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Icosapent ethyl reduces inflammatory markers in high-risk patients
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ORLANDO, Fla. — Icosapent ethyl safely reduced atherogenic and inflammatory parameters without increasing LDL in patients with high triglycerides and elevated high-sensitivity C-reactive protein who were treated with statin therapy, according a poster presented at the American College of Cardiology Scientific Session.
Harold E. Bays, MD, medical director and president of the Louisville Metabolic and Atherosclerosis Research Center in Kentucky, and colleagues analyzed data from 246 patients (mean age, 61 years; 55% men) from the ANCHOR study who were at increased CV risk, were on statin therapy, had a baseline high-sensitivity CRP of at least 2 mg/dL and triglycerides between 200 mg/dL and 499 mg/dL even with LDL control.
“There was a new study that showed the benefits of an anti-inflammatory approach with canukinumab (Ilaris, Novartis),” Christie M. Ballantyne, MD, professor of medicine, chief of the sections of cardiology and cardiovascular research and director of the Center for Cardiometabolic Disease Prevention at Baylor College of Medicine, told Cardiology Today. “It was specifically done in people who were basically on optimal treatment with CRPs over 2. This was looking at that subset.”
In this 12-week study, patients were assigned 4 g per day of icosapent ethyl (Vascepa, Amarin; n = 126) or placebo (n = 120).
Triglycerides reduced by 20% in patients assigned icosapent ethyl without increasing LDL (P < .0001). Other parameters such as total cholesterol (–11%; P < .0001), HDL (–5%; P < .01), VLDL (–21; P < .0001) and high-sensitivity CRP (–18%; P < .05) also decreased in the treatment group.
Compared with placebo, eicosapentaenoic acid levels increased 632% in red blood cells and 637% in plasma (P < .0001 for both).
“This may have implications for clinical practice,” Ballantyne said in an interview. “There’s a large ongoing outcomes trial. This is called the REDUCE-IT study, and it is specifically testing the hypothesis in the same population that was used in the ANCHOR study. They’re being randomized to the EPA vs. placebo. It’s going to be looking at outcomes [related to] cardiovascular event reduction. That should be reporting out by the end of the year. ... If this study is successful, it will also say well perhaps a pure EPA formulation of an omega-3 fatty acid could be an option for these patients.” – by Darlene Dobkowski
Reference:
Miller M, et al. Abstract 1287-251. Presented at: American College of Cardiology Scientific Session; March 10-12, 2018; Orlando, Fla.
Disclosure: The original ANCHOR study was funded by Amarin. Bays reports financial ties with Akcea, Allergan, Alnylam, Amarin, Amgen. AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Catabasis, Cymabay, Dr. Reddy’s Laboratories, Eisai, Elcelyx, Eli Lilly, Esperion, Ferrer Chiltern, Gemphire, Gilead, GlaxoSmithKline, Hanmi, Hisun, Hoffman LaRoche, Home Access, Ionis, iSpecimen, Janssen, Johnson & Johnson, Kowa, Merck, Nektar, Novartis, Novo Nordisk, Omthera, Orexigen, Pfizer, Prosciento, Regeneron, Sanofi Aventis, Selekta and Takeda. Ballantyne reports he receives consultant fees/honoraria from Abbott Diagnostic, Amarin, Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Esperion, Ionis, Matinas BioPharma Inc, Merck, Novartis, Pfizer, Regeneron, Roche Diagnostic and Sanofi-Synthelabo; research support from Abbott Diagnostic, Amarin, Amgen, Esperion, Ionis, Novartis, Pfizer, Regeneron, Roche Diagnostic and Sanofi-Synthelabo, and other support from Roche.