Benefit of icosapent ethyl consistent regardless of background statin type
In a new analysis of the REDUCE-IT trial, the treatment effect of icosapent ethyl was consistent across different agents and categories of statins patients were taking.
As Healio previously reported, in the main results of REDUCE-IT, icosapent ethyl (Vascepa, Amarin), a pharmaceutical-grade omega-3 fatty acid, reduced risk for ischemic events compared with placebo in patients with elevated triglycerides and established CVD or diabetes plus other risk factors who were taking statin therapy.
For the present analysis, Nickpreet Singh, MD, MS, internal medicine resident at Massachusetts General Hospital, and colleagues evaluated whether the treatment effect of icosapent ethyl for the primary endpoint of CV death, MI, stroke, coronary revascularization or unstable angina and the key secondary endpoint of CV death, MI or stroke varied by statin agent and statin category.
The primary endpoint did not vary by statin agent (P for interaction = .95) and favored icosapent ethyl in all agents: atorvastatin (HR = 0.79; 95% CI, 0.67-0.93; P = .006), simvastatin (HR = 0.79; 95% CI, 0.65-0.96; P = .02), rosuvastatin (HR = 0.73; 95% CI, 0.57-0.94; P = .01) and pravastatin (HR = 0.79; 95% CI, 0.54-1.16; P = .24), according to the researchers.
The primary endpoint also did not vary by statin category (lipophilic, HR = 0.78; 95% CI, 0.69-0.88; P < .0001; lipophobic, HR = 0.75; 95% CI, 0.61-0.93; P = .007; P for interaction = .67), Singh and colleagues wrote.
In addition, the treatment effect of icosapent ethyl for the key secondary endpoint was consistent by statin agent (P for interaction = .68) and statin category (P for interaction = .74), the researchers found.
“This key finding offers insight for prescribing physicians that the benefits of icosapent ethyl are not only additive to those of statin therapy, but also appear not to vary by the particular statin used,” Singh and colleagues wrote. “This lack of dependence suggests mechanisms that are modified by statin intensity, agent or lipophilicity are not primary drivers of icosapent ethyl’s clinical efficacy. Further studies may clarify the mechanisms by which icosapent ethyl reduces cardiovascular risk, including a better understanding of the interplay between other therapies and these mechanisms.”