known as high density lipoproteins ("HDL"), are also associated with hyperlipidemia.
(Jd.)
Hyperlipidemia can lead to an increased risk
of
atherosclerosis, which is a hardening
of
thearteries due to an accumulation
of
cholesterol plaque in the arterial walls.
(Id.
at 3-4)Atherosclerosis may cause a number
of
significant health problems, such as coronary heartdisease (that often leads to heart attacks), peripheral arterial disease, and strokes.
(Id.
at 4)
C.
Prior Art Treatments for Hyperlipidemia
Niacin, or "nicotinic acid," has long been used to reduce total cholesterol, LDLs,triglycerides, and LP(a), while increasing HOLs.
(!d.)
Niacin administered to treat theseconditions, however, is accompanied by uncomfortable and dangerous side effects.
(Jd.)
Thetype
of
niacin treatment determines its effects and side effects; generally, niacin is given topatients in either immediate release
or
sustained release dosage forms. (D.L 54 at 2-3)"Immediate release" ("IR") niacin treatments are typically administered three or fourtimes per day, and release nearly all
of
their niacin in the bloodstream very quickly (e.g., within30 to 60 minutes
of
ingestion). (D.L
55
at 4) While
IR
niacin treatments were generally knownto reduce unfavorable cholesterol and increase desirable cholesterol, they were also commonlyassociated with "flushing," a side effect that causes a patient to develop a visibly red,uncomfortable, tingly and/or hot feeling for about one hour after each niacin dose.
(ld.;
D.1.
54 at3) For some, these effects are severe enough to stop taking the drug.
(0.1.
55
at 4) "As a result,physicians have been reluctant to recommend
IR
niacin (and patients have been reluctant to takeit), despite its beneficial lipid-altering effects."
(Id.)
"Sustained release" ("SR") niacin was developed to avoid the flushing side effect thataccompanies
IR
niacin.
(Id.
at 5) Although normally dosed between two and four times per day,3
Case 1:09-cv-00152-JJF-LPS Document 95 Filed 06/18/10 Page 3 of 70
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