Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Dyslipidaemia

Failure to THRIVE: the end for niacin?

Trials in patients with dyslipidaemia or cardiovascular disease have shown no beneficial effects on 'hard' clinical end points, and increased rates of adverse effects, when niacin is added to statin therapy. These findings lead us to question whether niacin has a role in modern lipid-lowering strategies.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. The Coronary Drug Project Research Group. Clofibrate and niacin in coronary heart disease. JAMA 231, 360–381 (1975).

  2. HPS2-THRIVE Collaborative Group. HPS2-THRIVE randomized placebo-controlled trial in 25,673 high-risk patients of ER niacin/laropiprant: trial design, pre-specified muscle and liver outcomes, and reasons for stopping study treatment. Eur. Heart J. http://dx.doi.org/10.1093/eurheartj/eht055.

  3. O'Riordan, M. “If not dead, not healthy”: Niacin full results in HPS2-THRIVE aired at ACC. Theheart.org[online], (2013).

  4. The AIM-HIGH investigators. Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy. N. Engl. J. Med. 365, 2255–2267 (2011).

  5. The ACCORD study group. Effects of combination lipid therapy in type 2 diabetes mellitus. N. Engl. J. Med. 362, 1563–1574 (2010).

  6. Schwartz, G. G. et al. Effects of dalcetrapib in patients with a recent acute coronary syndrome. N. Engl. J. Med. 367, 2089–2099 (2012).

    Article  CAS  Google Scholar 

  7. Vogt, A., Kassner, U., Hostalek, U. & Steinhagen-Thiessen, E. Evaluation of the safety and tolerability of prolonged-release nicotinic acid in a usual care setting: the NAUTILUS study. Curr. Med. Res. Opin. 22, 417–425 (2006).

    Article  CAS  Google Scholar 

  8. Preiss, D. et al. Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta-analysis. JAMA 305, 2556–2564 (2011).

    Article  CAS  Google Scholar 

  9. Cholesterol Treatment Trialists' (CTT) Collaboration. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet 376, 1670–1681 (2010).

  10. Maher, V. M. et al. Effects of lowering elevated LDL cholesterol on the cardiovascular risk of lipoprotein(a). JAMA 274, 1771–1774 (1995).

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Ethics declarations

Competing interests

The author declares no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wierzbicki, A. Failure to THRIVE: the end for niacin?. Nat Rev Cardiol 10, 246–247 (2013). https://doi.org/10.1038/nrcardio.2013.48

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrcardio.2013.48

Search

Quick links

Nature Briefing: Translational Research

Sign up for the Nature Briefing: Translational Research newsletter — top stories in biotechnology, drug discovery and pharma.

Get what matters in translational research, free to your inbox weekly. Sign up for Nature Briefing: Translational Research