Matthew Budoff, MD: Effect of Icosapent Ethyl on Plaque Regression

New research from the EVAPORATE trial are offering greater insight into the effects of icosapent ethyl (Vascepa) on plaque volume in patients with coronary atherosclerosis.

A randomized, double-blind, placebo-controlled trial, results suggest use of icosapent ethyl was associated with a 17% reduction in low attenuation plaque volume on multidetector computed tomography (MDCT) compared with placebo over an 18-month period.

“EVAPORATE provides important mechanistic data on coronary plaque characteristics that are potentially relevant to the overall REDUCE-IT results and clinical use of icosapent ethyl,” said Matthew Budoff, MD, director of Cardiovascular CT at The Lundquist Institute and professor of medicine at the David Geffen School of Medicine at UCLA, in a statement from Amarin.

Including 80 patients randomized to either icosapent ethyl or placebo, EVAPORATE sought to determine the effect of the omega-3 fatty acid derived-agent on plaque regression in patients with coronary atherosclerosis. Patients included in the trial were on statin therapy and had a mean triglyceride level of 259.1±78.1 mg/dL. With scans planned at 9 months and 18 months, the primary endpoint of the study was a comparison in change of low attenuation plaque volume at 18 months between the study arms.

Upon analysis, investigators found use of icosapent ethyl was associated with an 17% reduction of low attenuation plaque volume at the 18-month scan while placebo therapy was associated with an increase in the progression of plaque volume. Additionally, results indicated all patients in the icosapent ethyl group experienced regression in plaque volume (P <.01 for all) and the only secondary end point not achieved in the trial was a significant difference in dense calcium (P=.053).

For more on the results of the EVAPORATE trial and how they inform clinicians on the use of icosapent ethyl in real-world settings, Practical Cardiology reached out to Budoff to participate in an ESC 2020 House Call.

This study, “Final Results of the EVAPORATE Trial,” was presented as part of the ESC Congress 2020.