AHA Abstract 18492: Cross-Sectional Analysis of Demographic and Clinical Characteristics of Patients Using Icosapent Ethyl,With a Focus on Patients wi
John Nelson MD,FACC,FNLA,FASNC
Director at California Cardiovascular Institute
th Diabetes,Presented by Om P. Ganda on behalf of co-authors Peter P Toth,Handrean Soran,John R Nelson,Nathan D Wong,David Abrahamson,Hakima Hannachi,Josh Hartman and Sephy Philip.Circulation.2023;148:A18492,https://doi.org/10.1161/circ.148.suppl_1.18492
This study describes demographical/clinical characteristics of US patients taking icosapent ethyl,focusing on those with diabetes
A database of >89 million electronic records identified patients taking icosapent ethyl(ie,./=2 prescriptions on 2 separate days).Patient demographical/clinical baseline data were retrieved
As of Jan 19,2023, 40,408 patients taking icosapent ethyl were identified with a mean(SD) age of 60.3(12.9)y,BMI of 31.9(6.07)kg/m2,HbA1c of 7.24%(1.88)and glucose level of 143(67.8)mg/dl.71.8% were taking statins.
Mean(SD;median)triglycerides(TG) in the 3 moths before icosapent ethyl initiation was 422(506;300);8.1% of patients had TG>/=500mg/dl.
In line with the indication of icosapent ethyl ,65.3% had prior atherosclerotic CVD or diabetes and >/= 1 risk factor.
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Among the 16,564 patients with diabetes,13% had a history of myocardial infarction,12.5% had stroke, and 10.4% had revasularization.Common antidiabetic medications were metformin(37.4),insulin(27.9%),and sulfonylurea(15.1%)
Conclusions:Patients using icosapent ethyl often had diabetes and/or CVD,took statins,and had elevated TG,meeting indications for its use.However,the high median TG before therapy suggests that many physicians reserve icosapent ethyl for more severe TG;thus many patients with moderate levels(>150mg/dl)could potentially benefit.
Personal comment: I was shocked by the baseline TG level ,but still not completely surprised as I see the lack of utilization of prescription icosapent ethyl and treating residual CV risk every week running a large lipid clinic.As Nathan Wong,PhD,MPH et al published in Am J.Cardiol.2020;134:62-68 using FDA eligibility criteria,an estimated 4.6 million persons would be eligible for icosapent ethyl ,with 60,544 preventable primary CVD outcomes annually from REDUCE-IT USA event rates.Over 4.9 years 27,377 cardiovascular deaths could be prevented!!!! There must be an increased focus on treating patients with prescription icosapent ethyl which has been shown to be cost-effective and is on guideline recommendations.Focusing only on LDL-C leaving elevated Tg/residual CV risk untreated especially in high/very high risk is unacceptable.
C.E.O. & Chief Geologist at Pronounced-Hydrocarbons, LLC (Retired)
10 个月This is an excellent study that highlights the robust efficacy of IPE in DM2 patients. Furthermore, it shows that generics which have captured over 43% of the market (from recent scripts data), are definitely infringing on the CV indication patents that is owned by Amarin (the manufacturer of branded VASCEPA). Your study confirms that only 8.1% of the 40,000 VASCEPA patients in your study were severe hypotriglyceridemic (TG>= 500mg/dl), which is the only indication generics are approved for. It's my hope that you and your co-authors are called as expert witnesses in the pending Dr. Reddy's Lab's Antitrust lawsuit against Amarin. In that suit DRL claims that Amarin tried to corner the market supply of IPE. This while at the same time marketing way over what they are entitled to. As a well-informed CV patient and an admitted Amarin investor I thank you and your colleagues for your commitment to "Evidence Based Medicine." #EBM