ARBITER 2

Last reviewed 01/2018

• double-blind randomized placebo-controlled study of once-daily extended-release niacin (1000 mg) added to background statin therapy in 167 patients (mean age 67 years) with known coronary heart disease and low levels of high-density lipoprotein cholesterol (HDL-C; <45 mg/dL)
  • primary end point was the change in common carotid intima-media thickness (CIMT) after 1 year
    • baseline CIMT (0.884±0.234 mm), low-density lipoprotein cholesterol (89±20 mg/dL), and HDL-C (40±7 mg/dL) were comparable in the placebo and niacin groups
    • adherence to niacin exceeded 90%, and 149 patients (89.2%) completed the study
    • HDL-C increased 21% (39 to 47 mg/dL) in the niacin group
    • After 12 months, mean CIMT increased significantly in the placebo group (0.044±0.100 mm; P<0.001) and was unchanged in the niacin group (0.014±0.104 mm; P=0.23)
      • overall difference in IMT progression between the niacin and placebo groups was not statistically significant (P=0.08)
  • authors concluded that the addition of extended-release niacin to statin therapy slowed the progression of atherosclerosis among individuals with known coronary heart disease and moderately low HDL-C

Reference:

1. Taylor AJ et al. Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol (ARBITER) 2: a double-blind, placebo-controlled study of extended-release niacin on atherosclerosis progression in secondary prevention patients treated with statins. Circulation. 2004 Dec 7;110(23):3512-7.