Two new studies published in the New England Journal of Medicine show that the drug niacin, a B vitamin supplement thought to reduce risk of heart disease because of its effect on cholesterol, may cause more harm than good. The drug can cause significant damage, and the new studies show that the benefits may not be as great as previously thought.
One study focused on extended-release niacin, and the other studied the use of extended-release niacin in concert with another drug, laropiprant, which is thought to make it more effective.
Although niacin use has been shown to increase levels of "good" cholesterol (HDL) and reduce levels of "bad" cholesterol (ADL), the studies did not show any major benefit to using niacin in preventing heart disease or stroke. The studies showed that groups using niacin had the same risk for heart disease and stroke as a control group using a placebo. However, both studies found that there was a high chance for harmful side effects that damage the gastrointestinal and musculoskeletal systems, causing side effects like diarrhea and gout. The study found that using niacin in concert with laropiprant was associated with a 9% increase in death risk. The international study associated niacin use with increasing the risk of gastrointestinal problems such as diarrhea and ulcers by 28 percent. It increased musculoskeletal symptoms such as muscle damage and gout by 26 percent. It increased rashes, skin ulcerations and other serious skin disorders by 67 percent. Infections were increased by 22 percent; and gastrointestinal bleeding or other bleeding were increased by 38 percent.
The largest study done on the use of niacin to prevent risk of heart disease and stroke was done in the 1960s, and is thought to be outdated. That's why scientists thought it was time to do a new study. Of the studies published, one was an American study sponsored by the National Institutes of Health (NIH); the other was funded by the drug company Merck, and was a large international study.
In an editorial published in the same journal as the studies, Dr. Donald Lloyd-Jones of Northwestern University in Chicago wrote that, "on the basis of the weight of available evidence showing net clinical harm, niacin must be considered to have an unacceptable toxicity profile for the majority of patients, and it should not be used routinely." He said that niacin may have some benefit to patients with extremely high risk for heart disease who can't use statins.
This new studies shows very strong evidence that niacin is not as good at preventing heart disease and stroke as another type of drug called statins. It also carries some serious negative effects that can harm people. However, doctors stress that people who are currently taking niacin should not stop using a prescription drug without first consulting their doctors. They can, however, talk to their doctors about use of niacin and discuss whether they think they should continue using the drug.
