Icosapent ethyl (eicosapentaenoic acid ethyl ester): Effects on plasma apolipoprotein C-III levels in patients from the MARINE and ANCHOR studies

Christie M Ballantyne, Harold E Bays, Rene A Braeckman, Sephy Philip, William G Stirtan, Ralph T Doyle Jr, Paresh N Soni, Rebecca A Juliano, Christie M Ballantyne, Harold E Bays, Rene A Braeckman, Sephy Philip, William G Stirtan, Ralph T Doyle Jr, Paresh N Soni, Rebecca A Juliano

Abstract

Background: Apolipoprotein C-III (ApoC-III) regulates lipoprotein and triglyceride (TG) metabolism and may have a causal role in cardiovascular disease. In the Multi-Center, Placebo-Controlled, Randomized, Double-Blind, 12-Week Study With an Open-Label Extension (MARINE) and ANCHOR studies, icosapent ethyl, a high-purity prescription eicosapentaenoic acid ethyl ester, reduced TG, and other atherogenic lipid parameters without increasing low-density lipoprotein cholesterol (LDL-C) compared with placebo.

Objective: To evaluate the effects of icosapent ethyl on plasma ApoC-III levels in patients from 2 phase 3 studies.

Methods: MARINE and ANCHOR were 12-week double-blind studies of icosapent ethyl in adult patients. Patients in MARINE had very high TG levels (≥500 and ≤2000 mg/dL) and patients in ANCHOR had high TG levels (≥200 and <500 mg/dL) despite statin control of LDL-C. This post hoc analysis of MARINE and ANCHOR assessed the median percent change from baseline in plasma ApoC-III levels vs placebo and includes subgroup analyses by statin use/efficacy and median ApoC-III levels.

Results: We assessed ApoC-III levels in 148 and 612 patients in the MARINE and ANCHOR studies, respectively. In MARINE, the approved prescription dose of icosapent ethyl (4 g/day) significantly reduced ApoC-III levels by 25.1% (P < .0001) vs placebo. In ANCHOR, icosapent ethyl 4 g/day significantly reduced ApoC-III levels by 19.2% (P < .0001) vs placebo; subanalysis by statin efficacy revealed significant reductions vs placebo in the higher-efficacy and medium-efficacy groups (24.6% and 17.2%, respectively; both P < .0001).

Conclusion: Icosapent ethyl 4 g/day significantly reduced plasma ApoC-III levels in patients with elevated TGs from the MARINE and ANCHOR studies.

Keywords: Apolipoprotein C-III; Cardiovascular diseases; Eicosapentaenoic acid; Hypertriglyceridemia; Omega-3 fatty acid; Triglycerides.

Copyright © 2016 National Lipid Association. Published by Elsevier Inc. All rights reserved.

Source: PubMed

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