What if a study treated patients with ROSUVASTATIN 40 mg and the goal/PERFECT/disease-reversing non-HDL cholesterol reached was 90 (HDL 44 & LDL 63 as in HPS2-THRIVE). And then it was decided to add 80 mg of ATORVISTATIN to look for improved atherosclerotic end points. Since disease stabilizing/reversing values had already been obtained before adding the second lipid lowering medication, no doubt only further toxicity would be apparent, as was the case in HPS2-THRIVE. It is disappointing to see such a large study created by such important lipid specialists. Frankly, I consider HPS2-THRIVE unethical and the authors should be appropriately criticized for this pointless undertaking. I felt the same about AIM-HIGH. HRS, MD, FACC. No conflicts
Featured in NEJM Journal Watch: Again, Niacin Proves Ineffective in Statin-Treated Patients with Vascular Disease — Physician’s First Watch
Featured in NEJM Journal Watch: Again, Niacin Proves Ineffective in Statin-Treated Patients with Vascular Disease
By the NEJM Journal Watch Editors
Niacin, when added to a statin, is associated with serious adverse effects and no cardiovascular benefit, according to a randomized trial published in the New England Journal of Medicine.
In NEJM Journal Watch General Medicine, Allan Brett says the findings should "put niacin out of business as add-on therapy for statin-treated patients." Harlan Krumholz agrees: "I don't see any indication for niacin at this point."