The Real Implication of the Niaspan Study

Yesterday we had bad news about Niaspan:

The NIH has stopped a study with Abbott Laboratories’ cholesterol fighter Niaspan 18 months early after results showed the drug failed to prevent heart attacks and even may have boosted stroke risk. And as Bloomberg notes, the results could heighten the debate over whether raising good cholesterol actually helps patients….

….In a study follow-up, participants who took Niaspan and simvastatin had increased HDL cholesterol and lowered triglyceride levels compared to participants who took a statin alone. But the combination treatment failed to reduce heart attacks, strokes, hospitalizations for acute coronary syndromen or revascularization procedures to improve blood flow in the arteries of the heart and brain.

Certainly Abbott Laboratories (ABT) stock will fall in the short run. But in the big picture, this is an important step forward in the long and excruciating process of sorting out fact from fiction.  It fits in with the stream of stories like this one, which finds yet another biochemical mechanism that people had not suspected.

The central dogma in molecular biology states that DNA is copied into RNA, one nucleotide at a time. But it turns out that copy may be a lot less exact than scientists previously thought. ….A new paper, published today in Science,identifies widespread differences between DNA sequences and their corresponding RNA transcripts in human cells, and demonstrates that these differences result in proteins that do not precisely match the genes that encode them.

When pharma companies embraced genomics, they thought they had a faster path to finding new drugs that would treat well-known and well-understood problems.  Unfortunately, the deeper they got in, the more they discovered was that the problems were actually not well-understood–that conventional medical understanding was simply not correct much of the time.  This fits in with the lesson of evidence-based medicine so far,  which is that we know less than we thought we did. For example,  here’s what a panel of experts recently concluded about diet, lifestyle, and Alzheimer’s:

Although numerous studies have investigated risk factors and potential therapies for Alzheimer’s disease, significant gaps in scientific knowledge exist,” Dr. Martha Daviglus of Northwestern University Feinberg School of Medicine, Chicago, and colleagues wrote in the Archives of Neurology.

“Currently, firm conclusions simply cannot be drawn about the association of any modifiable risk factor with Alzheimer’s disease, and there is insufficient evidence to support the use of any lifestyle interventions or dietary supplements to prevent Alzheimer’s,” the panel wrote.

It turns out we are building a bridge across a wide and deep canyon rather than a narrow ravine.  Researchers are on the canyon floor, putting in the foundations and supports that no one thought we needed.  It’s a long, expensive, depressing, and dangerous process.

But there will come a moment–maybe soon, maybe years from now–when the bridge  will be, not done, but usable.  Traffic across the once-impassable canyon will soar almost overnight, and the Biosciences Century will truly begin.  And I, for one, want to be invested in those companies when that happens.

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About Michael Mandel 126 Articles

Michael Mandel was BusinessWeek's chief economist from 1989-2009, where he helped direct the magazine's coverage of the domestic and global economies.

Since joining BusinessWeek in 1989, he has received multiple awards for his work, including being honored as one of the 100 top U.S. business journalists of the 20th century for his coverage of the New Economy. In 2006 Mandel was named "Best Economic Journalist" by the World Leadership Forum.

Mandel is the author of several books, including Rational Exuberance, The Coming Internet Depression, and The High Risk Society.

Mandel holds a Ph.D. in economics from Harvard University.

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3 Comments on The Real Implication of the Niaspan Study

  1. This study says nothing…except that Big Pharma has decided that they cannot make money with Niaspan; who’s active ingredient (Niacin) is available over the counter for pennies a dose. This study does not negate the several hundred or so studies that show that Niacin raises HDL. So it did not prevent heart attacks. Duh. Do you think that raising HDL for a period of 6 months or even 1-3 years is sufficient to turn around 50 years worth of bodily neglect, smoking, poor diet, and lack of exercise? Of course not. Substances that raise HDL would take much much longer to actually reduce plaque size in arteries. This study is so stupid it is laughable. Of course it does not prevent heart attacks. If your artery health has deteriorated that far, then you more than likely have so much inflammation and blockage that nothing will prevent you from having a heart attack. Drugs and supplements that lower LDL and that raise HDL would take 5-10 and maybe even 15 years to reduce plaque enough in the body to actually prevent a heart attack. This is nothing but a Big Pharma misinformation campaign and I don’t buy it and neither should you. Niacin has been an effective raiser of HDL for years and has been helping people for years and years. Big Pharma does not want an HDL solution. That will take market share away from their LDL statin business. Pathetic.

    • Uh, I thought Abbott was selling at least a billion dollars worth of Niaspan a year, and that several large statin trials did show benefit in cardiovascular outcomes in similar time patients in a similar time frame. Not sure what your point is

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