AHA: Prescription Fish Oil Wins for CV Prevention

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A proprietary fish oil cut the risk of ischemic events among patients taking the formulation for primary or secondary cardiovascular disease (CV) prevention in the REDUCE-IT trial.

REDUCE-IT was presented here at the American Heart Association’s annual meeting and published simultaneously online in the New England Journal of Medicine.

The results are “truly extraordinary” given the magnitude of CV event reduction, commented Haitham Ahmed, MD, MPH, of the Cleveland Clinic, who was not involved with the trial.

“We have never seen such strong risk reduction with fish oil before. Prior results have been conflicting or showing only minimal benefit,” he told MedPage Today. The effect appears to be even bigger than with PCSK9 inhibitors, and the risk reduction is “even more impressive since these are contemporary patients, on statin therapy, and with controlled LDL already in the [70 mg/dL range].”

“We don’t start to see separation in the curves until at least one year, so the longer study duration here may have been one of the reasons why the trial was so positive compared to previous studies. Also the drug used here represents highly purified EPA which does not lead to LDL elevation and may be superior to other fish oil supplements,” Ahmed suggested.

Icosapent ethyl is a purified, prescription fish oil known to lower triglyceride levels, and FDA approved for this indication in tandem with a low-fat and low-cholesterol diet. The compound is pure eicosapentaenoic acid (EPA) with no DHA.

Importantly, its observed CV benefits held strong no matter a person’s baseline level of triglycerides or the levels achieved at 1 year, Bhatt’s group noted.

“These observations suggest that at least some of the effect of icosapent ethyl that resulted in a lower risk of ischemic events than that with placebo may be explained by metabolic effects other than a reduction of triglyceride levels,” they said.

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