Study: Onset of Niacin-Associated Adverse Effects Dictate Perception of Severity
According to a recent study, the patient-perceived severity of Niacin-Associated Skin Toxicity symptoms was related to the time until onset of flushing, contradicting the prior theory that worse severity of symptoms predicted patients’ subjective assessments of symptoms.
Although the negative physical effects of niacin have been lessened over time, severity of these effects are often self-reported and vary greatly.
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In order to examine how physical measurements of symptom severity compared with patient-reported perceptions, researchers followed 16 patients in which niacin-related skin responses were provoked 68 times under different conditions. Clinical colorimetry and white light spectroscopy was used to measure rubor, laser Doppler was used to measure plethora, and contact thermometry was used to measure calor and frigor in participants after niacin exposure.
Their study showed that rapid onset of symptoms was associated with an increase in reported severity by the patient, regardless of physical measurements. Likewise, patients who had delayed side effects did not perceive their symptom intensity to be above “moderate.”
“Surprisingly, each stigma’s abruptness predicted symptom perception, whereas peak intensity did not,” the researchers wrote.
“These techniques, either in combination or individually may also be applied in diverse investigations both in the field of dermatology and of vascular medicine,” the researchers concluded.
—Melissa Weiss
Reference:
- Penn study paints clearer picture of “NASTy” side effects from well-known heart drug [press release]. Philadelphia, Pennsylvania: Penn Medicine News; February 6, 2017. https://www.pennmedicine.org/news/news-releases/2017/february/study-paints-clearer-picture-of-side-effects-from-well-known-heart-drug
- Dunbar RL, Goel H, Tuteja S, et al. Measuring Physical Stigmata of Niacin-Associated Skin Toxicity by Colorimetry, White-Light Spectroscopy, Laser Doppler Flowmetry, and Thermometry in Combination with Symptom Perception Scoring: Methods to Aid Development of Niacin Mimetics [published online January 23, 2017]. Journal of Lipid Research. doi:10.1194/jlr.D071696.