title: Icosapent ethyl for the treatment of hypertriglyceridemia.
abstract: BACKGROUND
  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) hypertriglyceridemia. 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).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Baylor College of Medicine and Methodist DeBakey Heart and Vascular Center, 6565 Fannin, M.S. A-601, Houston, TX 77030, USA. cmb@bcm.tmc.edu
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
authors.forename: Rene A
authors.initials: RA
authors.lastname: Braeckman
authors.forename: Paresh N
authors.initials: PN
authors.lastname: Soni
mesh_terms: D019587:Dietary Supplements; D017277:Drug Approval; D015118:Eicosapentaenoic Acid / Q000031:analogs & derivatives* / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D015228:Hypertriglyceridemia / Q000188:drug therapy* / Q000378:metabolism; D000960:Hypolipidemic Agents / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D000960:Hypolipidemic Agents; C035276:eicosapentaenoic acid ethyl ester; D015118:Eicosapentaenoic Acid