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美国食品药品监督管理局(FDA)对二十碳五烯酸乙酯扩大适应症对进一步降低心血管残留风险的影响。

Impact of expanded FDA indication for icosapent ethyl on enhanced cardiovascular residual risk reduction.

作者信息

Boden William E, Baum Seth, Toth Peter P, Fazio Sergio, Bhatt Deepak L

机构信息

VA New England Healthcare System, Boston, MA, & Boston University School of Medicine, Boston, MA 02130, USA.

Boca Raton Regional Hospital, Boca Raton, FL 33486, USA.

出版信息

Future Cardiol. 2021 Jan;17(1):155-174. doi: 10.2217/fca-2020-0106. Epub 2020 Sep 22.

Abstract

Hypertriglyceridemia is associated with increased cardiovascular disease (CVD) risk. The Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT) demonstrated that the purified, stable ethyl ester of eicosapentaenoic acid, icosapent ethyl (IPE), added to statins reduced CVD events by 25% (p < 0.001), leading to an expanded indication in the USA. IPE is now approved as an adjunct to maximally tolerated statins to reduce CVD event risk in adults with triglyceride (TG) levels ≥150 mg/dl and either established CVD or diabetes mellitus plus ≥2 additional CVD risk factors. The new indication allows co-administration of IPE for elevated TG levels with statin treatment, enabling effective residual risk reduction in a broader at-risk population beyond what can be achieved with intensive low-density lipoprotein cholesterol control alone.

摘要

高甘油三酯血症与心血管疾病(CVD)风险增加相关。二十碳五烯酸乙酯干预降低心血管事件试验(REDUCE-IT)表明,在他汀类药物基础上加用纯化的、稳定的二十碳五烯酸乙酯(IPE)可使心血管疾病事件减少25%(p<0.001),这使得其在美国的适应证得以扩大。IPE现被批准作为最大耐受剂量他汀类药物的辅助用药,用于降低甘油三酯(TG)水平≥150mg/dl且患有已确诊的心血管疾病或糖尿病以及至少另外2种心血管疾病风险因素的成人发生心血管疾病事件的风险。这一新适应证允许在他汀类药物治疗的同时加用IPE来治疗升高的甘油三酯水平,从而在更广泛的高危人群中有效降低残余风险,这是仅通过强化控制低密度脂蛋白胆固醇所无法实现的。

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