Cardiology Medical News about extended-release niacin therapy;flushing

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Flushing and other dermatologic adverse events associated with extended-release niacin therapy
Journal of Clinical Lipidology, 03/24/09

Guyton JR et al. – Niacin lowers levels of atherogenic apolipoprotein-B–containing lipoproteins, including lipoprotein(a), and raises levels of atheroprotective high-density lipoproteins. However, cutaneous flushing has been a major impediment to clinical use of niacin.

Methods

Pooled analysis of previously unpublished data on flushing and related side effects from 4 randomized, double-blind studies of niacin extended-release niacin (niacin ER)
Review of long-term data on flushing from a 96-wk open label, uncontrolled study

Results

Among 333 pts treated with niacin ER (once daily at bedtime) for 3-6 mo, 83% reported at least 1 flushing episode, vs 18% of pts treated with placebo or gemfibrozil
Flushing events: ≤5 events in ~50% of pts; >20 events in 5% of pts
Most (76%) of pts treated with niacin ER rated flushing events as mild to moderate in intensity; 6% withdrew due to flushing
In 8-wk comparison of niacin ER once daily at bedtime vs immediate-release niacin 3 times daily at equivalent total daily doses, total number of flushing events was 76% lower in niacin ER group

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