posted 12/02/02
Treating diabetic patients with the cholesterol-lowering drug
niacin does not result in increased heart attacks or mortality, despite
historical evidence that niacin raises blood sugars.
Paul Canner, PhD, senior biostatistician at the Maryland Medical Research
Institute, Baltimore, Maryland, United States, performed a new analysis of the
data accumulated during the landmark Coronary Drug Project, which evaluated the
effects of several medications on heart disease parameters.
Looking at the 6- and 15-year data, Dr. Canner said, "In the Coronary Drug
Project, niacin reduced non-fatal myocardial infarctions and mortality similarly
in patients at all levels of blood glucose, including those with fasting blood
glucose of 126 mg/dL".
Co-investigator, Mark McGovern, MD, senior vice president and chief medical
officer for Kos Pharmaceuticals, Inc., said the results were somewhat
counterintuitive. Even though diabetic patients who were given niacin had
increases in blood glucose levels their risk of heart attack and death
decreased.
"This study, which we asked Dr. Canner to perform, and others suggest that you
can give diabetic patients niacin and they tolerate it very well," Dr. McGovern
said. "Niacin is very effective at raising [high-density lipoprotein] and in
reducing triglycerides in patients with diabetes, and that is important because
the type of metabolic abnormalities diabetics have are often characterized by
low HDL and high triglycerides."
Among subjects who were not diabetic at baseline, Dr. Canner said 11.1 percent
of the niacin group had a non-fatal heart attack within six years of the end of
the trial compared with 15.4 percent of the placebo group. After 15 years, about
50.5 percent of the niacin patients had died, compared to 53.5 percent of the
patients on placebo.
Among patients who were diabetic at the start of the trial and were taking
niacin, 7.1 percent experience a heart attack at six years and 71.4 percent had
died compared to 15.5 percent and 77.9 for the placebo group, respectively.
Those difference were statistically significant at the p<0.005 level, Dr. Canner
said. The study was paid for by Kos Pharmaceuticals.
Source: Diabetes In Control Dot Com.
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