Section of Atherosclerosis, Baylor College of Medicine and Methodist DeBakey Heart and Vascular Center, 6565 Fannin, MS A601, Houston, TX 77030, USA.
J Clin Lipidol. 2012 May-Jun;6(3):235-43. doi: 10.1016/j.jacl.2011.11.004. Epub 2011 Dec 3.
The use of extended-release niacin and the prostaglandin D₂ receptor antagonist laropiprant (ERN/LRPT) reduces niacin-induced flushing in patients while preserving its lipid-modifying effects.
This predefined exploratory analysis examined the individual and combined effects of ERN/LRPT and simvastatin (SIM) on lipoprotein subclasses.
This double-blind study randomized 1398 dyslipidemic patients equally to ERN/LRPT 1 g/20 mg, SIM (10, 20, or 40 mg), or ERN/LRPT 1 g/20 mg + SIM (10, 20, or 40 mg) once daily for 4 weeks. At week 5, doses were doubled, except SIM 40 mg (unchanged) and ERN/LRPT 1 g/20 mg + SIM 40 mg (switched to ERN/LRPT 2 g/40 mg + SIM 40 mg). Cholesterol associated with lipoprotein subclasses was quantified by vertical auto profile II (VAP II).
ERN/LRPT + SIM and SIM alone lowered LDL-C 1 and 3, whereas the effects were variable for ERN/LRPT; all three treatments increased LDL-C 4. ERN/LRPT + SIM and ERN/LRPT raised HDL-C 2 and 3, with greater relative percent changes in HDL 2 than HDL 3. ERN/LRPT + SIM for 12 weeks produced substantial reductions in IDL-C, which was additive compared with each monotherapy.
Coadministered ERN/LRPT + SIM produced marked reductions in atherogenic lipoproteins, with the greatest effect on IDL-C, and increases in protective HDL subclasses.
应用缓释烟酸和前列环素 D₂受体拮抗剂拉罗匹仑（ERN/LRPT）可减少烟酸引起的潮红，同时保留其调脂作用。
本预先设定的探索性分析研究了ERN/LRPT 和辛伐他汀（SIM）单独及联合用药对脂蛋白亚类的影响。
这项双盲研究将 1398 例血脂异常患者随机分为 ERN/LRPT 1 g/20 mg、SIM（10、20 或 40 mg）或 ERN/LRPT 1 g/20 mg+SIM（10、20 或 40 mg）组，每日一次，疗程 4 周。第 5 周时，除 SIM 40 mg（剂量不变）和 ERN/LRPT 1 g/20 mg+SIM 40 mg（转换为 ERN/LRPT 2 g/40 mg+SIM 40 mg）外，其余各组剂量加倍。采用垂直自动分析系统 II（VAP II）定量检测脂蛋白亚类中的胆固醇。
ERN/LRPT+SIM 和 SIM 单药均可降低 LDL-C1 和 LDL-C3，而 ERN/LRPT 的作用则各不相同；三种治疗方法均可升高 LDL-C4。ERN/LRPT+SIM 和 ERN/LRPT 均可升高 HDL-C2 和 HDL-C3，HDL-C2 的相对百分比变化大于 HDL-C3。ERN/LRPT+SIM 治疗 12 周可显著降低 IDL-C，与每种单药治疗相比具有相加作用。
ERN/LRPT+SIM 联合应用可显著降低致动脉粥样硬化脂蛋白，对 IDL-C 的作用最大，同时增加保护性 HDL 亚类。
