Key points
- A systematic review evaluated clinical research on extended-release wax-matrix niacin (WMNA).
- Studies found that WMNA improved several blood lipid measures in a dose-dependent manner.
- The review examined doses of 1,500–2,000 mg per day for periods of up to 38 weeks.
- Liver enzyme and uric acid levels generally remained within acceptable ranges in the studies reviewed.
- Some participants experienced increases in fasting blood glucose, highlighting the importance of medical supervision.
Study Overview
A systematic review examined the safety and effectiveness of extended-release wax-matrix nicotinic acid—also known as niacin—for managing dyslipidemia, a condition involving unhealthy blood lipid levels.
Researchers searched the OVID-Medline database for English-language prospective, placebo-controlled, crossover, and pharmacokinetic studies involving WMNA. Five studies met the review criteria, including two randomized clinical trials, a long-term extension study, a post-hoc analysis comparing younger and older adults, and a dissolution study.
Findings on blood lipids
The review found that WMNA improved blood lipid levels in a dose-dependent manner.
At a daily dose of 1,500 mg, the studies reported average reductions of approximately:
- 10–13% in total cholesterol
- 16–20% in LDL cholesterol
- 20% in the total-to-HDL cholesterol ratio
- 9.3% in triglycerides
HDL cholesterol increased by approximately 6%.
At a daily dose of 2,000 mg, average changes included:
- 16–19% reduction in total cholesterol
- 21–26% reduction in LDL cholesterol
- 17% reduction in triglycerides
- Approximately 7.2% increase in HDL cholesterol
This systematic review found that extended-release wax-matrix niacin at doses of 1,500–2,000 mg per day improved several lipid measurements for up to 38 weeks. The available evidence also suggested an acceptable safety profile in the populations studied, although changes in blood glucose and other potential risks warrant appropriate monitoring.
Safety findings
Safety was assessed using liver function tests, uric acid measurements, and fasting blood glucose levels.
Across the clinical studies, average levels of alkaline phosphatase, AST, and ALT generally remained within normal limits. In the studies that reported these results, abnormal laboratory findings were not more common among participants receiving WMNA than among control participants. No significant changes in uric acid levels were reported.
However, fasting blood glucose increased in a dose-dependent manner. Statistically significant increases occurred in some groups receiving 1,500 or 2,000 mg per day. In the studies reporting follow-up data, these changes resolved after treatment ended or by the end of the study period.
Conclusion
This systematic review found that extended-release wax-matrix niacin at doses of 1,500–2,000 mg per day improved several lipid measurements for up to 38 weeks. The available evidence also suggested an acceptable safety profile in the populations studied, although changes in blood glucose and other potential risks warrant appropriate monitoring.
Niacin at these doses should be used only with guidance from a qualified healthcare professional. It may not be appropriate for everyone and can interact with medications or affect liver function and blood sugar.
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Reference
Dunatchik AP, Ito MK, Dujovne CA. A systematic review on evidence of the effectiveness and safety of a wax-matrix niacin formulation. Journal of Clinical Lipidology. 2012;6(2):121–131. PMID: 22385545.
