From the Guidelines
Icosapent ethyl (IPE) is the recommended treatment for fatty acid management, specifically for reducing triglyceride levels in adult patients with severe hypertriglyceridemia (≥500 mg/dL) or as an adjunct to maximally tolerated statin therapy to reduce the risk of cardiovascular events in patients with elevated triglyceride levels (≥150 mg/dL) and established cardiovascular disease or diabetes mellitus with ≥2 additional risk factors for cardiovascular disease 1.
Key Points
- IPE is an ethyl ester of EPA, which has been shown to be effective in reducing triglyceride levels and cardiovascular risk 1.
- The treatment is indicated for adult patients with severe hypertriglyceridemia (triglycerides ≥500 mg/dL) or as an adjunct to maximally tolerated statin therapy to reduce the risk of cardiovascular events 1.
- IPE has been demonstrated to reduce the risk of myocardial infarction, stroke, coronary revascularization, and unstable angina requiring hospitalization in adult patients with elevated triglyceride levels and established cardiovascular disease or diabetes mellitus with ≥2 additional risk factors for cardiovascular disease 1.
Important Considerations
- Prescription omega-3 fatty acid preparations, including IPE, have been associated with an increased risk of atrial fibrillation (AF) 1.
- Clinicians should evaluate the potential net benefit of IPE in patients at high risk of AF 1.
- Nonprescription fish oil products are not interchangeable with prescription omega-3 products and have not been demonstrated to have cardiovascular outcomes benefits 1.
From the Research
IPE for Fatty Acid Treatment
- IPE stands for Intravenous Lipid Emulsion or Intravenous Phospholipid Emulsion, but in the context of fatty acid treatment, it is not explicitly defined in the provided studies.
- However, the studies discuss the use of medium-chain triglycerides (MCT) and other fatty acids in the treatment of various health disorders, including long-chain fatty acid oxidation disorders (LC-FAOD) 2.
- MCT oil is used as a functional or nutraceutical oil in various food and pharmaceutical formulations due to its numerous health benefits, including its ability to serve as an immediate energy source 3.
Medium-Chain Triglycerides (MCT)
- MCT contain medium-chain fatty acid esterified to the glycerol backbone, which are quickly metabolized in the body 3.
- Studies have shown that MCT oil can increase plasma total cholesterol, LDL cholesterol, and triglycerides, but does not affect HDL cholesterol levels 4, 5.
- However, MCT oil has been found to have beneficial effects on blood lipid profiles in certain populations, such as male hypertriglyceridemic subjects 6.
Fatty Acid Oxidation Disorders
- LC-FAOD are a group of disorders characterized by the inability to oxidize long-chain fatty acids, leading to serious morbidity and mortality 2.
- Triheptanoin, a triglyceride oil, has been shown to be effective in the treatment of LC-FAOD by replenishing deficient tricarboxylic acid cycle intermediates 2.
- MCT oil may be less effective in certain types of FAOD, such as carnitine-acylcarnitine translocase deficiency, and requires further investigation 2.