Icosapent ethyl, a pure EPA omega-3 fatty acid: Effects on lipoprotein particle concentration and size in patients with very high triglyceride levels (the MARINE

BACKGROUND: Icosapent ethyl (IPE; formerly AMR101) is a high-purity prescription form of eicosapentaenoic acid ethyl ester. In the MARINE study we evaluated the efficacy and safety of IPE in patients with very high triglycerides (TG; $500 mg/dL) and previously demonstrated significant reductions in TG levels with no significant increases in low-density lipoprotein (LDL) cholesterol levels. OBJECTIVES: In this follow-up, exploratory analysis, we report the effects of IPE on lipoprotein particle concentration and size. METHODS: MARINE was a phase 3, multicenter, placebo-controlled, randomized, double-blind, 12-week study. Hypertriglyceridemic patients (N 5 229) were randomized to three treatment groups: IPE 4 g/day, IPE 2 g/day, or placebo. Lipoprotein particle concentrations and sizes were measured by nuclear magnetic resonance spectroscopy. RESULTS: Compared with placebo, IPE 4 g/day significantly reduced median concentrations of large very-low-density lipoprotein (VLDL; 227.9$500 mg/dL, IPE did not significantly change the overall sizes of LDL or HDL particles. CONCLUSION: IPE 4 g/day significantly reduced large VLDL, total LDL, small LDL, and total HDL particle concentrations and VLDL particle size in patients with TG $500 mg/dL. Changes in VLDL particle concentration and size reflect the TG-lowering effects of eicosapentaenoic acid. The reduction in LDL particle concentration with IPE is novel among u-3 therapies and is consistent with the previously reported reduction in apolipoprotein B and lack of LDL-C increase with IPE in patients with very high TG levels. Clinical trial registration number: NCT01047683

Original Articles National Lipid Association recommendations for patient-centered management of dyslipidemia: Part 1 -executive summary E M B A R G O E D

Abstract: Various organizations and agencies have issued recommendations for the management of dyslipidemia. Although many commonalities exist among them, material differences are present as well. The leadership of the National Lipid Association (NLA) convened an Expert Panel to develop a consensus set of recommendations for patient-centered management of dyslipidemia in clinical medicine. The current Executive Summary highlights the major conclusions in Part 1 of the recommendations report of the NLA Expert Panel and includes: (1) background and conceptual framework for formulation of the NLA Expert Panel recommendations; (2) screening and classification of lipoprotein lipid levels in adults; (3) targets for intervention in dyslipidemia management; (4) atherosclerotic cardiovascular disease risk assessment and treatment goals based on risk category; (5) atherogenic cholesterol-non-high-density lipoprotein cholesterol and low-density lipoprotein cholesterol-as the primary targets of therapy; and (6) lifestyle and drug therapies intended to reduce morbidity and mortality associated with dyslipidemia. Ó 2014 National Lipid Association. All rights reserved. Various organizations and agencies have issued recommendations for the management of dyslipidemia. The current Executive Summary highlights the major conclusions in Part 1 of the recommendations report of the NLA Expert Panel. The Executive Summary does not include a comprehensive reference list, but citations have been included for several key publications. The full report will include additional details on the rationale for the recommendations and citations to published research considered in the panel's deliberations. A presentation containing the main elements of these recommendations was made available to the public and other organizations involved with the prevention of atherosclerotic cardiovascular disease (ASCVD) to solicit input during an open comment period. Comments and suggestions were received from many members of the NLA as well as other individuals and organizations and were collated for consideration and adjudication by the panel in formulating the final set of recommendations contained herein. Part 1 of the NLA Expert Panel Recommendations for Patient-Centered Management of Dyslipidemia, will cover: Background and conceptual framework for formulation of the NLA Expert Panel recommendations; Screening and classification of lipoprotein lipid levels in adults; Targets for intervention in dyslipidemia management; ASCVD risk assessment and treatment goals based on risk category; Atherogenic cholesterol-non-high-density lipoprotein cholesterol (non-HDL-C) and low-density lipoprotein cholesterol (LDL-C)-as the primary targets of therapy; and Lifestyle and drug therapies intended to reduce morbidity and mortality associated with dyslipidemia

Original Articles National Lipid Association recommendations for patient-centered management of dyslipidemia: Part 1 -executive summary

Abstract: Various organizations and agencies have issued recommendations for the management of dyslipidemia. Although many commonalities exist among them, material differences are present as well. The leadership of the National Lipid Association (NLA) convened an Expert Panel to develop a consensus set of recommendations for patient-centered management of dyslipidemia in clinical medicine. The current Executive Summary highlights the major conclusions in Part 1 of the recommendations report of the NLA Expert Panel and includes: (1) background and conceptual framework for formulation of the NLA Expert Panel recommendations; (2) screening and classification of lipoprotein lipid levels in adults; (3) targets for intervention in dyslipidemia management; (4) atherosclerotic cardiovascular disease risk assessment and treatment goals based on risk category; (5) atherogenic cholesterol-non-high-density lipoprotein cholesterol and low-density lipoprotein cholesterol-as the primary targets of therapy; and (6) lifestyle and drug therapies intended to reduce morbidity and mortality associated with dyslipidemia. Ó 2014 National Lipid Association. All rights reserved. Various organizations and agencies have issued recommendations for the management of dyslipidemia. The current Executive Summary highlights the major conclusions in Part 1 of the recommendations report of the NLA Expert Panel. The Executive Summary does not include a comprehensive reference list, but citations have been included for several key publications. The full report will include additional details on the rationale for the recommendations and citations to published research considered in the panel's deliberations. A presentation containing the main elements of these recommendations was made available to the public and other organizations involved with the prevention of atherosclerotic cardiovascular disease (ASCVD) to solicit input during an open comment period. Comments and suggestions were received from many members of the NLA as well as other individuals and organizations and were collated for consideration and adjudication by the panel in formulating the final set of recommendations contained herein. Part 1 of the NLA Expert Panel Recommendations for Patient-Centered Management of Dyslipidemia, will cover: Background and conceptual framework for formulation of the NLA Expert Panel recommendations; Screening and classification of lipoprotein lipid levels in adults; Targets for intervention in dyslipidemia management; ASCVD risk assessment and treatment goals based on risk category; Atherogenic cholesterol-non-high-density lipoprotein cholesterol (non-HDL-C) and low-density lipoprotein cholesterol (LDL-C)-as the primary targets of therapy; and Lifestyle and drug therapies intended to reduce morbidity and mortality associated with dyslipidemia

Original Articles National Lipid Association recommendations for patient-centered management of dyslipidemia: Part 1 -executive summary

Abstract: Various organizations and agencies have issued recommendations for the management of dyslipidemia. Although many commonalities exist among them, material differences are present as well. The leadership of the National Lipid Association (NLA) convened an Expert Panel to develop a consensus set of recommendations for patient-centered management of dyslipidemia in clinical medicine. The current Executive Summary highlights the major conclusions in Part 1 of the recommendations report of the NLA Expert Panel and includes: (1) background and conceptual framework for formulation of the NLA Expert Panel recommendations; (2) screening and classification of lipoprotein lipid levels in adults; (3) targets for intervention in dyslipidemia management; (4) atherosclerotic cardiovascular disease risk assessment and treatment goals based on risk category; (5) atherogenic cholesterol-non-high-density lipoprotein cholesterol and low-density lipoprotein cholesterol-as the primary targets of therapy; and (6) lifestyle and drug therapies intended to reduce morbidity and mortality associated with dyslipidemia. Ó 2014 National Lipid Association. All rights reserved. Various organizations and agencies have issued recommendations for the management of dyslipidemia. The current Executive Summary highlights the major conclusions in Part 1 of the recommendations report of the NLA Expert Panel. The Executive Summary does not include a comprehensive reference list, but citations have been included for several key publications. The full report will include additional details on the rationale for the recommendations and citations to published research considered in the panel's deliberations. A presentation containing the main elements of these recommendations was made available to the public and other organizations involved with the prevention of atherosclerotic cardiovascular disease (ASCVD) to solicit input during an open comment period. Comments and suggestions were received from many members of the NLA as well as other individuals and organizations and were collated for consideration and adjudication by the panel in formulating the final set of recommendations contained herein. Part 1 of the NLA Expert Panel Recommendations for Patient-Centered Management of Dyslipidemia, will cover: Background and conceptual framework for formulation of the NLA Expert Panel recommendations; Screening and classification of lipoprotein lipid levels in adults; Targets for intervention in dyslipidemia management; ASCVD risk assessment and treatment goals based on risk category; Atherogenic cholesterol-non-high-density lipoprotein cholesterol (non-HDL-C) and low-density lipoprotein cholesterol (LDL-C)-as the primary targets of therapy; and Lifestyle and drug therapies intended to reduce morbidity and mortality associated with dyslipidemia