Prescription Omega-3 Fatty Acids Cut Cardiovascular Events: REDUCE-IT

In the second big trial surprise of the week, high-dose, prescription fish oil significantly reduced the risk of hard cardiovascular events in a large, global study of statin-treated patients at elevated CV risk.

The top-line results of REDUCE-IT were released by the manufacturer, Amarin, today and will be reported in full at the upcoming American Heart Association (AHA) 2018 Scientific Sessions this November.

The news comes less than a month after the 15,000-patient ASCEND trial found no benefit of a 1-g dose of omega-3 polyunsaturated fatty acids in preventing cardiovascular events among people with diabetes over more than 7 years of follow-up. At the time, experts interviewed by TCTMD said it was time for guidelines to change, retracting any support for fish oil supplementation in the primary prevention of CVD.

The drug, Vascepa, is a purified ethyl ester of eicosapentaenoic acid (EPA) derived from omega-3 fatty acids and intended to target high triglycerides. In the trial, 8,179 statin-treated adults with elevated triglyceride levels and at least one cardiovascular risk factor were randomized to the omega-3 pill at a dose of 4 g/day or to placebo. At a median follow-up of 4.9 years, patients randomized to the omega-3 had a 25% reduction in major adverse cardiovascular events, with no increase in adverse events.

Multiple secondary endpoints were also supportive of the primary results, a company press release notes.

The AHA does not recommend omega-3 polyunsaturated fatty acid supplementation for the primary prevention of coronary heart disease. In a 2017 scientific advisory, however, it stated that omega-3 fatty acids could be considered a reasonable option in secondary prevention, particularly in individuals who have had an MI. In addition, the AHA does advocate a diet that includes oily fish.