Journal
EXPERT OPINION ON PHARMACOTHERAPY
Volume 14, Issue 10, Pages 1409-1416Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1517/14656566.2013.798645
Keywords
dyslipidemias; eicosapentaenoic acid; hypertriglyceridemia; omega-3 fatty acids; triglycerides
Categories
Funding
- Abbott
- Amarin
- AstraZenca
- Bristol-Myers Squibb
- GlaxoSmithKline
- Genentech
- Merck
- Novartis
- Roche
- Sanofi-Synthelabo
- Takeda
- NIH
- ADA
- AHA
- Amarin Pharma, Inc.
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Introduction: Icosapent ethyl (IPE; Vascepa) is a high-purity prescription form of eicosapentaenoic acid (EPA) ethyl ester recently approved in 2012 to reduce triglyceride (TG) levels in adult patients with severe (>= 500 mg/dL) hypertrigly-ceridemia. Elevated TG levels are associated with increased risk for coronary heart disease. Currently available TG-lowering agents (fibrates, niacins, omega-3 fatty acid products containing both EPA and docosahexaenoic acid [DHA]) may be associated with adverse effects such as flushing, hepatotoxicity, myopathy, elevated glucose levels, and/or increases in low-density lipoprotein cholesterol (LDL-C). Areas covered: This review describes IPE chemistry, pharmacokinetics, and clinical studies. In two Phase III randomized, placebo-controlled trials, one in patients with very high TG levels (>= 500 mg/dL; MARINE) and the other in statin-treated patients at high cardiovascular risk with well-controlled LDL-C and residual high TG levels (>= 200 to < 500 mg/dL; ANCHOR), IPE lowered levels of TG, non-high-density lipoprotein cholesterol, and other atherogenic lipoproteins without increasing LDL-C levels. Expert opinion: IPE is safe and effective for managing high TG levels, and it offers a new alternative with potential benefits over currently available treatments for dyslipidemia. The ongoing cardiovascular outcomes REDUCE-IT trial will provide valuable information on the efficacy of IPE to prevent cardiovascular events in high-risk patients already taking statins.
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