title: Addition of omega-3 carboxylic acids to statin therapy in patients with persistent hypertriglyceridemia.
abstract: The incidence of hypertriglyceridemia has grown alongside that of obesity. Statin therapy has been widely recommended for the treatment of dyslipidemias. Omega-3 (OM3) fatty acid concentrates are commonly prescribed concurrently with statins in patients with persistent hypertriglyceridemia for additional lowering of triglyceride and non-HDL cholesterol. The bioavailability of currently available OM3 ethyl ester drugs is limited by their need for hydrolysis by pancreatic lipases, largely stimulated by dietary fat, prior to intestinal absorption. This review will discuss the chemistry, pharmacokinetics and clinical efficacy of a novel OM3 carboxylic acid drug that provides polyunsaturated docosahexaenoic and eicosapentaenoic acids in the free fatty acid form, which is readily absorbed by the intestine. This drug was approved in May 2014 as an adjunct to diet to reduce triglyceride levels in adults with severe (≥500 mg/dl) hypertriglyceridemia.
authors.affiliation: Department of Medicine, The University of Chicago, 5841 S. Maryland Avenue, MC 6080, Chicago, IL 60637, USA.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Davidson
authors.forename: Alyssa K
authors.initials: AK
authors.lastname: Phillips
authors.forename: Douglas
authors.initials: D
authors.lastname: Kling
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Maki
mesh_terms: D000328:Adult; D001682:Biological Availability; D002264:Carboxylic Acids / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D004281:Docosahexaenoic Acids / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D015228:Hypertriglyceridemia / Q000188:drug therapy*
chemical_list: D002264:Carboxylic Acids; D004338:Drug Combinations; D015525:Fatty Acids, Omega-3; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid
keywords: cholesterol-lowering drug; fish oil; hyperlipidemia; lipids; omega-3 carboxylic acid; triglycerides