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Drexel H et al.  
Clinical Experience With Prolonged-Release Nicotinic Acid in Statin-Treated Patients Managed in the Usual-Care Setting in Austria: An Analysis from Niaspan®-Induced HDL-Elevation for Optimizing Risk Control (NEMO) Study

Journal of Clinical and Basic Cardiology 2007; 10 (1-4): 7-10

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Fig. 1: NEMO study Fig. 2: Lipid profiles

Keywords: DyslipidämieHDL-CholesterinKardiologiekardiovaskuläres Risikonicotinic acidcardiologycardiovascular riskdyslipidaemiaHDL cholesterolNikotinsäure

Low HDL cholesterol is an independent risk factor for adverse cardiovascular outcomes and is prevalent in statin-treated patients in Europe. The Niaspan®-induced HDL-Elevation for Optimizing Risk Control (NEMO) study was an open, uncontrolled, observational evaluation of the effects of 6 months of prolonged-release nicotinic acid (target dose 2000 mg/day) in 1053 statin-treated patients with low HDL cholesterol and/ or hypertriglyceridaemia and additional cardiometabolic risk factors in four European countries. This analysis focuses on the effects observed in 220 patients recruited in Austria. Tolerability and safety were principal study endpoints (particularly treatment-related adverse drug reactions [ADRs]). The prevalence of coronary heart disease and hypertension was higher in Austria versus the overall NEMO population. Flushing (mostly of mild severity) was the most common side effect of prolonged-release nicotinic acid: 35 % of the patients flushed in the first month, declining to 14 % in the sixth month. Other ADRs occurred mainly in the gastrointestinal (9 %) and nervous systems (5 %). There were no treatment-related serious ADRs. Tolerability was assessed in 152 patients and was rated as "acceptable", "good" or "very good" for 75 % of patients. Treatment with prolonged-release nicotinic acid increased HDL cholesterol by 24 % and decreased triglycerides by 11 % at 6 months, with modest decreases in total (–4 %) and LDL cholesterol (–8.2 %). Overall, the incidence of side effects and efficacy outcomes were comparable for prolonged-release nicotinic acid in the Austrian and overall NEMO populations. Correction of low HDL cholesterol with prolonged-release nicotinic acid may represent a rational therapeutic strategy for managing the residual cardiometabolic risk after statin treatment in Austria, as elsewhere.
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