A U.S. cohort of the REDUCE IT trial found that icosapent ethyl had "particularly robust risk reductions across a variety of composite and individual endpoints, including all-cause mortality." The analysis published Nov. 11 in Circulation and will be presented during AHA 2019 in Philadelphia, PA.

Deepak L. Bhatt, MD, MPH, FACC, et al., looked at a prespecified group of patients from the REDUCE IT trial enrolled in the U.S. to determine the effects of 4 grams per day of icosapent ethyl vs. placebo. Of the 6,962 patients in the U.S. who were screened, 3,146 were randomized and followed for a median of 4.9 years.

Results showed that the primary endpoint of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, coronary revascularization, or hospitalization for unstable angina occurred in 24.7 percent of placebo patients vs. 18.2 percent of icosapent ethyl patients. Further, the key secondary endpoint of cardiovascular death, nonfatal myocardial infarction or nonfatal stroke occurred in 16.6 percent vs. 12.1 percent of those randomized to placebo vs. icosapent ethyl, respectively.

Further, "there was a 31 percent relative risk reduction and 6.5 absolute risk reduction in the first ischemic events." The key secondary endpoint "was also reduced by 31 percent with a 4.6 percent absolute risk reduction."

The investigators conclude that, "the results of the present analysis from REDUCE IT provide confidence that USA patients would derive at least as much benefit from icosapent ethyl as seen in the overall trial."

A separate cost-effectiveness study by William S. Weintraub, MD, MACC, was also presented during AHA 2019 and found that icosapent ethyl at $4.16 a day offered "the rare finding of better outcomes at lower health care costs" for payer-eligible patients in the REDUCE IT trial. Further, in a sensitivity analysis simulation, icosapent ethyl was also found to be cost effective vs. placebo.

The researchers conclude that, "icosapent ethyl at $4.16 a day in high cardiovascular risk patients showed exceptional benefit."

Keywords: AHA19, AHA Annual Scientific Sessions, Primary Prevention, Dyslipidemias, Metabolic Syndrome, Cost-Benefit Analysis, Hypertriglyceridemia

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