Effects of prescription omega-3-acid ethyl esters, coadministered with atorvastatin, on circulating levels of lipoprotein particles, apolipoprotein CIII, and lipoprotein-associated phospholipase A2 mass in men and women with mixed dyslipidemia.

Abstract

BACKGROUND:

Prescription omega-3-acid ethyl esters (POM3) reduce triglycerides (TG) and very low-density lipoprotein cholesterol and increase high-density lipoprotein cholesterol (HDL-C) in patients with hypertriglyceridemia.

OBJECTIVE:

To examine the effects of POM3 plus atorvastatin versus placebo plus atorvastatin on lipoprotein particle concentrations and sizes, apolipoprotein (Apo) CIII, and lipoprotein-associated phospholipase A(2) mass in subjects with mixed dyslipidemia.

METHODS:

After a 4-week diet lead in, men and women with non-HDL-C >160 mg/dL and TG 250-599 mg/dL, while taking no lipid-altering drugs, received double-blind 4 g/d POM3 (n = 118) or placebo (n = 119) with open-label atorvastatin 10 mg/d for 8 weeks, followed by escalation to 20 mg/d atorvastatin for 4 weeks, then 40 mg/d atorvastatin for 4 weeks.

RESULTS:

Total low-density lipoprotein particle (LDL-P) concentration decreased significantly from baseline, and the reductions did not differ between the POM3 and placebo groups (-659.7 vs -624.4 nmol/L, P = .181). With POM3, compared with placebo, small LDL-P concentration decreased (P = .026), large LDL-P concentration increased (P < .001), mean LDL-P size increased (P = .001), a larger fraction of subjects switched from LDL subclass pattern B to A, and Apo CIII and lipoprotein-associated phospholipase A(2) levels were reduced (P < .001). The incremental effects of POM3 were similar across atorvastatin doses for most variables.

CONCLUSION:

This analysis supports the view that LDL-P concentration is not increased by POM3 plus atorvastatin, relative to atorvastatin monotherapy, and is associated with potentially favorable shifts in LDL-P subfractions, Apo CIII and lipoprotein-associated phospholipase A(2) in mixed dyslipidemia.

• Authors: Kevin C Maki, Harold E Bays, Mary R Dicklin, Susan L Johnson, Mayadah Shabbout
• Journal: Journal of clinical lipidology (J Clin Lipidol) 2011 Nov-Dec Vol. 5 Issue 6 Pg. 483-92 ISSN: 1933-2874 [Print] United States
• PMID: 22108152 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 National Lipid Association. Published by Elsevier Inc. All rights reserved.

Chemical References

• Apolipoprotein C-III
• Cholesterol, LDL
• Heptanoic Acids
• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Lipoproteins, LDL
• Pyrroles
• Docosahexaenoic Acids
• Atorvastatin
• Eicosapentaenoic Acid
• 1-Alkyl-2-acetylglycerophosphocholine Esterase

Topics

• 1-Alkyl-2-acetylglycerophosphocholine Esterase (blood, chemistry)
• Adolescent
• Adult
• Aged
• Apolipoprotein C-III (blood, chemistry)
• Atorvastatin
• Cholesterol, LDL (blood)
• Docosahexaenoic Acids (administration & dosage, therapeutic use)
• Dose-Response Relationship, Drug
• Double-Blind Method
• Drug Therapy, Combination
• Dyslipidemias (blood, drug therapy)
• Eicosapentaenoic Acid (administration & dosage, therapeutic use)
• Female
• Heptanoic Acids (administration & dosage, therapeutic use)
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (administration & dosage, pharmacology)
• Lipoproteins, LDL (blood, chemistry)
• Male
• Middle Aged
• Pyrroles (administration & dosage, therapeutic use)
• Treatment Outcome
• Young Adult