70% of 350 US physicians will increase the use niacin for patients, says report

Dec 2 2009

Sermo (http://www.sermo.com), the world's largest online physician's community, today announced the results of a new report indicating that 70% of 350 US physician respondents would increase their use of niacin based on results from the ARBITER 6-HALTS trial. The head-to-head trial demonstrated the superiority of extended-release niacin (Abbott) over ezetimibe (Merck’s Zetia) when combined with statin therapy. This data is part of Sermo’s new FirstLine report series, which rapidly assess physician reaction to major events impacting the US pharmaceutical market.

According to the report, 70% of physicians would increase their use of niacin for patients in which monotherapy statin usage was not sufficient. One physician comment captured much of the discussion: “It will change my practice in that it reminds me to try niacin more often, even though it requires more hand-holding with patients and slow titration.”

This report also indicates that almost half of respondents were unable to rate carotid intima-media thickness (CIMT) as being particularly good or bad as a surrogate marker for clinical end points. Less than 40% rate CIMT as being particularly good and cardiologists were the least likely to consider CIMT as being a particularly strong surrogate marker.

“There is still uncertainty in the physician community on two key factors. The first is whether or not physicians feel that carotid intima-media thickness is a good enough surrogate for clinical end points -- physicians interviewed were largely unsure,” said Sermo Inc. analyst, Richard Leigh-Pemberton, MD. “Second, while over half were unsure, one quarter of respondents believe that the paradoxical progression of atherosclerosis seen with larger reductions of LDL in the ezetimibe group was a real (i.e., biologically plausible) finding.”