Addition of omega-3 carboxylic acids to statin therapy in patients with persistent hypertriglyceridemia

Expert Rev Cardiovasc Ther. 2014 Sep;12(9):1045-54. doi: 10.1586/14779072.2014.942640. Epub 2014 Aug 4.

Abstract

The incidence of hypertriglyceridemia has grown alongside that of obesity. Statin therapy has been widely recommended for the treatment of dyslipidemias. Omega-3 (OM3) fatty acid concentrates are commonly prescribed concurrently with statins in patients with persistent hypertriglyceridemia for additional lowering of triglyceride and non-HDL cholesterol. The bioavailability of currently available OM3 ethyl ester drugs is limited by their need for hydrolysis by pancreatic lipases, largely stimulated by dietary fat, prior to intestinal absorption. This review will discuss the chemistry, pharmacokinetics and clinical efficacy of a novel OM3 carboxylic acid drug that provides polyunsaturated docosahexaenoic and eicosapentaenoic acids in the free fatty acid form, which is readily absorbed by the intestine. This drug was approved in May 2014 as an adjunct to diet to reduce triglyceride levels in adults with severe (≥500 mg/dl) hypertriglyceridemia.

Keywords: cholesterol-lowering drug; fish oil; hyperlipidemia; lipids; omega-3 carboxylic acid; triglycerides.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Biological Availability
  • Carboxylic Acids / administration & dosage
  • Carboxylic Acids / pharmacokinetics
  • Carboxylic Acids / therapeutic use
  • Docosahexaenoic Acids / administration & dosage*
  • Docosahexaenoic Acids / pharmacokinetics
  • Docosahexaenoic Acids / therapeutic use
  • Drug Combinations
  • Drug Therapy, Combination
  • Eicosapentaenoic Acid / administration & dosage*
  • Eicosapentaenoic Acid / pharmacokinetics
  • Eicosapentaenoic Acid / therapeutic use
  • Fatty Acids, Omega-3 / administration & dosage
  • Fatty Acids, Omega-3 / pharmacokinetics
  • Fatty Acids, Omega-3 / therapeutic use
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Hypertriglyceridemia / drug therapy*

Substances

  • Carboxylic Acids
  • Drug Combinations
  • Fatty Acids, Omega-3
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Docosahexaenoic Acids
  • Eicosapentaenoic Acid