Although I do not include advertisements on my reading list, I can’t help but notice them as I leaf through journals (no, I’m still not quite completely digital). I wonder if anyone else was bothered by Abbott’s print advertisement for Niaspan, an extended-release formulation of niacin. The ad, shown below, focuses on Niaspan’s effect on HDL-cholesterol levels without any reference to patient outcomes.
This ad makes no mention of AIM-HIGH, the NIH trial showing that adding extended-release niacin (supplied by Abbott) to simvastatin provided no benefit to patients with established cardiovascular disease. The trial did show that extended-release niacin could increase HDL-c levels by 21%, consistent with the ad’s claims — but (and this is a big “but”) the drug did not reduce the risks for myocardial infarction, ischemic stroke, symptom-driven revascularization, or death from coronary heart disease.
I can’t blame Abbott for omitting information about AIM-HIGH. The FDA has retained an indication for Niaspan in lowering the risk for heart attack in people with high cholesterol who have previously had a heart attack. The Abbott ad does mention the lack of additional benefit in preventing heart disease from Niaspan in combination with simvastatin or lovastatin over that from simvastatin or lovastatin monotherapy. You can see the potential for confusion. Also confusing is the fact that the indication names specific statins, not statin therapy in general: Does the FDA think that Niaspan is likely to improve outcomes when added to, say, atorvastatin?
By the way, I was curious what the NIH says about extended-release niacin to consumers, given that it funded the multimillion-dollar AIM-HIGH trial. Interestingly, the NIH’s consumer webpages on niacin provide no context about AIM-HIGH. One page, revised in June 2012, doesn’t mention AIM-HIGH at all; another, last reviewed in August 2011, has AIM-HIGH in a reference list at the bottom but provides no findings from the study. Wouldn’t you want to educate the public about the science you funded? Maybe we should suggest that when the NIH publishes important research, it should update its information for patients as well.
A Merck-sponsored trial of extended-release niacin is due out next year. While we await any new information about this drug, I am concerned at seeing an ad that touts an effect on HDL-c levels without making clear that the only large contemporary trial of the drug in the statin era failed to show that it improved outcomes.
What do you think of this Niaspan ad?