Abstract 16803: Icosapent Ethyl (Eicosapentaenoic Acid Ethyl Ester): Effects on Remnant-Like Particle Cholesterol From the MARINE and ANCHOR Studies
Background: Remnant-like particle cholesterol (RLP-C) represents the cholesterol carried by partially catabolized triglyceride (TG)-rich lipoproteins such as very-low-density lipoproteins (VLDL) in the fasted state and chylomicron remnants in the post-prandial state. Increased RLP-C levels are atherogenic and may increase the risk of atherosclerotic cardiovascular disease. Long-chain polyunsaturated omega-3 fatty acids such as eicosapentaenoic acid (EPA) and docosahexaenoic acid reduce RLP-C levels. Icosapent ethyl (IPE) is a high-purity prescription form of EPA ethyl ester approved to reduce TG levels in patients with severe (>=500 mg/dL) hypertriglyceridemia.
Objective: To evaluate the effects of IPE on RLP-C levels in patients from the MARINE and ANCHOR studies.
Methods: MARINE (TG >=500 and <=2000 mg/dL; N=229) and ANCHOR (TG >=200 and <500 mg/dL despite statin control of low-density lipoprotein cholesterol; N=702) were both 12-week, phase 3, double-blind studies that randomized patients to IPE 4 g/day, 2 g/day, or placebo. This analysis assessed the median percentage change from baseline to study end in RLP-C levels compared with placebo. Serum RLP-C was measured with an immunoseparation assay (Polymedco).
Results: In both the MARINE (n=218 with RLP-C data) and ANCHOR (n=252 with RLP-C data) studies, compared with placebo, IPE 4 g/day (Table) and 2 g/day reduced RLP-C levels. Compared with placebo, the approved IPE dose of 4 g/day also reduced RLP-C to a greater extent in subgroups with higher baseline TG levels, reduced RLP-C in statin-treated patients in the MARINE study, and reduced RLP-C in patients receiving moderate- to high-intensity statins in the ANCHOR study.
Conclusions: Compared with placebo, IPE reduced RLP-C levels in patients in the MARINE and ANCHOR studies, including significant reductions in RLP-C in hypertriglyceridemic patients with TG >=200 mg/dL or >=500 mg/dL receiving statin therapy.
Author Disclosures: C.M. Ballantyne: Research Grant; Significant; Abbot, Amarin, Amgen, EliLilly, GlaxoSmithKline, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi-Synthelabo, NIH. Consultant/Advisory Board; Modest; Abbott, Aegerion, Amarin, Cerenis, Esperion, Genzyme, Kowa, Novartis, Resverlogix, Roche, Sanofi-Synthelabo. Consultant/Advisory Board; Significant; Merck, Pfizer. H. Bays: Research Grant; Significant; Alere, Amarin, Amgen, Ardea Inc., Boehringer Ingelheim, Bristol-Myers Squibb, California Raisin Board, Catabasis, Cymabay, Eisai, Elcelyx, Esperion, Eli Lilly, Forest, Gilead, Given, GlaxoSmithKline, High Point Pharmaceuticals, LLC, Hahmi, Hisun, Hoffman LaRoche, Home Access, Isis, Janssen, Merck, Micropharma Limited, Nektar, Novartis, Novo Nordisk, Omthera, Orexigen Therapeutics, Pfizer, Pronovo, Regeneron, Sanofi, Takeda, TIMI, Transtech Pharma, Inc., Trygg Pharmaceuticals, VIVUS, WPU. Honoraria; Modest; Amarin, Amgen, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Catabasis, Daiichi Sankyo, Inc., Isis, Merck, Omthera, Sanofi, Shire, VIVUS, WPU. R. Braeckman: Employment; Modest; Former Employee of Amarin Pharma, Inc. S. Philip: Employment; Significant; Amarin Pharma Inc. W. Stirtan: Employment; Significant; Amarin Pharma Inc. R. Doyle: Employment; Significant; Amarin Pharma Inc. P.N. Soni: Employment; Modest; Former Employee of Amarin Pharma, Inc. R.A. Juliano: Employment; Significant; Amarin Pharma Inc..
- © 2014 by American Heart Association, Inc.