Center for Diabetes, Metabolism and Endocrinology, Toho University Sakura Medical Center, Chiba 285-8741, Japan.
J Clin Lipidol. 2013 May-Jun;7(3):199-207. doi: 10.1016/j.jacl.2013.01.006. Epub 2013 Feb 4.
Hypertriglyceridemia is a risk factor for cardiovascular disease, and clinical practice guidelines advocate treatment to reduce triglyceride (TG) levels. In Japan, an EPA-E (eicosapentaenoic acid-ethyl ester) product has been used clinically for treating dyslipidemia.
We investigated the TG-lowering effects of TAK-085 (EPA-E + docosahexaenoic acid-ethyl ester) in comparison with EPA-E in Japanese patients with hypertriglyceridemia (TG ≥150 mg/dL and <750 mg/dL).
In this multicenter, 12-week, double-blind study, subjects were stratified for coadministration of a 3-hydroxy-3-methyl-glutaryl-CoA reductase inhibitor then randomized to TAK-085 2 g once daily (n = 205), TAK-085 2 g twice daily (n = 210), or EPA-E 0.6 g three times daily (n = 195). Each one gram of fatty acid in TAK-085 contains approximately 465 mg of EPA plus 375 mg of docosahexaenoic acid-ethyl as ethyl esters. Guidance on lifestyle modifications was provided throughout.
The primary end point was the percent change in TG levels (baseline from end of treatment), which was -10.8 ± 22.6, -22.9 ± 23.1, and -11.2 ± 25.7 in the TAK-085 2 g/day, TAK-085 4 g/day, and EPA-E 1.8 g/day groups, respectively. TAK-085 4 g/day produced a significantly greater reduction in TG than EPA-E 1.8 g/day (P < .0001), whereas TAK-085 2 g/day was not inferior to EPA-E 1.8 g/day. Changes in other lipid parameters were relatively modest. There were no notable safety or tolerability differences between the groups.
In Japanese patients with modest hypertriglyceridemia who also underwent lifestyle intervention, TAK-085 4 g/day reduced TG more than EPA-E 1.8 g/day. TAK-085 2 g/day had similar effects on TG as EPA-E 1.8 g/day. TAK-085 was well-tolerated.
高甘油三酯血症是心血管疾病的一个危险因素,临床实践指南提倡治疗以降低甘油三酯(TG)水平。在日本,一种 EPA-E(二十碳五烯酸乙酯)产品已用于治疗血脂异常。
我们研究了 TAK-085(EPA-E+二十二碳六烯酸乙酯)与 EPA-E 相比在日本高甘油三酯血症(TG≥150mg/dL 且<750mg/dL)患者中的降 TG 作用。
在这项多中心、12 周、双盲研究中,根据同时服用 3-羟基-3-甲基戊二酰辅酶 A 还原酶抑制剂的情况对受试者进行分层,然后随机分为 TAK-085 1 克每日 1 次(n=205)、TAK-085 1 克每日 2 次(n=210)或 EPA-E 0.6 克每日 3 次(n=195)。TAK-085 中的每 1 克脂肪酸含有约 465 毫克 EPA 和 375 毫克二十二碳六烯酸乙酯作为乙酯。在整个研究过程中都提供了生活方式改变的指导。
主要终点是 TG 水平的变化百分比(从基线到治疗结束),分别为 TAK-085 1 克/天、TAK-085 2 克/天和 EPA-E 1.8 克/天组的-10.8%±22.6%、-22.9%±23.1%和-11.2%±25.7%。TAK-085 2 克/天组的 TG 降低幅度显著大于 EPA-E 1.8 克/天组(P<0.0001),而 TAK-085 1 克/天组与 EPA-E 1.8 克/天组无差异。其他脂质参数的变化相对较小。各组之间在安全性或耐受性方面没有明显差异。
在接受生活方式干预的日本中度高甘油三酯血症患者中,TAK-085 4 克/天降低 TG 的效果优于 EPA-E 1.8 克/天。TAK-085 2 克/天与 EPA-E 1.8 克/天的 TG 作用相似。TAK-085 耐受性良好。