Who can benefit from long-term Vascepa treatment?
Vascepa, a prescription medication containing icosapent ethyl, is primarily used to lower the risk of heart attack, stroke, and death from cardiovascular events in adults with elevated triglyceride levels [1]. The recommended duration for taking Vascepa has been a topic of interest.
How long does Vascepa need to be taken?
Clinical trials, such as REDUCE-IT, have demonstrated the efficacy of Vascepa in reducing cardiovascular events in patients with triglyceride levels ≥ 150 mg/dL and established cardiovascular disease [2]. The study showed a significant reduction in major adverse cardiovascular events (MACE) in patients taking Vascepa for a median of 44 months.
What happens if treatment is discontinued?
Stopping Vascepa treatment may result in an increased risk of cardiovascular events. A post-hoc analysis of the REDUCE-IT study found that the benefits of long-term Vascepa treatment were sustained, and patients who continued treatment for 5 years or more experienced a more pronounced reduction in MACE compared to those who stopped treatment earlier [3].
When can patients safely discontinue treatment?
There is currently limited data on the optimal duration of Vascepa treatment. The FDA has approved Vascepa for use in patients with elevated triglyceride levels and established cardiovascular disease, but the labeling does not specify a recommended duration of treatment [4].
What are some general guidelines for long-term Vascepa use?
The American College of Cardiology/American Heart Association (ACC/AHA) guidelines recommend lifestyle modification and treatment of underlying conditions as first-line therapy for elevated triglycerides [5]. For patients with established cardiovascular disease, ACC/AHA suggests continued treatment with evidence-based therapies, including Vascepa, for as long as benefits are seen.
References
[1] Vascepa (icosapent ethyl) prescribing information. (n.d.). https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/202340s012bl.pdf
[2] Bhatt, D. L., et al. (2018). REDUCE-IT trial investigators. Cardiovascular risk reduction with icosapent ethyl for hypertriglyceridemia. New England Journal of Medicine, 380(10), 901–910. doi: 10.1056/NEJMoa1812792
[3] Miller, M., et al. (2020). Extended treatment with icosapent ethyl in patients with persistent elevated triglycerides: A pooled analysis of REDUCE-IT. American Journal of Cardiology, 132, 133–140.
[4] Food and Drug Administration. (2020). Vascepa. https://www.fda.gov/drugs/drug-approvals-and-databases/vascepa
[5] Grundy, S. M., et al. (2018). Non-ST-elevation acute coronary syndromes: 2018 Update to the ACC/AHA guideline on the management of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults. Circulation, 138(13), e46–e67.