Another HDL-raiser bites the dust

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In a large, federally-funded trial investigating niacin (vitamin B-3), researchers hoping to harness its known ability to raise HDL, or “good cholesterol,” levels to prevent heart disease were once again disappointed. After niacin was administered to patients in conjunction with cholesterol-lowering statin medications, the study was halted 18 months prematurely, due to patients' increased risk for cardiovascular events.

The trial, called AIM-HIGH, began in early 2006 and consisted of more than 3,400 patients who were taking cholesterol-lowering drugs. Some patients were also given long-acting niacin (trade name Niaspan). Researchers hoped that by combining this HDL-raising drug with statins, which lower LDL, or bad cholesterol, the result would be improved patient outcomes.

Unfortunately, the reverse was shown to be true. There were actually slightly more cardiovascular events (heart attacks and stroke) per year in the placebo group, compared to patients receiving Niaspan.

After reading the news story, ACSH’s Dr. Gilbert Ross was reminded of a similar trial involving Pfizer’s Torcetrapib, a drug that was intended to prevent heart disease by increasing HDL levels, but those drug trials were halted as well after it was shown that patients receiving the experimental drug had higher mortality rates compared to the control group. “Now, with the halt of the recent AIM-HIGH trial, it looks like scientists are still looking for the pot of gold at the end of the HDL rainbow,” he says. “Epidemiologically speaking, people with high HDL levels have a lower risk for cardiovascular disease, yet when you intervene with drugs to raise it, the same effect is not found.”

ACSH’s Dr. Elizabeth Whelan echoes these sentiments: “So often in medicine you are aware of the end goal, but even when you achieve it, you’re still unable to prevent the disease.”