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Clinical Trials of Eicosapentaenoic Acid (EPA) Prescription Products for the Treatment of Hypertriglyceridemia

Clinical Trials of Eicosapentaenoic Acid (EPA) Prescription Products for the Treatment of Hypertriglyceridemia

Sheila A Doggrell

Expert Opin Pharmacother. 2019 Jul;20(10):1221-1225.

PMID: 31038369

Abstract:

Introduction: Hypertriglyceridemia is common and increases cardiovascular risk. Fish oil decreases triglyceride levels, but also increases low-density lipoprotein (LDL) cholesterol, which may negate any cardiovascular benefits. EPA, a component of fish oil, reduces triglyceride levels without increasing LDL cholesterol. Areas covered: Two forms of purified EPA ethyl ester are available on prescription. This review considers the clinical trials of these purified esters to treat hypertriglyceridemia and shows that the EPA ethyl esters reduce triglyceride levels and reduce cardiovascular events. Expert opinion: To date, the effects of the purified EPA ethyl esters on cardiovascular events have only been tested in subjects taking statins. With statin treatment, if hypertriglyceridemia persists, it may be worthwhile considering adding an EPA ethyl ester. However, as the fibrates reduce the triglyceride levels by similar amounts to the EPA ethyl esters, while increasing the levels of HDL cholesterol, they are an alternative to EPA ethyl esters in combination with statins. As the proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors reduce triglycerides to a similar extent to the EPA ethyl ester, while reducing LDL cholesterol levels to a greater extent than the statins, they should be considered as an alternative to the statin/EPA ethyl ester combination.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
AP73222614	Ethyl formate-13C		73222-61-4	Price

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