Langjarige inname van niacine is effectief tegen dislipidemie, bestrijdt atherosclerose en beschermt significant tegen hart- en vaatziekten.1 Toch wordt niacine relatief weinig geadviseerd en gebruikt vanwege het optreden van de typische niacineflush. De amidevorm van vitamine B3 (niacinamide), die geen flush veroorzaakt, is in dit kader niet geschikt omdat niacinamide geen invloed heeft op de bloedlipiden. Als niacine al wordt voorgeschreven, dan zal de therapietrouw ongetwijfeld laag zijn als voorschrijvers zelf geen ervaring hebben met niacine en hun patiënten onvoldoende voorbereiden op de niacineflush. Deze onschuldige bijwerking kan binnen de perken worden gehouden door de niacinedosis geleidelijk te verhogen over een periode van 1 tot 4 maanden. Daarnaast kunnen verschillende voedingsstoffen de niacineflush remmen, waaronder omega-3-vetzuren en appelpectine.
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1. Carlson LA. Nicotinic acid: the broad-spectrum lipid drug. A 50th anniversary review. J Intern Med. 2005;258(2):94-114.
2. Altschul R et al. Influence of nicotinic acid on serum cholesterol in man. Arch Biochem. 1955;54:558-9.
3. Lavigne PM et al. The current state of niacin in cardiovascular disease prevention: a systematic review and meta-regression. J Am Coll Cardiol. 2013;61(4):440-6.
4. Jafri H et al. Effects of niacin on LDL particle number. Clin Lipidology 2009;4(5):565-571.
5. Carlson LA et al. Pronounced lowering of serum levels of lipoprotein Lp(a) in hyperlipidaemic subjects treated with nicotinic acid. J Intern Med. 1989;226(4):271-276.
6. Markel A. The resurgence of niacin: from nicotinic acid to niaspan/laropiprant. Isr Med Assoc J. 2011;13(6):368-74.
7. Creider JC et al. Niacin: another look at an underutilized lipid-lowering medication. Nat Rev Endocrinol. 2012;8(9):517-28.
8. Song WL et al. Niacin, an old drug with a new twist. J Lipid Res. 2013;54(10):2586-94.
9. Chapman MJ et al. Niacin and fibrates in atherogenic dyslipidemia: pharmacotherapy to reduce cardiovascular risk. Pharmacol Ther. 2010;126(3):314-45.
10. Sahebkar A. Effect of niacin on endothelial function: a systematic review and meta-analysis of randomized controlled trials. Vasc Med. 2014;19(1):54-66.
11. Bays HE et al. Does nicotinic acid (niacin) lower blood pressure? Int J Clin Pract. 2009;63(1):151-9.
12. Thoenes M et al. The effects of extended-release niacin on carotid intimal media thickness, endothelial function and inflammatory markers in patients with the metabolic syndrome. Int J Clin Pract 2007;61:1942-1948.
13. Duggal JK et al. Effect of niacin therapy on cardiovascular outcomes in patients with coronary artery disease. J Cardiovasc Pharmacol Ther. 2010;15(2):158-66.
14. Canner PL et al. Fifteen year mortality in Coronary Drug Project patients: long-term benefit with niacin. J Am Coll Cardiol. 1986;8(6):1245-55.
15. Canner PL et al. Benefits of niacin in patients with versus without the metabolic syndrome and healed myocardial infarction (from the Coronary Drug Project). Am J Cardiol. 2006;97(4):477-9.
16. Trovato AT et al. The impact of niacin-induced flushing during the first week of therapy in a real-world setting. J Am Coll Cardiol 2008; 51(Suppl 1):A255.
17. Kamal-Bahl et al. Dosage, titration, and gaps in treatment with extended release niacin in clinical practice. Curr Med Res Opin 2008;24:1817-21.
18. Kalogeromitros D et al. A quercetin containing supplement reduces niacin-induced flush in humans. Int J Immunopathol Pharmacol. 2008;21(3):509-14.
19. Jacobson TA. A "hot" topic in dyslipidemia management--"how to beat a flush": optimizing niacin tolerability to promote long-term treatment adherence and coronary disease prevention. Mayo Clin Proc. 2010;85(4):365-79.
20. Hoffer A, Saul AW, Foster HD. Niacin, the real story. Basic Health Publications 2012.
21. Hussein AA et al. Critical appraisal of laropiprant and extended-release niacin combination in the management of mixed dyslipidemias and primary hypercholesterolemia. Ther Clin Risk Manag. 2010;6:183-90.
22. Vanhorn J et al. Attenuation of niacin-induced prostaglandin D(2) generation by omega-3 fatty acids in THP-1 macrophages and Langerhans dendritic cells. J Inflamm Res. 2012;5:37-50.
23. Papaliodis D et al. Niacin-induced "flush" involves release of prostaglandin D2 from mast cells and serotonin from platelets: evidence from human cells in vitro and an animal model. J Pharmacol Exp Ther. 2008;327(3):665-72.
24. Hanson J et al. Nicotinic acid- and monomethyl fumarate-induced flushing involves GPR109A expressed by keratinocytes and COX-2-dependent prostanoid formation in mice. J Clin Invest. 2010;120(8):2910-9.
25. http://orthomolecular.org/resources/omns/v01n10.shtml
26. Papaliodis D et al. The flavonoid luteolin inhibits niacin-induced flush. Br J Pharmacol. 2008;153:1382-1387.
27. Moriarty PM et al. Apple pectin for the reduction of niacin-induced flushing. J Clin Lipidol. 2013;7(2):140-6.
28. Canner PL et al. Benefits of niacin by glycemic status in patients with healed myocardial infarction (from the Coronary Drug Project). Am J Cardiol. 2005;95(2):254-57.
29. Goldberg RB, Jacobson TA. Effects of niacin on glucose control in patients with dyslipidemia. Mayo Clin Proc. 2008;83(4):470-8
