Effects of Extended-Release Niacin with Laropiprant in High-Risk Patients

Adults with vascular disease were treated with a statin to lower LDL cholesterol and were assigned to receive either extended-release niacin plus laropiprant or placebo. Niacin–laropiprant did not significantly reduce the risk of major vascular events and increased the risk of serious adverse events. Patients with cardiovascular disease remain at substantial risk for major vascular events despite current approaches to treatment of risk factors. 1 Observational data indicate that the low-density lipoprotein (LDL) cholesterol level is strongly positively associated with the risk of coronary heart disease and that the high-density lipoprotein (HDL) cholesterol level is strongly inversely associated. 2 High-dose niacin decreases the LDL cholesterol level and increases the HDL cholesterol level, as well as lowering triglyceride and lipoprotein(a) levels and blood pressure. 3 , 4 Current guidelines recommend that niacin therapy be considered for reducing cardiovascular risk, 5 , 6 and its use in the United States has been . . .