Pharmacologic Therapy with Niacin for Nonalcoholic Fatty Liver Disease (NAFLD): Emerging Evidence

In pharmacologic doses niacin (nicotinic acid) has been used clinically for over six decades for atherogenic dyslipidemia and reduction of cardiovascular event risk [1]. In combination with statin therapy, it effects regression of coronary atherosclerosis [2,3]. Emerging evidence indicates a new potential use for niacin for the treatment of NAFLD and its complications [4]. Despite this enormous amount of data on niacin, there is confusion and misconceptions about its use of a drug rather than as a vitamin, its formulations, and how it can be used in clinical practice. The purpose of this invited brief communication is to update and summarize this emerging evidence. We comment on how it may be valuable in the context of other drugs-in-development for NAFLD, especially for combination therapy for synergistic efficacy.