5 Steps to prevent Heart Disease

Thursday, May 26, 2016

Niacin vs. PCSK9 - why the expensive drug replace the inexpensive drug?

PCSK9 has no outcome trials, yet it is advised over Niacin by Consensus ACC/AHA consensus statement with NLA.  Niacin taken off list despite excellent cost and excellent compliance with wax matrix OTC niacin 1,000 mg.

Zetia only has one positive outcome trial yet it was used for many years before that trial came out.


Niacin's Randomize trials with clinical positive cardiovascular outcomes:
source Table 26.2 C JR Guyton in Contemporary Endocrinology,  Dyslipidemias p 446 Chapter 26.

  AIM-HIGH and HPS2 ended early after 3 yrs.
 Zetia IMPROVE-IT trial was 9 yrs.

 LDLc  lowering matters.

FACT: reduction of 10 mg per deciliter in the LDL cholesterol level in HPS2-THRIVE

Wax matrix niacin review Journal Clinical Lipidology  
Very few flushing side effects with this preparation.  Thus compliance good.
Cost $100 for 1,000 tablets, thus cost is excellent at two 500 mg tablets a day.

PCSK9 IV drug costs $14,000 a year?  

Niacin at the very least should still be an option on the guidelines for Doctors to use with statins even if LDLc is 70.

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