Effects of coadministered extended-release niacin/laropiprant and simvastatin on lipoprotein subclasses in patients with dyslipidemia

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• 作者：Christie Ballantyne ; MD^a ; ^{cmb@bcm.tmc.edu} ; Gilbert Gleim ; PhD^b ; Nancy Liu ; PhD^c ; Christine McCrary Sisk ; BS^d ; Amy O. Johnson-Levonas ; PhD^d ; Yale Mitchel ; MD^e
• 关键词：Extended-release niacin ; Laropiprant ; Lipids ; Lipoprotein subclasses ; Vertical autoprofile II
• 刊名：Journal of Clinical Lipidology
• 出版年：2012
• 出版时间：May-June, 2012
• 年：2012
• 卷：6
• 期：3
• 页码：235-243
• 全文大小：573 K

文摘

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Background

The use of extended-release niacin and the prostaglandin D₂ receptor antagonist laropiprant (ERN/LRPT) reduces niacin-induced flushing in patients while preserving its lipid-modifying effects.

Objective

This predefined exploratory analysis examined the individual and combined effects of ERN/LRPT and simvastatin (SIM) on lipoprotein subclasses.

Methods

This double-blind study randomized 1398 dyslipidemic patients equally to ERN/LRPT 1 g/20 mg, SIM (10, 20, or 40 mg), or ERN/LRPT 1 g/20 mg?+ SIM (10, 20, or 40 mg) once daily for 4?weeks. At week 5, doses were doubled, except SIM 40 mg (unchanged) and ERN/LRPT 1 g/20 mg?+ SIM 40 mg (switched to ERN/LRPT 2g/40 mg?+ SIM 40 mg). Cholesterol associated with lipoprotein subclasses was quantified by vertical auto profile II (VAP II).

Results

ERN/LRPT?+ SIM and SIM alone lowered LDL-C 1 and 3, whereas the effects were variable for ERN/LRPT; all three treatments increased LDL-C 4. ERN/LRPT?+ SIM and ERN/LRPT raised HDL-C 2 and 3, with greater relative percent changes in HDL 2 than HDL 3. ERN/LRPT?+ SIM for 12 weeks produced substantial reductions in IDL-C, which was additive compared with each monotherapy.

Conclusion

Coadministered ERN/LRPT?+ SIM produced marked reductions in atherogenic lipoproteins, with the greatest effect on IDL-C, and increases in protective HDL subclasses.