Amarin Corporation plc (NASDAQ:AMRN) today announced the
publication in the Journal of the American College of Cardiology
(JACC) of a new REDUCE-IT® data analysis further strengthening
evidence of the benefits of icosapent ethyl in adult patients most
at risk of suffering from a potentially fatal or non-fatal
cardiovascular (CV) event. This new sub-analysis was led by Deepak
L. Bhatt, M.D., M.P.H., Brigham and Women’s Hospital, Harvard
Medical School, Boston, MA.
The patients identified in the new REDUCE-IT
sub-analysis had experienced a prior myocardial infarction (MI),
commonly called a heart attack, and as previously demonstrated, are
therefore at much higher risk of another serious CV event without
further intervention.(1) Research has shown that people who have
had a heart attack are up to 50% more likely to have another CV
event or heart procedure within only one year.(2)
The REDUCE-IT Prior MI sub-analysis studied
3,693 patients (45.2% of initial REDUCE-IT study population) who
had a prior MI within a median of 4.8 years before randomization.
Baseline characteristics were similar among patients randomized to
icosapent ethyl versus placebo. Icosapent ethyl significantly
reduced the primary composite endpoint (first occurrence of CV
death, non-fatal MI, non-fatal stroke, coronary revascularization,
or hospitalization for unstable angina) by 26% (HR 0.74, 95% CI
0.65-0.85, P=0.00001), equating to an absolute risk reduction of
5.9%. Total events (first and subsequent events) were significantly
reduced by 35% (RR 0.65, 95% CI 0.56-0.77, P=0.0000001) in patients
with prior MI who are at high risk of another major
event.(1)
Icosapent ethyl also led to a 29% reduction in
the key secondary composite endpoint of CV death, non-fatal MI, or
non-fatal stroke (equating to an absolute risk reduction of 4.7%
(HR 0.71, 95% CI 0.61-0.84, P=0.00006)). Rates of sudden cardiac
death and cardiac arrest were also significantly reduced, showing
40% relative risk reduction (P=0.02) and 56% relative risk
reduction (P=0.02), respectively.(1)
The safety of icosapent ethyl among patients
with prior MI was consistent with the main study findings in the
entire population, with increased rates of atrial fibrillation and
of minor bleeding, though no significant increase in major
bleeding. These data included both prespecified and post hoc
analyses. It Is important to note that the exploratory nature
limited the post hoc analysis. REDUCE-IT was not powered for
subgroup analyses and all P-values should be considered hypothesis
generating.(1)
The landmark REDUCE-IT cardiovascular outcomes
study, published in New England Journal of Medicine (NEJM) in 2019,
enrolled 8,179 patients for a median of 4.9 years, who were
required to be treated with statins and other standard of care
therapies. All patients had controlled low-density lipoprotein
cholesterol (LDL-C), elevated triglyceride levels, and either
established CVD or diabetes with other cardiovascular risk factors.
(11)
Deepak L. Bhatt, M.D., M.P.H., Executive
Director of Interventional Cardiovascular Programs at Brigham and
Women’s Hospital and Professor of Medicine at Harvard Medical
School, principal investigator of REDUCE-IT and senior author of
the REDUCE-IT Prior MI analyses, said: “The REDUCE-IT Prior MI
analyses provide valuable new data on the use of icosapent ethyl in
patients who have had previous heart attacks. Treatment decisions
for heart attack patients are particularly important given their
elevated risk for another serious and potentially fatal
cardiovascular event. These results build upon the positive
findings from the main REDUCE-IT analysis and further strengthen
the case for eicosapentaenoic acid (EPA) in the form of
prescription icosapent ethyl in appropriate high-risk patients,
such as those with prior heart attacks.”
Cardiovascular disease (CVD) is the leading
cause of death and economic burden in many countries and regions
around the world, including in industrialized countries. In the
U.S., for example, someone dies of a CVD every 36 seconds, on
average.(3) The estimated economic burden from CVD in the U.S. is
projected to exceed $1 trillion by 2035.(4) Europe’s single biggest
killer, CVD, is responsible for more than 4 million(5) patient
deaths each year in the WHO European Region and has an economic
health burden of €210 billion.(6)
Multiple trials have shown that statin therapy
delivers a significant risk reduction of 25% to 35%(7, 8, 9, 10)
for CV events, but this leaves a residual risk, beyond LDL-C
treatment, of 65% to 75%.(7, 8, 9, 10) The high level of remaining
risk strongly suggests the need for additional cardioprotective
measures to help patients avoid a potentially life-changing or
lethal CVD event by reducing the underlying CV risk beyond LDL
reduction.
“We are pleased to see this sub-analysis
published in the Journal of the American College of Cardiology
showing that icosapent ethyl significantly reduces cardiovascular
risk for high-risk patients, in particular those most vulnerable to
a major event because of a prior heart attack,” said Karim Mikhail,
Amarin’s president and chief executive officer. “These and prior
findings with icosapent ethyl are in stark contrast to clinical
trial results and updates for other classes of therapy --
particularly widely-used fibrates – once thought to have the
potential to reduce cardiovascular risk, but which are now known to
not adequately serve cardiovascular patients who are on statin
therapy. Those patients who have had a prior event and are
therefore at increased risk of a subsequent potentially serious
cardiovascular event, such as heart attack or stroke, should only
receive therapies with proven cardiovascular outcomes data.”
The REDUCE-IT Prior MI subgroup analysis was funded by Amarin.
Dr Bhatt receives research funding from Amarin that goes to Brigham
and Women’s Hospital.
Release References
- Gaba P, Bhatt DL, Steg PG et al. Prevention of Cardiovascular
Events and Mortality with Icosapent Ethyl in Patients with Prior
Myocardial Infarction. J Am Coll Cardiol. 2022 May
3;79(17):1660-1671
- Bansilal S, Castellano JM, Fuster V. Global burden of CVD:
focus on secondary prevention of cardiovascular disease. Int J
Cardiol 2015;201:S1–S7.
- Heart Disease and Stroke Statistics—2021 Update; American
College of Cardiology
- Cardiovascular Disease: A Costly Burden for America Projections
Through 2035; American Heart Association; 10
- ERA CVD. ERA-CVD – Cardiovascular Research is our mission
https://www.era-cvd.eu/254.php. Accessed March 2022.
- European Heart Network. European Cardiovascular Disease
Statistics 2017.
https://ehnheart.org/cvd-statistics/cvd-statistics-2017.html.
Accessed March 2022.
- Ganda OP. Bhatt DL. Mason, RP. Unmet Need for Adjunctive
Dyslipidemia Therapy in Hypertriglyceridemia Management. J Am Coll
Cardiol. 2018;72(3):330-343.
- Hong KN, Fuster V, Rosenson RS, Rosendorff C, Bhatt DL. How low
to go with glucose, cholesterol, and blood pressure in primary
prevention of CVD. J Am Coll Cardiol. 2017 Oct
24;70(17):2171-85.
- Collins R, Reith C, Emberson J, et al. Interpretation of the
evidence for the efficacy and safety of statin therapy. Lancet.
2016 Nov 19;388(10059):2532-61.
- Boekholdt SM, Hovingh GK, Mora S, et al. Very low levels of
atherogenic lipoproteins and the risk for cardiovascular events a
meta-analysis of statin trial. J Am Coll Cardiol. 2014 Aug
5;64(5):485-94.
- Bhatt DL, Steg PG, Miller M, et al. Cardiovascular Risk
Reduction with Icosapent Ethyl for Hypertriglyceridemia. N Engl J
Med. 2019;380(1):11 -22.
- Summary of Product Characteristics Vazkepa® – May 2021
https://ec.europa.eu/health/documents/community-register/2021/20210326150935/anx_150935_en.pdf
Accessed March 2022.
About Amarin Amarin is an innovative
pharmaceutical company leading a new paradigm in cardiovascular
disease management. From our foundation in scientific research to
our focus on clinical trials, and now our commercial expansion, we
are evolving and growing rapidly. Amarin has offices in
Bridgewater, New Jersey in the United States, Dublin in Ireland,
Zug in Switzerland, and other countries in Europe as well as
commercial partners and suppliers around the world. We are
committed to increasing the scientific understanding of the
cardiovascular risk that persists beyond traditional therapies and
advancing the treatment of that risk.
About VASCEPA® (icosapent ethyl)
CapsulesVASCEPA (icosapent ethyl) capsules are the
first-and-only prescription treatment approved by the U.S. Food and
Drug Administration (FDA) comprised solely of the active
ingredient, icosapent ethyl (IPE), a unique form of
eicosapentaenoic acid. VASCEPA was launched in the United States in
January 2020 as the first and only drug approved by the U.S. FDA
for treatment of the studied high-risk patients with persistent
cardiovascular risk after statin therapy. VASCEPA was initially
launched in the United States in 2013 based on the drug’s initial
FDA approved indication for use as an adjunct therapy to diet to
reduce triglyceride levels in adult patients with severe (≥500
mg/dL) hypertriglyceridemia. Since launch, VASCEPA has been
prescribed over ten million times. VASCEPA is covered by most major
medical insurance plans. In addition to the United States, VASCEPA
is approved and sold in Canada, Lebanon and the United Arab
Emirates. In Europe, in March 2021 marketing authorization was
granted to icosapent ethyl in the European Union for the reduction
of risk of cardiovascular events in patients at high cardiovascular
risk, under the brand name VAZKEPA.
Indications and Limitation of Use (in the United
States)
VASCEPA is indicated:
- As an adjunct to maximally tolerated
statin therapy to reduce the risk of myocardial infarction, stroke,
coronary revascularization and unstable angina requiring
hospitalization in adult patients with elevated triglyceride (TG)
levels (≥ 150 mg/dL) and
- established
cardiovascular disease or
- diabetes mellitus
and two or more additional risk factors for cardiovascular
disease.
- As an adjunct to diet to reduce TG
levels in adult patients with severe (≥ 500 mg/dL)
hypertriglyceridemia.
The effect of VASCEPA on the risk for pancreatitis in patients
with severe hypertriglyceridemia has not been determined.
Important Safety Information
- VASCEPA is contraindicated in patients
with known hypersensitivity (e.g., anaphylactic reaction) to
VASCEPA or any of its components.
- VASCEPA was associated with an
increased risk (3% vs 2%) of atrial fibrillation or atrial flutter
requiring hospitalization in a double-blind, placebo-controlled
trial. The incidence of atrial fibrillation was greater in patients
with a previous history of atrial fibrillation or atrial
flutter.
- It is not known whether patients with
allergies to fish and/or shellfish are at an increased risk of an
allergic reaction to VASCEPA. Patients with such allergies should
discontinue VASCEPA if any reactions occur.
- VASCEPA was associated with an
increased risk (12% vs 10%) of bleeding in a double-blind,
placebo-controlled trial. The incidence of bleeding was greater in
patients receiving concomitant antithrombotic medications, such as
aspirin, clopidogrel or warfarin.
- Common adverse reactions in the
cardiovascular outcomes trial (incidence ≥3% and ≥1% more frequent
than placebo): musculoskeletal pain (4% vs 3%), peripheral edema
(7% vs 5%), constipation (5% vs 4%), gout (4% vs 3%), and atrial
fibrillation (5% vs 4%).
- Common adverse reactions in the
hypertriglyceridemia trials (incidence >1% more frequent than
placebo): arthralgia (2% vs 1%) and oropharyngeal pain (1% vs
0.3%).
- Adverse events may be reported by
calling 1-855-VASCEPA or the FDA at 1-800-FDA-1088.
- Patients receiving VASCEPA and
concomitant anticoagulants and/or anti-platelet agents should be
monitored for bleeding.
FULL U.S. FDA-APPROVED VASCEPA
PRESCRIBING INFORMATION CAN BE FOUND
AT WWW.VASCEPA.COM.
Forward-Looking StatementsThis press release
contains forward-looking statements which are made pursuant to the
safe harbor provisions of the Private Securities Litigation Reform
Act of 1995, including beliefs about the potential for VASCEPA
(marketed as VAZKEPA in Europe); beliefs about icosapent ethyl
(IPE)’s role concerning patients suffering from cardiovascular
disease (CVD) and impacts on the risk of heart attack, stroke or
other fatal or non-fatal cardiovascular events for patients who
suffered a prior heart attack, as well as general beliefs about the
safety and effectiveness of VASCEPA. These forward-looking
statements are not promises or guarantees and involve substantial
risks and uncertainties. A further list and description of these
risks, uncertainties and other risks associated with an investment
in Amarin can be found in Amarin's filings with the U.S. Securities
and Exchange Commission, including Amarin’s annual report on Form
10-K for the full year ended 2021. Existing and prospective
investors are cautioned not to place undue reliance on these
forward-looking statements, which speak only as of the date they
are made. Amarin undertakes no obligation to update or revise the
information contained in its forward-looking statements, whether as
a result of new information, future events or circumstances or
otherwise. Amarin’s forward-looking statements do not reflect the
potential impact of significant transactions the company may enter
into, such as mergers, acquisitions, dispositions, joint ventures
or any material agreements that Amarin may enter into, amend or
terminate. Availability of Other Information About Amarin
communicates with its investors and the public using the company
website (www.amarincorp.com) and the investor relations website
(investor.amarincorp.com), including but not limited to investor
presentations, Securities and Exchange Commission filings, press
releases, public conference calls and webcasts. The information
that Amarin posts on these channels and websites could be deemed to
be material information. As a result, Amarin encourages investors,
the media and others interested in Amarin to review the information
that is posted on these channels, including the investor relations
website, on a regular basis. This list of channels may be updated
from time to time on Amarin’s investor relations website and may
include social media channels. The contents of Amarin’s website or
these channels, or any other website that may be accessed from its
website or these channels, shall not be deemed incorporated by
reference in any filing under the Securities Act of 1933.
Amarin Contact Information Investor Inquiries:
Investor Relations Amarin Corporation plc In U.S.: +1 (908)
719-1315 IR@amarincorp.com (investor inquiries)
Media Inquiries: Communications Amarin Corporation plc In U.S.:
+1 (973) 906-1526PR@amarincorp.com (media inquiries)
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