Which of the following drugs primarily raises HDL-C and decreases triglycerides?

Niacin, also known as vitamin B3 or nicotinic acid, primarily raises high-density lipoprotein cholesterol (HDL-C) and decreases triglycerides. It achieves this by several mechanisms, including the promotion of HDL production in the liver and the activation of enzymes that facilitate lipid metabolism, leading to lower triglyceride levels.

In addition to enhancing HDL-C, niacin has a unique ability to target triglycerides by inhibiting lipolysis in adipose tissue, which reduces the amount of free fatty acids available for liver conversion to triglycerides. This dual action makes niacin particularly effective in patients who require both increased HDL-C levels and decreased triglycerides.

While other drugs listed may also influence lipid profiles, they do not have the same primary effect on raising HDL-C combined with decreasing triglycerides. For example, fenofibrate primarily lowers triglycerides without a major impact on HDL-C. Alirocumab, a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, significantly lowers low-density lipoprotein cholesterol (LDL-C) but does not typically raise HDL-C. Lovastatin, a statin, primarily focuses on lowering LDL-C rather than significantly raising HDL-C or affecting triglycerides.

Thus