From the Guidelines
Vascepa (icosapent ethyl) may potentially increase the risk of gout flares in some patients, particularly those with a history of gout or elevated uric acid levels. This medication, which contains purified eicosapentaenoic acid (EPA), an omega-3 fatty acid, has been associated with elevated uric acid levels in clinical trials 1. The mechanism appears to be related to how omega-3 fatty acids can interfere with uric acid excretion in some individuals.
Some key points to consider:
- The American College of Physicians recommends that clinicians choose corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), or colchicine to treat patients with acute gout 1.
- Prophylactic therapy with low-dose colchicine or low-dose NSAIDs reduces the risk for acute gout attacks in patients initiating urate-lowering therapy 1.
- Urate-lowering therapy is not necessary in cases where the patient would have no or infrequent recurrences of gout attacks 1.
- Patients who decide not to initiate urate-lowering therapy can revisit their decision if they have multiple recurrences of acute gout 1.
If you're taking Vascepa and experience symptoms of a gout flare (such as sudden, severe joint pain, typically in the big toe, ankle, or knee), contact your healthcare provider promptly. They may recommend monitoring your uric acid levels, adjusting your Vascepa dosage, or prescribing medications to prevent or treat gout flares while continuing Vascepa therapy if the cardiovascular benefits outweigh this potential side effect.
From the FDA Drug Label
Common adverse reactions (incidence ≥3% on icosapent ethyl and ≥1% more frequent than placebo) included musculoskeletal pain, peripheral edema, constipation, gout, and atrial fibrillation
The FDA drug label indicates that gout is a common adverse reaction associated with icosapent ethyl, suggesting that Vascepa may cause a gout flare in some patients.
From the Research
Vascepa (Icosapent Ethyl) and Gout Flares
- There is no direct evidence in the provided studies that suggests Vascepa (icosapent ethyl) causes a gout flare 2, 3, 4, 5, 6.
- The studies primarily focus on the use of icosapent ethyl for treating hypertriglyceridemia and its effects on cardiovascular events, rather than its potential impact on gout flares 2, 6.
- Gout flares are typically managed with medications such as colchicine, NSAIDs, and corticosteroids, and are often triggered by factors such as obesity, high alcohol and purine-rich food consumption, and the use of diuretics 3, 4, 5.
- Urate-lowering therapies, such as allopurinol and febuxostat, are used to prevent gout flares, but there is no mention of icosapent ethyl in this context 3, 4, 5.