Icosapent ethyl (eicosapentaenoic acid ethyl ester): Effects on remnant-like particle cholesterol from the MARINE and ANCHOR studies.
Remnant-like particle cholesterol (RLP-C) is atherogenic and may increase atherosclerotic cardiovascular disease risk. Icosapent ethyl is a high-purity prescription eicosapentaenoic acid ethyl ester (approved as an adjunct to diet to reduce triglyceride [TG] levels in adult patients with TGs ≥500 mg/dL [≥5.65 mmol/L] at 4 g/day). In the MARINE and ANCHOR studies, icosapent ethyl reduced TG and other atherogenic lipid parameter levels without increasing low-density lipoprotein cholesterol (LDL-C) levels. This exploratory analysis evaluated the effects of icosapent ethyl on calculated and directly measured RLP-C.



MARINE (TGs ≥500 and ≤2000 mg/dL [≥5.65 mmol/L and ≤22.6 mmol/L]) and ANCHOR (TGs ≥200 and <500 mg/dL [≥2.26 and <5.65 mmol/L] despite statin-controlled LDL-C) were phase 3, 12-week, double-blind studies that randomized adult patients to icosapent ethyl 4 g/day, 2 g/day, or placebo. This analysis assessed median percent change from baseline to study end in directly measured (immunoseparation assay) RLP-C levels (MARINE, n = 218; ANCHOR, n = 252) and calculated RLP-C levels in the full populations.



Icosapent ethyl 4 g/day significantly reduced directly measured RLP-C levels -29.8% (p = 0.004) in MARINE and -25.8% (p = 0.0001) in ANCHOR versus placebo, and also reduced directly measured RLP-C levels to a greater extent in subgroups with higher versus lower baseline TG levels, in patients receiving statins versus no statins (MARINE), and in patients receiving medium/higher-intensity versus lower-intensity statins (ANCHOR). Strong correlations were found between calculated and directly measured RLP-C for baseline, end-of-treatment, and percent change values in ANCHOR and MARINE (0.73-0.92; p < 0.0001 for all).



Icosapent ethyl 4 g/day significantly reduced calculated and directly measured RLP-C levels versus placebo in patients with elevated TG levels from the MARINE and ANCHOR studies.
Baylor College of Medicine and the Houston Methodist DeBakey Heart and Vascular Center, 6565 Fannin St. MSA 601, Houston, TX 77030, USA. Electronic address: cmb@bcm.tmc.edu.
Christie M
CM
Ballantyne
Louisville Metabolic and Atherosclerosis Research Center, Louisville, KY, USA.
Harold E
HE
Bays
Amarin Pharma Inc., Bedminster, NJ, USA.
Sephy
S
Philip
Amarin Pharma Inc., Bedminster, NJ, USA.
Ralph T
RT
Doyle
Amarin Pharma Inc., Bedminster, NJ, USA.
Rene A
RA
Braeckman
Amarin Pharma Inc., Bedminster, NJ, USA.
William G
WG
Stirtan
Amarin Pharma Inc., Bedminster, NJ, USA.
Paresh N
PN
Soni
Amarin Pharma Inc., Bedminster, NJ, USA.
Rebecca A
RA
Juliano
D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000188:drug therapy / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000188:drug therapy*; D002784:Cholesterol / Q000097:blood*; D003627:Data Interpretation, Statistical; D004311:Double-Blind Method; D015118:Eicosapentaenoic Acid / Q000031:analogs & derivatives* / Q000494:pharmacology; D015525:Fatty Acids, Omega-3 / Q000378:metabolism; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology*; D015228:Hypertriglyceridemia / Q000188:drug therapy; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008074:Lipoproteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology; D014280:Triglycerides / Q000097:blood*
D015525:Fatty Acids, Omega-3; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D008074:Lipoproteins; D010975:Platelet Aggregation Inhibitors; D014280:Triglycerides; C112017:remnant-like particle cholesterol; C035276:eicosapentaenoic acid ethyl ester; D002784:Cholesterol; D015118:Eicosapentaenoic Acid
Eicosapentaenoic acid; Hypertriglyceridemia; Omega-3 fatty acid; Remnant-like particle cholesterol; Triglycerides