OBJECTIVES: Use of niacin extended-release with statin monotherapy (SM) for combined lipid target attainment (CLTA) of LDL-C, HDL-C, and triglycerides (TG) has been limited. The objective was to compare real-world CLTA among patients receiving niacin extended-release+any statin (NER+S) versus fixed-dose simvastatin+ezetimibe (S+E) combination therapy. METHODS: A retrospective analysis was conducted on patients aged ≥ 18 years, newly initiating NER+S or S+E therapy between July 1, 2000 - June 30, 2006 (index date), with health plan eligibility of at least 12 months pre- and post-index date, and at non-target HDL-C (<40 mg/dL) and TG levels (>150 mg/dL) at index date using a large integrated research claims database. CLTA, assessed at the last laboratory visit within 12 months of index date, was defined according to NCEP ATP III, ADA, and AHA Women’s guidelines where appropriate. A propensity score, controlling for differences in index date age, gender, LDL-C, HDL-C, and TG levels, was included as a covariate in a multivariate logistic regression model comparing odds of achieving CLTA between treatment groups. RESULTS: A total of 883 patients were analyzed, 445 initiating NER+S and 438 initiating S+E.  NER+S patients were significantly older (54±9 years vs. 51±8 years; p<0.0001), more male (81% vs. 55%; p<0.0001), hypertensive (80% vs. 67%; p<0.0001), and with prior cardiovascular disease (CVD) (46% vs. 17%; p<0.0001) than S+E patients. All NER+S patients and some S+E patients (48%) were prescribed SM prior to index date. Mean baseline values for LDL-C (98±36 vs. 136±43 mg/dL; p<0.0001) and HDL-C (37±9 vs.44±11 mg/dL; p<0.0001) were significantly lower among NER+S patients. Logistic regression analysis indicated 64% (OR: 1.64; 95% C.I.: 1.02 – 2.61) increased likelihood of CLTA among NER+S patients versus S+E patients. CONCLUSIONS: Dyslipidemia patients initiating NER+S therapy were more likely to achieve CLTA than patients initiating S+E therapy in a real-world setting, thus implying a greater potential reduction in cardiovascular risk.