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  • Effects of Icosapent Ethyl (Eicosapentaenoic Acid Ethyl Ester) on Atherogenic Lipid/Lipoprotein, Apolipoprotein, and Inflammatory Parameters in Patients With Elevated High-Sensitivity C-Reactive Protein (From the ANCHOR Study)
  • Add time:07/17/2019         Source:sciencedirect.com

    ABSTRACTIcosapent ethyl is pure prescription eicosapentaenoic acid (EPA) approved at 4 g/day as an adjunct to diet to reduce triglycerides (TG) in adults with TG ≥500 mg/dL. Elevated high-sensitivity C-reactive protein (hsCRP) is associated with increased cardiovascular (CV) risk. The 12-week ANCHOR study randomized 702 statin-treated patients at increased CV risk with TG 200–499 mg/dL despite low-density lipoprotein cholesterol (LDL-C) control (40–99 mg/dL). This post hoc analysis assessed 246 ANCHOR patients with baseline hsCRP ≥2.0 mg/L randomized to icosapent ethyl 4 g/day (n=126; approved dose) or placebo (n=120). Without increasing LDL-C, icosapent ethyl significantly reduced median TG (−20%; P<0.0001), non–high-density lipoprotein cholesterol (−12.3%; P<0.0001), total cholesterol (−11.1%; P<0.0001), high-density lipoprotein cholesterol (−5.2%; P=0.0042), very-low-density lipoprotein cholesterol (−21.0%; P<0.0001), very-low-density lipoprotein TG (−22.9%; P<0.0001), remnant lipoprotein cholesterol (−23.0%; P=0.0125), apolipoprotein B (−7.4%; P=0.0021), apolipoprotein C-III (−16%; P<0.0001), oxidized LDL (−13.7%; P=0.0020), lipoprotein-associated phospholipase A2 (−19.6%; P<0.0001), and hsCRP (−17.9%; P=0.0213) vs placebo, while interleukin-6 and intercellular adhesion molecule-1 were not significantly changed. EPA increased with icosapent ethyl 4 g/day +637% in plasma and +632% in red blood cells vs placebo (both P<0.0001). Icosapent ethyl exhibited a safety profile similar to placebo. In conclusion, in statin-treated patients with hsCRP ≥2.0 mg/L and TG 200–499 mg/dL at baseline, icosapent ethyl 4 g/day significantly and safely reduced TG and other atherogenic and inflammatory parameters without increasing LDL-C versus placebo.

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