College of Pharmacy, University of Florida, Jacksonville, USA.
East Coast Institute for Research, Jacksonville, USA.
Am J Cardiovasc Drugs. 2023 Jul;23(4):393-406. doi: 10.1007/s40256-023-00583-8. Epub 2023 May 15.
Icosapent ethyl (IPE) was the first fish oil product the US Food and Drug Administration (FDA) approved to reduce the risk of atherosclerotic cardiovascular disease (ASCVD) in adults. IPE is an esterified version of eicosapentaenoic acid (EPA) and acts as a prodrug in the body to exert its effects. IPE affects the body primarily through triglyceride (TG) reduction and was initially indicated for hypertriglyceridemia in addition to statin therapy or for patients with statin intolerances. Various studies have investigated this agent, and multiple subanalyses have been conducted since the FDA approval. These subanalyses have assessed factors such as sex, statin therapy, high-sensitivity C-reactive protein levels (hs-CRP), and various inflammatory biomarkers in groups of patients taking IPE. This article aims to provide a critical review of the clinical data available regarding cardiovascular benefits of IPE in patients with ASCVD and its value as a treatment option for patients with elevated TG levels.
二十碳五烯酸乙酯(IPE)是美国食品和药物管理局(FDA)批准的第一种可降低成人动脉粥样硬化性心血管疾病(ASCVD)风险的鱼油产品。IPE 是二十碳五烯酸(EPA)的酯化版本,在体内作为前药发挥作用。IPE 主要通过降低甘油三酯(TG)来影响人体,最初用于他汀类药物治疗之外的高甘油三酯血症,或用于他汀类药物不耐受的患者。各种研究都对该药物进行了调查,自 FDA 批准以来,已经进行了多次亚分析。这些亚分析评估了服用 IPE 的患者群体中的性别、他汀类药物治疗、高敏 C 反应蛋白(hs-CRP)水平和各种炎症生物标志物等因素。本文旨在对现有关于 ASCVD 患者 IPE 的心血管获益的临床数据进行批判性回顾,并评估其作为升高的 TG 水平患者的治疗选择的价值。