The Canadian Maternity Experiences Survey,or, When It Comes To Pregnancy,Childbirth, and Infant and Maternal Health,It Never Hurts To Ask

ABSTRACT: The Canadian Maternity Experiences Survey provides a wealth of data on reproductive decision‐making, prenatal care and experiences of women during their pregnancies, intrapartum and postpartum experiences, as well as women’s mental health, social supports, and health behaviors. This population‐based representative sample survey, drawn from a sampling frame based on the Canadian Census for 2006, puts a human face on pregnancy, childbirth, postpartum maternal health, and parenting, and could serve as a model for similar data collection efforts in other countries. (BIRTH 35:4 December 2008)     

Consistency of Extended-Release Niacin/Laropiprant Effects on Lp(a), ApoB, non-HDL-C, Apo A1, and ApoB/ApoA1 Ratio Across Patient Subgroups

Background

According to prior analyses, extended-release niacin/laropiprant (ERN/LRPT) consistently reduces low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) and increases high-density lipoprotein cholesterol (HDL-C) levels across a wide range of dyslipidemic patient subgroups.

Objectives

This analysis examined ERN/LRPT’s consistency across four phase III, randomized, double-blind trials in improving other lipid/lipoprotein parameters associated with cardiovascular risk, across several key dyslipidemic patient subgroups.

Methods

In three of the studies, the randomized population included patients with primary hypercholesterolemia or mixed hyperlipidemia; in the remaining study, the population included patients with type 2 diabetes mellitus. The lipid-altering consistency of ERN/LRPT’s efficacy was evaluated versus the predefined comparator (placebo or active control) among key subgroups of sex, race (White, non-White), region (US, ex-US), baseline age (<65 years, ≥65 years), use of statin therapy (yes, no), coronary heart disease (yes, no), risk status (low, multiple, high), and type of hyperlipidemia (primary hypercholesterolemia, mixed dyslipidemia), as well as across baseline LDL-C, HDL-C, and TG levels. The consistency of the treatment effects on lipoprotein(a) [Lp(a)], apolipoprotein B (ApoB), non-HDL-C, ApoA1, and ApoB/ApoA1 ratio was evaluated by examining treatment difference estimates of the percentage change from baseline with 95% confidence intervals.

Results

Treatment with ERN/LRPT produced significantly greater improvements in Lp(a), ApoB, non-HDL-C, ApoA1, and ApoB/ApoA1 ratio compared with placebo/active comparator in each study. These effects were generally consistent across key subgroups within each study.

Conclusion

ERN/LRPT produced lipid-altering efficacy on the parameters evaluated in four controlled studies; these effects were generally consistent across all examined subgroups. ERN/LRPT represents an effective and reliable therapeutic option for the treatment of dyslipidemia in a wide range of patient types.

Clinical Trial Registration

Registered as Clinicaltrials.gov NCT00269204, NCT00269217, NCT00479388, and NCT00485758.