Icosapent ethyl for the treatment of severe hypertriglyceridemia

Abstract

Hassan Fares,1 Carl J Lavie,2,3 James J DiNicolantonio,4 James H O'Keefe,5 Richard V Milani2 1Department of Hospital Medicine, Ochsner Medical Center, New Orleans, LA, 2Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, LA, 3Department of Preventive Medicine, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, 4Mid America Heart Institute at Saint Luke's Hospital, Kansas City, MO, 5Mid America Heart Institute, University of Missouri–Kansas City, Kansas City, MO, USA Abstract: Hypertriglyceridemia is a highly prevalent lipid abnormality and it is associated with atherosclerosis, with a growing body of evidence linking elevated triglycerides (TGs) with cardiovascular disease. The current major omega-3 polyunsaturated fatty acids, eicosapentaenoic acid (EPA)/docosahexaenoic acid (DHA) combination, lowers serum TGs while often increasing levels of low-density lipoprotein cholesterol. Icosapent ethyl is an omega-3 polyunsaturated fatty acid with a 96% pure ethyl ester of EPA that has been recently approved for lowering TG levels in patients with very high TGs (≥500 mg/dL), and it does so without significantly affecting serum low-density lipoprotein cholesterol. The potential benefits of omega-3 fatty acid therapy for dyslipidemias will be discussed, including the potential pros and cons of EPA alone versus the more common and readily available EPA/DHA combination therapy. Keywords: triglycerides, low-density lipoprotein, eicosapentaenoic acid, docosahexaenoic acid