Document Detail


Niacin extended-release/simvastatin combination therapy produces larger favorable changes in high-density lipoprotein particles than atorvastatin monotherapy.
MedLine Citation:
PMID:  22323895     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The purpose of this research was to compare the effects of niacin extended-release in combination with simvastatin (NER/S) versus atorvastatin monotherapy on high-density lipoprotein (HDL) particle number and size in patients with hyperlipidemia or dyslipidemia from the SUPREME study.
METHODS: This was a post hoc analysis of patients (n = 137) who completed the SUPREME study and who had lipid particle number and size measurements at both baseline and at week 12 by nuclear magnetic resonance spectroscopy. Following ≥4 weeks without lipid-modifying therapy (washout period), the patients received NER/S 1000/40 mg/day for 4 weeks followed by NER/S 2000/40 mg/day for 8 weeks, or atorvastatin 40 mg/day for 12 weeks. Median percent changes in HDL particle number and size from baseline to week 12 were compared between the NER/S and atorvastatin treatment groups using the Wilcoxon rank-sum test. Distribution of HDL particle subclasses at week 12 was compared between the treatment groups using the Cochran-Mantel-Haenszel test.
RESULTS: Treatment with NER/S resulted in a significantly greater percent reduction in small HDL particle number at week 12 compared with atorvastatin monotherapy (-1.8% versus 4.2%, P = 0.014), and a numerically greater percent increase in large HDL particle number (102.4% versus 39.2%, P = 0.078) compared with atorvastatin monotherapy. A significantly greater percent increase in HDL particle size from baseline at week 12 was observed with NER/S compared with atorvastatin (6.0% versus 1.3%, P < 0.001). NER/S treatment also resulted in a significant shift in HDL particle size from small and medium at baseline to large at week 12 (P < 0.0001).
CONCLUSION: Treatment with NER/S resulted in larger favorable changes in number and size of HDL particle subclasses compared with atorvastatin monotherapy, including a numerically greater increase in number of large HDL particles, and a significantly greater decrease in number of small HDL particles compared with atorvastatin monotherapy. In addition, NER/S treatment resulted in a significant change in HDL particle size distribution from small and medium to large.
Authors:
Peter P Toth; Kamlesh M Thakker; Ping Jiang; Robert J Padley
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2012-01-25
Journal Detail:
Title:  Vascular health and risk management     Volume:  8     ISSN:  1178-2048     ISO Abbreviation:  Vasc Health Risk Manag     Publication Date:  2012  
Date Detail:
Created Date:  2012-02-10     Completed Date:  2012-06-06     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  101273479     Medline TA:  Vasc Health Risk Manag     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  39-44     Citation Subset:  IM    
Affiliation:
Department of Family and Community Medicine, University of Illinois College of Medicine, Peoria, CGH Medical Center, 101 East Miller Road, Sterling, IL 61081, USA. peter.toth@cghmc.com
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MeSH Terms
Descriptor/Qualifier:
Biological Markers / blood
Delayed-Action Preparations
Drug Combinations
Dyslipidemias / blood,  drug therapy*
Female
Heptanoic Acids / therapeutic use*
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects,  therapeutic use*
Hypolipidemic Agents / adverse effects,  therapeutic use*
Lipoproteins, HDL / blood*
Magnetic Resonance Spectroscopy
Male
Middle Aged
Niacin / adverse effects,  therapeutic use*
Particle Size
Prospective Studies
Pyrroles / therapeutic use*
Simvastatin / adverse effects,  therapeutic use*
Time Factors
Treatment Outcome
United States
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Delayed-Action Preparations; 0/Drug Combinations; 0/Heptanoic Acids; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Hypolipidemic Agents; 0/Lipoproteins, HDL; 0/Pyrroles; 59-67-6/Niacin; 79902-63-9/Simvastatin; A0JWA85V8F/atorvastatin
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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