or in combination with a statin (inhibitor of hydroxymethylglutaryl coenzyme A reductase), a bile acid sequestrant, or both. Patients included 269 hypercholesterolemic male and female adults enrolled in a 96-week study, and 230 additional adults for whom short-term safety data were available. The dosages of Niaspan attained by 269 patients were 1,000 mg (95% of patients), 1,500 mg (86%), and 2,000 mg (65%). After 48 weeks of treatment, Niaspan alone (median dose 2,000 mg) reduced low-density lipaprotein (LDL) cholesterol (18%), apolipoprotein B (15%), total cholesterol (11%), triglycerides (24%), and lipoprotein(a) (36%), and increased high-density lipoprotein (HDL) cholesterol (29%). Niaspan plus a statin lowered LDL cholesterol (32%), apolipoprotein B (26%), total cholesterol (23%), triglycerides (30%), and lipoprotein(a) (19%), and increased HDL cholesterol (26%). Reversible elevations of aspartate aminotransferase or alanine aminotransferase more than twice the normal range occurred in 2.6% of patients. One patient discontinued Niaspan because of transaminase elevations. Intolerance to flushing, leading to discontinuation of Niaspan, occurred in 4.8% of patients. The overall rate of discontinuance due to flushing in this study combined with 2 previous randomized trials was 7.3%. In the long-term treatment of hypercholesterolemia, Niaspan produced favorable changes in LDL and HDL cholesterol, triglycerides, and lipoprotein(a). Adverse hepatic effects were minor and occurred at rates similar to those reported for statin therapy.

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Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

September 15, 1998

Volume

82

Issue

6

Start / End Page

737 / 743

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Safety
  • Niacin
  • Middle Aged
  • Male
  • Lipids
  • Hypercholesterolemia
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Humans
  • Female
 

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Guyton, J. R., Goldberg, A. C., Kreisberg, R. A., Sprecher, D. L., Superko, H. R., & O’Connor, C. M. (1998). Effectiveness of once-nightly dosing of extended-release niacin alone and in combination for hypercholesterolemia. Am J Cardiol, 82(6), 737–743. https://doi.org/10.1016/s0002-9149(98)00448-2
Guyton, J. R., A. C. Goldberg, R. A. Kreisberg, D. L. Sprecher, H. R. Superko, and C. M. O’Connor. “Effectiveness of once-nightly dosing of extended-release niacin alone and in combination for hypercholesterolemia.Am J Cardiol 82, no. 6 (September 15, 1998): 737–43. https://doi.org/10.1016/s0002-9149(98)00448-2.
Guyton JR, Goldberg AC, Kreisberg RA, Sprecher DL, Superko HR, O’Connor CM. Effectiveness of once-nightly dosing of extended-release niacin alone and in combination for hypercholesterolemia. Am J Cardiol. 1998 Sep 15;82(6):737–43.
Guyton, J. R., et al. “Effectiveness of once-nightly dosing of extended-release niacin alone and in combination for hypercholesterolemia.Am J Cardiol, vol. 82, no. 6, Sept. 1998, pp. 737–43. Pubmed, doi:10.1016/s0002-9149(98)00448-2.
Guyton JR, Goldberg AC, Kreisberg RA, Sprecher DL, Superko HR, O’Connor CM. Effectiveness of once-nightly dosing of extended-release niacin alone and in combination for hypercholesterolemia. Am J Cardiol. 1998 Sep 15;82(6):737–743.
Journal cover image

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

September 15, 1998

Volume

82

Issue

6

Start / End Page

737 / 743

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Safety
  • Niacin
  • Middle Aged
  • Male
  • Lipids
  • Hypercholesterolemia
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Humans
  • Female