Niacin therapy and the risk of new-onset diabetes: a meta-analysis of randomised controlled trials.

MedStar author(s):
Citation: Heart. 102(3):198-203, 2016 Feb.PMID: 26370223Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | Meta-Analysis | Research Support, Non-U.S. Gov'tSubject headings: *Diabetes Mellitus/ep [Epidemiology] | *Hydroxymethylglutaryl-CoA Reductase Inhibitors/tu [Therapeutic Use] | *Hypercholesterolemia/dt [Drug Therapy] | *Hypolipidemic Agents/tu [Therapeutic Use] | *Niacin/tu [Therapeutic Use] | Drug Therapy, Combination | Dyslipidemias/dt [Drug Therapy] | Humans | Randomized Controlled Trials as Topic | Risk FactorsYear: 2016Local holdings: Available online from MWHC library: 1939 - present, Available in print through MWHC library: 1996 - 2006ISSN:
  • 1355-6037
Name of journal: Heart (British Cardiac Society)Abstract: CONCLUSIONS: Niacin therapy is associated with a moderately increased risk of developing diabetes regardless of background statin or combination laropiprant therapy.Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/METHODS: We searched Medline, EMBASE and the Cochrane Central Register of Controlled Trials, from 1975 to 2014, for randomised controlled trials of niacin primarily designed to assess its effects on cardiovascular endpoints and cardiovascular surrogate markers. We included trials with >50 non-diabetic participants and average follow-up of >24 weeks. Published data were tabulated and unpublished data sought from investigators. We calculated risk ratios (RR) for new-onset diabetes with random-effects meta-analysis. Heterogeneity between trials was assessed using the I(2) statistic.OBJECTIVE: Previous studies have suggested that niacin treatment raises glucose levels in patients with diabetes and may increase the risk of developing diabetes. We undertook a meta-analysis of published and unpublished data from randomised trials to confirm whether an association exists between niacin and new-onset diabetes.RESULTS: In 11 trials with 26 340 non-diabetic participants, 1371 (725/13 121 assigned niacin; 646/13 219 assigned control) were diagnosed with diabetes during a weighted mean follow-up of 3.6 years. Niacin therapy was associated with a RR of 1.34 (95% CIs 1.21 to 1.49) for new-onset diabetes, with limited heterogeneity between trials (I(2)=0.0%, p=0.87). This equates to one additional case of diabetes per 43 (95% CI 30 to 70) initially non-diabetic individuals who are treated with niacin for 5 years. Results were consistent regardless of whether participants received background statin therapy (p for interaction=0.88) or combined therapy with laropiprant (p for interaction=0.52).All authors: Goldie C, McCoy C, Nguyen P, Preiss D, Taylor AJ, Zhao XQFiscal year: FY2016Digital Object Identifier: Date added to catalog: 2016-06-03
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 26370223 Available 26370223

Available online from MWHC library: 1939 - present, Available in print through MWHC library: 1996 - 2006

CONCLUSIONS: Niacin therapy is associated with a moderately increased risk of developing diabetes regardless of background statin or combination laropiprant therapy.Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

METHODS: We searched Medline, EMBASE and the Cochrane Central Register of Controlled Trials, from 1975 to 2014, for randomised controlled trials of niacin primarily designed to assess its effects on cardiovascular endpoints and cardiovascular surrogate markers. We included trials with >50 non-diabetic participants and average follow-up of >24 weeks. Published data were tabulated and unpublished data sought from investigators. We calculated risk ratios (RR) for new-onset diabetes with random-effects meta-analysis. Heterogeneity between trials was assessed using the I(2) statistic.

OBJECTIVE: Previous studies have suggested that niacin treatment raises glucose levels in patients with diabetes and may increase the risk of developing diabetes. We undertook a meta-analysis of published and unpublished data from randomised trials to confirm whether an association exists between niacin and new-onset diabetes.

RESULTS: In 11 trials with 26 340 non-diabetic participants, 1371 (725/13 121 assigned niacin; 646/13 219 assigned control) were diagnosed with diabetes during a weighted mean follow-up of 3.6 years. Niacin therapy was associated with a RR of 1.34 (95% CIs 1.21 to 1.49) for new-onset diabetes, with limited heterogeneity between trials (I(2)=0.0%, p=0.87). This equates to one additional case of diabetes per 43 (95% CI 30 to 70) initially non-diabetic individuals who are treated with niacin for 5 years. Results were consistent regardless of whether participants received background statin therapy (p for interaction=0.88) or combined therapy with laropiprant (p for interaction=0.52).

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