title: Effects of icosapent ethyl on lipoprotein particle concentration and size in statin-treated patients with persistent high triglycerides (the ANCHOR Study).
abstract: BACKGROUND
  Icosapent ethyl (IPE) is a high-purity prescription form of eicosapentaenoic acid ethyl ester approved at a dose of 4 g/day as an adjunct to diet to reduce triglyceride (TG) levels in adult patients with severe hypertriglyceridemia (TG ≥ 500 mg/dL).
  
  
  OBJECTIVE
  In this prespecified exploratory analysis from the ANCHOR study of patients at high cardiovascular risk with TG ≥ 200 and <500 mg/dL despite statin control of low-density lipoprotein cholesterol, we assessed the effects of IPE on lipoprotein particle concentration and size and examined correlations of atherogenic particles with apolipoprotein B (ApoB).
  
  
  METHODS
  Nuclear magnetic resonance spectroscopy was used to measure lipoprotein particle concentration and size.
  
  
  RESULTS
  Compared with placebo (n = 211), IPE 4 g/day (n = 216) significantly reduced concentrations of: total (12.2%, P = .0002), large (46.4%, P < .0001), and medium (12.1%, P = .0068) very-low-density lipoprotein (VLDL) particles; total (7.7%, P = .0017) and small (13.5%, P < .0001) LDL particles; and total (7.4%, P < .0001) and large (31.0%, P < .0001) high-density lipoprotein particles. Atherogenic lipoprotein particles (total VLDL and total LDL) correlated with ApoB at baseline (R(2) = 0.57) and week 12 (R(2) = 0.65) as did total LDL particle concentration at baseline (R(2) = 0.53) and week 12 (R(2) = 0.59). Compared with placebo, IPE 4 g/day significantly reduced VLDL (7.7%, P < .0001) and high-density lipoprotein (1.2%, P = .0014) particle sizes with a modest but significant increase in LDL particle size (0.5%, P = .0031).
  
  
  CONCLUSIONS
  Compared with placebo, treatment with IPE 4 g/day for 12 weeks reduced key atherogenic lipoprotein particle concentrations. At both baseline and end of study, atherogenic lipoprotein concentrations correlated with ApoB.
authors.affiliation: Baylor College of Medicine and the Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA. Electronic address: cmb@bcm.tmc.edu.
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
authors.affiliation: Amarin Pharma Inc., Bedminster, NJ, USA.
authors.forename: Rene A
authors.initials: RA
authors.lastname: Braeckman
authors.affiliation: Louisville Metabolic and Atherosclerosis Research Center, Louisville, KY, USA.
authors.forename: Harold E
authors.initials: HE
authors.lastname: Bays
authors.affiliation: Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: John J
authors.initials: JJ
authors.lastname: Kastelein
authors.affiliation: LipoScience, Raleigh, NC, USA.
authors.forename: James D
authors.initials: JD
authors.lastname: Otvos
authors.affiliation: Amarin Pharma Inc., Bedminster, NJ, USA.
authors.forename: William G
authors.initials: WG
authors.lastname: Stirtan
authors.affiliation: Amarin Pharma Inc., Bedminster, NJ, USA.
authors.forename: Ralph T
authors.initials: RT
authors.lastname: Doyle
authors.affiliation: Amarin Pharma Inc., Bedminster, NJ, USA.
authors.forename: Paresh N
authors.initials: PN
authors.lastname: Soni
authors.affiliation: Amarin Pharma Inc., Bedminster, NJ, USA.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Juliano
mesh_terms: D000328:Adult; D008078:Cholesterol, LDL / Q000097:blood*; D004311:Double-Blind Method; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D015228:Hypertriglyceridemia / Q000097:blood / Q000188:drug therapy; D008079:Lipoproteins, VLDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D014280:Triglycerides / Q000097:blood*
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008079:Lipoproteins, VLDL; D014280:Triglycerides; C035276:eicosapentaenoic acid ethyl ester; D015118:Eicosapentaenoic Acid
keywords: Apolipoprotein B; Eicosapentaenoic acid; High-density lipoproteins; Hypertriglyceridemia; Icosapent ethyl; Low-density lipoproteins; Omega-3 fatty acid; Statin; Triglycerides