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Long-term niacin therapy may raise risk for new-onset diabetes
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Results of recent meta-analysis suggest a moderately increased risk for new-onset diabetes after treatment with niacin, regardless of background therapy with statins or laropiprant.
The meta-analysis incorporated 11 randomized controlled trials, including the recent AIM-HIGH and HPS2-THRIVE studies. All trials included enrolled 50 or more nondiabetic participants and had an average follow-up of at least 24 weeks.
In total, 26,340 participants in the 11 trials did not have diabetes at baseline (13,121 treated with niacin; 13,219 treated with control therapy). A diabetes diagnosis was recorded in 1,371 (5.22%) participants during a weighted mean follow-up of 3.6 years; 725 (5.22%) of those diagnosed with diabetes were assigned niacin and 646 (5.53%) were assigned control therapy.
The researchers calculated an RR of 1.34 (95% CI, 1.21-1.49) for new-onset diabetes with niacin therapy. According to the researchers, this translates to one case of new-onset diabetes for every 43 initially nondiabetic people treated with niacin for 5 years.
The moderate risk for new-onset diabetes persisted whether participants received background statin therapy (P = .88) or combination therapy with laropiprant (P = .52), according to the results.
The researchers noted that “the mechanism that explains niacin’s detrimental effect on glycemic control and diabetes risk remains unclear.” – by Tracey Romero
Disclosure: One researcher reports consulting for Sanofi; another researcher reports receiving honoraria from AbbVie; and a third researcher reports receiving research grants from Abbott, Daiichi-Sankyo, Merck and Pfizer.
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