Fish oil supplement could reduce the risk of heart attack or stroke in combination with statins
Australian patients at high risk of stroke and heart attack could benefit from access to a US-approved fish oil supplement in combination with their statin therapy, a new study has found.
In a study published in the European Journal of Preventive Cardiology, Monash University researchers explored the potential costs, risks and benefits of adding the purified fish oil supplement (icosapent ethyl) on top of statins in Australians already diagnosed with cardiovascular diseases (CVD) or who are at high risk.
One Australian dies every 12 minutes from CVD. Cholesterol-lowering pills such as statins can reduce the risk, however even among people prescribed statins, the risk of CVD can remain high.
The results suggested that the supplement, in combination with statin therapy compared to statin therapy alone, would lead to 270 less heart attacks or strokes and 295 less coronary revascularisation procedures in a cohort of 1000 people projected over a 20-year period.
Although the purified fish oil supplement is not currently available in Australia, the study assessed the potential cost-effectiveness of icosapent ethyl in combination with statin therapy compared to statin therapy alone for CVD risk reduction from the perspective of the Australian healthcare system.
The supplement just had expanded approval by the US FDA for preventing serious heart complications in high-risk patients already taking cholesterol-lowering pills. It has already been on the US market for several years to treat adults with high triglyceride levels (a type of fat in the blood) and was more recently approved for people with multiple risk factors such as heart disease and diabetes.
The study, led by Monash researchers Associate Professor Zanfina Ademi and Professor Danny Liew from the School of Public Health and Preventive Medicine, used data from the clinical trial (REDUCE-IT) that underpinned the US regulators’ approval.
The researchers estimated that at current estimated costs of $1600 per year (based on its equivalent price in the US (USD2907), icosapent ethyl is likely to be cost-effective if used to treat people who already have CVD.
However, they found the medication could contribute to a slight increased risk of bleeding and hospitalisations for atrial fibrillation (12 additional serious bleeding and 136 hospitalisations for atrial fibrillation in 1000 people over a 20-year time horizon), so is only recommended to those with CVD under their doctor’s advice.
“Given the high burden of CVD in Australia (and elsewhere across the world), icosapent ethyl has the potential to deliver significant health benefits, but needs to be priced affordably,” Associate Professor Zanfina Ademi said.
“If the annual cost of icosapent ethyl was priced by pharmaceutical companies at around $800 or less, then it would be much more cost effective and accessible to Australians.”
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