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Niacin, Statin Combo Regresses Atherosclerosis Compared to LDL-Lowering Therapy Alone

ORLANDO, Fla., Nov. 15 /PRNewswire-FirstCall/ -- Results from the investigator-initiated ARBITER 6 - HALTS study showed patients at high cardiovascular risk had significant regression of atherosclerosis after 8 and 14 months of therapy with Abbott's Niaspan® (niacin extended-release tablets) plus a statin, the study's primary endpoint. In a pre-specified secondary endpoint of the study, treatment with Niaspan plus statin also resulted in significantly fewer major adverse cardiac events, (or MACE, a composite endpoint consisting of heart attack, myocardial revascularization, admission to the hospital for an acute coronary syndrome, and death from coronary heart disease), as compared to ezetimibe plus a statin.

The study was stopped early after a pre-specified interim analysis was conducted on 208 patients who had completed treatment and had undergone final ultrasound imaging of the carotid artery to measure the impact of treatment on atherosclerosis. Atherosclerosis is fat build-up in the arteries and in the early stages it can be found inside the lining of the arteries, known as intima media thickness (IMT). HALTS measured IMT in the carotid artery.

"The ARBITER 6 - HALTS study is the first study showing that HDL-raising with Abbott's Niaspan on top of statin regresses atherosclerosis compared to an LDL-lowering strategy," said Eugene Sun, M.D, vice president, Global Pharmaceutical Development, Abbott. "These data reinforce the importance of looking beyond LDL treatment targets to address other lipid parameters."

Niaspan is not indicated to promote regression of atherosclerosis in combination with a statin. In patients taking Niaspan, the most commonly reported adverse event was flushing of the skin, a transient effect associated with niacin therapy. Adverse drug effects were cited as the reason for withdrawal in three ezetimibe patients and 17 niacin patients. The difference between treatment groups was not statistically significant.

ARBITER 6 - HALTS
The ARBITER 6 - HALTS study explored treatment approaches in patients at high cardiovascular risk already taking statins to control bad LDL cholesterol. The primary endpoint of the study compared the effect on atherosclerosis of raising good HDL cholesterol with the addition of Abbott's Niaspan to a statin versus LDL-lowering with the addition of ezetimibe. There were four secondary endpoints: change in lipid values; a composite endpoint consisting of MACE; drug discontinuation due to adverse effects; and health-related quality of life. ARBITER 6 - HALTS, led by Allen Taylor, M.D., of Washington Hospital Center, was conducted and analyzed independent of Abbott. Abbott provided funding and medication to support the study.

ARBITER 6 - HALTS Study Design and Patient Population
ARBITER 6 - HALTS is a prospective, randomized, parallel group, open-label, blinded endpoint study, which means the treatment was not blinded to patients or the investigators, but the analyses of scans were blinded. The study included 362 patients with coronary heart disease or risk equivalents, LDL less than 100 mg/dL and HDL less than 50 for men or 55 mg/dL for women receiving chronic statin therapy. Baseline mean HDL in the study was 43 mg/dL and mean LDL was 82 mg/dL. At the time of the pre-specified interim analysis, the 208 patients who completed treatment and final imaging were included in the analysis.

Source: Abbott

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