Effects of Extended-release Niacin/Laropiprant on Apolipoprotein B, LDL-Cholesterol, and Non-HDL-cholesterol Targets in Patients with Type 2 Diabetes

Abstract

s 285 small low-density lipoprotein particle (LDL-P) and CHD risk. Purpose: To compare the effects of niacin extendedrelease/simvastatin (NER/S) therapy on lipoprotein particles to atorvastatin (Atv) from the SUPREME study. Methods: This is a post-hoc analysis of 137 patients with dyslipidemia from a 12-week, randomized, study of patients treated with daily NER/S (n 5 74, 1000/40 mg x 4 weeks; 2000/40 mg x 8 weeks) or Atv (n 5 63, 40 mg x 12 weeks). A total of 137 patients had particle concentration and size measurements at baseline (BL) and 12 wk by NMR spectroscopy. Results: Patients in both treatment groups had comparable particle values at BL. Treatment with NER/S resulted in a greater increase in large HDL-P concentration (P 5 .078), significantly greater decrease in small HDL-P concentration (P , .05), and significantly greater increase in HDL-P size (P , .001), HDL-C and apoA-I vs Atv. Treatment with NER/S also significantly decreased the concentration of total LDL-P (P , .05) and small LDL-P (P , .05) and significantly increased LDL-P size (P , .01) vs Atv (Table 1). Conclusions: Compared with Atv 40 mg monotherapy, combination therapy NER/S at 2000/40 mg results in multiple favorable changes in both HDL and LDLmetrics. These data show that NER/S treatment promotes a greater shift toward less atherogenic lipoprotein subclasses than Atv.