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US stock market daily report (July 17, 2014, Thursday)

July 18, 2014, Friday, 05:40 GMT | 00:40 EST | 09:10 IST | 11:40 SGT
Contributed by Millennium Traders

Americans taking Niacin to help reduce cholesterol and for general heart health, are now told the drug could be too risky for routine use. Niacin is a type of B vitamin sold over the counter and by prescription in higher doses. Studies now reveal that the hundreds of thousands of Americans taking Niacin are experiencing more dangerous side effects. Niacin is prescribed alone and in some cases, with statin medicines such as Lipitor for cholesterol problems.

Niacin was introduced in during the 1950s and only went through rigorous testing in recent years as the maker was seeking market approval for a prescription version. The main complaint of patients using Niacin was flushing.

In the New England Journal of Medicine this week, results of two studies for a prescription version of Niacin show that the drug does not help prevent heart problems any more than statins alone do. The studies instead shows a troubling increase in the number of deaths of patients using Niacin.

Dr. Donald Lloyd-Jones of Northwestern University in Chicago said, "Niacin should not be used routinely in clinical practice at all." The larger study suggests that "for every 200 people that we treat with niacin, there is one excess death," plus higher rates of bleeding, infections and other problems - "a completely unacceptable level" of harm, said Dr. Lloyd-Jones.

Dr. Lloyd-Jones said Niacin may still be appropriate for some people with very high heart risks who cannot take statins, and for patients with very high triglycerides that can not be controlled through other means. The studies were on prescription Niacin while the risks and benefits of over-the-counter forms or Niacin remain unclear.

A panel for the American Heart Association and American College of Cardiology that recently issued new cholesterol treatment guideline, was co-led by Dr. Lloyd-Jones. The group, who did not recommend the drug, said Niacin was only considered for certain patients. Dr. Lloyd-Jones said if the panel had seen the new results, it "almost certainly" would have recommended against Niacin's routine use.

Each month in the USA, nearly 700,000 prescriptions are written for various Niacin drugs. Abbott Laboratories (ABT-NYSE) had long sold the top brand Niaspan which is now sold by AbbVie Inc. (ABBV-NYSE) - bringing in nearly $900 million in sales in the USA during 2013. Leaders of an earlier study that tested a different niacin drug - Niaspan - re-examined side effects among their 3,414 participants and detailed them in a letter in the medical journal. The new report details a higher rate of infections as well as a trend toward higher rates of serious bleeding, in addition to an increase in gastrointestinal, blood-sugar and other complications.

The larger of the two studies tested Tredaptive in nearly 26,000 people already taking a statin - a combo of niacin and an anti-flushing medicine from Merck & Co. Inc. (MRK-NYSE). Dr. Lloyd-Jones wrote in a commentary in the medical journal that, full results confirm there was a 9% increase in the risk of death for those taking the drug — a result of borderline statistical significance, meaning the difference could have occurred by chance alone, but still "of great concern."

Tredaptive also brought higher rates of gastrointestinal and muscle problems as well as infections and bleeding. More diabetics on the drug lost control of their blood sugar. Additionally, of those using Niacin, there were more new cases of diabetes. The initial results in December 2012 led Merck to stop pursuing approval of Tredaptive in the USA and to tell doctors in dozens of countries where it was sold, to stop prescribing the drug to new patients.