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DTB drug review
▼Icosapent ethyl for CV risk reduction

https://doi.org/10.1136/dtb.2024.000038

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    What you need to know

    • Icosapent ethyl is a stable ester of eicosapentaenoic acid, an omega-3 fatty acid.

    • It is licensed to reduce the risk of cardiovascular (CV) events in adults who are taking a statin and are at high CV risk with moderately elevated triglycerides and established CV disease, or diabetes and at least one other CV risk factor.

    • In one study of people taking a statin who had CV disease or were at high risk of CV disease, the risk of ischaemic events was 17.2% with icosapent ethyl compared with 22.0% with a placebo consisting of mineral oil.

    • Adverse events include bleeding, atrial flutter or fibrillation, constipation, gout, musculoskeletal pain, peripheral oedema and rash.

    • The National Institute for Health and Care Excellence found that icosapent ethyl was not cost-effective for primary prevention but recommended it as an option for secondary prevention of CV disease.

    Introduction

    Cardiovascular disease (CVD) is the leading cause of death worldwide (causing >30% of all global deaths).1 Around 7 million people in the UK have CVD.1 The total healthcare cost of CVD in England is estimated to be £7.4 billion.1

    CVD is more prevalent in men, people aged >50 years, certain ethnic backgrounds (eg, South Asian) and in areas of high deprivation.2 3 Modifiable risk factors include smoking, alcohol intake above recommended levels, lack of physical activity, unhealthy diet, high blood pressure, high blood level of non-high-density lipoprotein (non-HDL) cholesterol, diabetes, hypothyroidism, overweight and obesity.4–6 It is important to lower low-density lipoprotein (LDL) cholesterol to reduce CV risk.5 Hypertriglyceridaemia is also a risk factor for CVD and is independent of total cholesterol.4

    A person’s estimated CVD risk within the next 10 years can be calculated. The National Institute for Health and Care Excellence (NICE) guideline recommends using the QRISK3 tool (https://qrisk.org), for people aged between …

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    Footnotes

    • Competing interests None declared. Refer to the online supplementary files to view the ICMJE form(s).

    • Provenance and peer review Commissioned; externally peer reviewed.