Docs look beyond B for heart help

A long-awaited study reveals no cardiac benefits from niacin. In fact, the B vitamin's side effects may be harmful.

Combining niacin with a cholesterol-lowering statin drug does not seem to offer any cardiac benefits and may harm patients, suggests a long-anticipated study reported on over the weekend at the American College of Cardiology annual meeting.

Niacin has long been used to boost levels of "good" HDL cholesterol and decrease levels of "bad" LDL cholesterol and triglycerides (fats) in the blood in people at risk for heart disease and stroke. Last weekend's news is most certainly “bad” news for niacin fans. It's even “worse” news for Merck, the company that funded the Oxford University study of it's drug Tredaptive, a combination of extended-release and laropiprant, an experimental substance designed to help prevent the facial flushing that's a common side effect of niacin.

"We are disappointed that these results did not show benefits for our patients," says Jane Armitage, FFPH, FRCP, professor at the University of Oxford and the lead author of the study in a release. "Still, finding out a drug is not helping people is just as important as finding that it has benefits—the net result is that people are healthier. Niacin has been used for many years in the belief that it would help patients and prevent heart attacks and stroke, but we now know that its adverse side effects outweigh the benefits when used with current treatments."

The four-year, 25,000-person study, Heart Protection Study 2-Treatment of HDL to Reduce the Incidence of Vascular Events (HPS2-THRIVE), found no reduction in the rate of heart problems such as heart attack and stroke among people who took the niacin-laropiprant combo. Those patients, however, had a higher risk of bleeding, infections, new-onset diabetes or diabetic complications.

The niacin/laropiprant has been approved in 70 countries and was being sold in 40. The Food and Drug Administration was awaiting results from HPS2-THRIVE to license the drug in the U.S. In response to preliminary findings, the drug manufacturer Merck announced in December 2012 that it no longer planned to take the drug before the FDA for approval and in January suspended ER niacin/laropiprant from markets worldwide.

American have been spending $800 million a year taking niacin, reports

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