Department of Medicine and Health, Faculty of Health Sciences, Linköping University, Linköping, Bergviksvägen 48, SE-176 63 Bromma, Sweden.
Nutr Metab Cardiovasc Dis. 2010 Oct;20(8):553-7. doi: 10.1016/j.numecd.2010.07.003. Epub 2010 Aug 23.
Recently two studies on the effect of addition of extended-release niacin to statin treatment on measures of carotid atherosclerosis were estimated in the ARBITER 6-HALTS study (Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol 6-HDL and LDL Treatment Strategies) study and the Oxford Niacin Study were published. Adding niacin to statin treatment significantly diminished carotid atherosclerosis as measured by ultrasound carotid intima-media thickness or magnetic resonance imaging. An inhibitor of niacin induced flushing, laropiprant has been developed and demonstrated to considerably improve the tolerability of niacin therapy without impeding on its effect on lipoproteins. Still however clear evidence for the clinical benefit of long-term niacin treatment on cardiovascular morbidity and mortality is lacking. The development situation for ezetimibe is similar to that of niacin. Long-term interventional studies with hard endpoints of both therapies are ongoing. Also both drugs, when proven efficient and safe, are eagerly needed in the prevention of cardiovascular disease.
最近，两项关于在他汀类药物治疗基础上添加缓释烟酸对颈动脉粥样硬化指标影响的研究在 ARBITER 6-HALTS 研究（用于研究降低胆固醇 6-HDL 和 LDL 治疗策略的动脉生物学）和牛津烟酸研究中进行了评估。研究表明，在他汀类药物治疗的基础上添加烟酸可显著减少颈动脉粥样硬化，这可通过超声颈动脉内膜中层厚度或磁共振成像来测量。烟酸诱导潮红的抑制剂——拉罗匹仑已被开发出来，并已证明其在不影响脂蛋白作用的情况下可显著提高烟酸治疗的耐受性。然而，长期使用烟酸治疗对心血管发病率和死亡率的临床益处仍缺乏明确证据。依折麦布的研发情况与烟酸类似。这两种药物的长期干预性研究都在进行硬终点评估。此外，这两种药物如果被证明有效且安全，在预防心血管疾病方面也非常需要。
