Niacin, Statins And Difficulties Of Drug Discovery

John LaMattina, Contributor

Former president of Pfizer Global Research covering news in pharma.

About a dozen years ago, a team of Merck scientists met with upper management to discuss a new approach for treating cardiovascular disease. The approach was simple, but clever. The scientists had a way of turning a well known and widely used drug, niacin, into an even better and safer drug, thereby expanding its usage.

Niacin, also known as vitamin B3, is known to raise HDL (“good cholesterol”) by about 25% as well as modestly lower LDL (“bad cholesterol”) and triglycerides. It had been used for decades to help patients control their blood lipid levels based on results from a trial done in the 1960s known as the Coronary Drug Project, which looked at niacin versus placebo in men who had a previous heart attack over a period of five years. While niacin showed no difference from placebo in the death rate of the men in this study, fewer patients on niacin had a non-fatal heart attack or stroke, by 26% and 24%, respectively. This study provides the basis for the use of niacin in cardiovascular disease.