From the Research
Vascepa (icosapent ethyl) is not currently recommended as a primary treatment for non-alcoholic steatohepatitis (NASH) due to limited evidence, despite its potential benefits in reducing liver fat content and inflammation. The medication, which contains purified eicosapentaenoic acid (EPA), is primarily approved for cardiovascular risk reduction and severe hypertriglyceridemia. For patients with NASH, standard treatment approaches include lifestyle modifications (weight loss, exercise, healthy diet), vitamin E (800 IU daily) for non-diabetic patients, and pioglitazone in select cases 1.
Current Treatment Options
- Lifestyle modifications: weight loss, exercise, healthy diet
- Vitamin E (800 IU daily) for non-diabetic patients
- Pioglitazone in select cases
- Other pharmacological agents, such as obeticholic acid (OCA), are being investigated for the treatment of NASH with fibrosis 2
Potential Benefits of Vascepa
- Anti-inflammatory and lipid-lowering properties may help address underlying mechanisms of NASH
- Reducing triglycerides and potentially decreasing hepatic steatosis
- However, the evidence is not yet strong enough to recommend Vascepa as a primary NASH treatment
Important Considerations
- If prescribed off-label, the typical dose would be 2 grams twice daily with meals, similar to its cardiovascular indication
- Patients should be aware of common side effects, including arthralgia, peripheral edema, and potential bleeding risk, especially if combined with anticoagulants
- The use of Vascepa in NASH patients should be carefully considered, taking into account the limited evidence and potential risks and benefits 3