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Dr. Peter Block interviews presenter Dr. Deepak Bhatt regarding REDUCE-IT: Reduction in Total Ischemic Events With Icosapent Ethyl. Visit for full meeting coverage.

I’m peter block in new orleans at acc 2019 and with me is an old friend from the brigham and women’s hospital deepak pot and we’ve done a number of these together deepak you’ve presented your trial at a h a and talked about i’m gonna say the nasty word right we’re talking about fish oil so tell everybody what this trial is number one what reduce it is and then

You have some more data now for acc absolutely so reduce it studied i cosas pent ethel which is an omega-3 fatty acid but a highly purified version of lycosa pentanoic acid or epa a– an ethyl ester that’s quite pure so very different from you know over-the-counter sort of officials and what we found and the overall analysis was a 25% reduction and important

Ischemic events that was what i presented at a h a we published a new england journal of medicine what it is a prescription drug yes it’s a prescription drug approved in patients with triglycerides five hundred and over okay so that’s the status of it pre reduce it but what we showed and reduce it was that this drug versus placebo reduced ischemic events by

About 25 percent in a little over 8,000 patients with triglycerides that were felt to be elevated who also had additional cardiovascular risk in particular secondary prevention or diabetes plus an additional cardiovascular risk factor high risk primary prevention so in that broad population it reduced first events by 25 percent so a good trial obviously very

Positively so what have you learned now for acc so what we’ve examined here now is total events so not just the time to first event which is a traditional conservative way of looking at data but total events so for example somebody could have a myocardial infarction that’s what we would count in our study but that same person could go on and have a stroke maybe

A fatal stroke a year or two years later the typical time to first event analysis doesn’t count those events which from a patient’s perspective might seem kind of screwy but there’s good reasons and conservative reasons in terms of statistics to do that but what we’ve done now is examine total events that we’ve is four total events there’s a 30% reduction

But even beyond that reduction in total events if one looks at second and third events there’s 30 to 31 percent reduction and fourth or more events it’s actually a 48 percent reduction so we’re getting up in big numbers yeah and you know the statistics are really quite strong at depending we did multiple ways of looking at recurrent events but you know p-values

From anywhere from 10 to the minus 10 but 10 to the minus 27 do you pretty significant erupt i mean this is a drug right it is a prescription medical or one i’m gonna ask you two questions number one do you prescribe it to your patients with high ld with high glycerine c sorry yes so i must say a pre reduce it i wasn’t a user of this i usually occasionally for

Folks with high triglycerides but most reduce it yeah i mean i believe the results so it’s a prescription drug gets branded it is really dependent on the patient’s insurance coverage so for the folks that have elevated triglycerides where i’ve used it in the past ones that have insurance coverage the co-pays like 30 bucks a year or something laksa mately now

Reduce it would be an off-label indication to be clear so it remains to be seen what the coverage is like but so far at least among colleagues of mine that have prescribed it and given me feedback ensure seem to be covering it do you take it i don’t but i don’t have a thorough sclerosis and i don’t have diabetes so you know we studied people in one of those two

Categories so fortunately to my knowledge i don’t have either i may need to get checked one last question we heard a lot about fish oil just in general right does it or doesn’t do good for population suppose i take instead of two tablets of fish oil every day i take 10 does that make up pork no not at all i mean for over-the-counter supplements you have to take

You know about 20 pills but then you won’t even be getting pure epa you’d beginning dha a bunch of other saturated fat and we’re not really sure what the health effects of all that might be so i wouldn’t recommend just doing a bunch of supplements that would also be super expensive the supplements aren’t cheap either we talk about prescription drug prices but the

Supplements can be kind of pricey for that reason i wouldn’t recommend it the other thing sometimes people say i’ll just need a lot of fish and you know fish does have a pn it but you’d have to have you know over 20 servings a week to get these little green portion yeah there’s other that’s okay it could happen so for everybody out there this drug prescription

Drug clearly is doing it’s good stuff right i think i think probably for patients with a through scott ik disease we’re going to see a lot more patients being prescribed this thanks so much deepak thank you you

Transcribed from video
REDUCE-IT | ACC.19 By American College of Cardiology