TABLE 2.
Lipid-Lowering Efficacy and Clinical Trial Evidence With Omega-3 Fatty Acids
| Study (Ref. #) | Patient Population | Sample Size | Omega-3 PUFAs | Dose (g) | Omega-3 FFA Equivalence (g) | Placebo | Duration (y) | Baseline TG (mg/dL) | Intergroup Change of TG (%) | Outcome HR (95% CI) |
|---|---|---|---|---|---|---|---|---|---|---|
| JELIS (25) | Hypercholesterolemia patients with baseline LDL-C 182 mg/dL | 18,645 | EPA EE | 1.8 | 1.6 | No placebo | 4.6 | 151 | 5.0 | 0.81 (0.69-0.95) |
| VITAL (26) | Healthy volunteers (men>50 y or women>55 y) | 25,871 | EPA EE DHA EE |
0.46 0.38 |
0.42 0.35 |
“Fish oil placebo” | 5.3 | Unknown | Unknown | 0.92 (0.8-1.06) |
| ASCEND (27) | Diabetic patients without ASCVD | 15,480 | EPA EE DHA EE |
0.46 0.38 |
0.42 0.35 |
Olive oil | 7.4 | Unknown | Unknown | 0.97 (0.87-1.08) |
| REDUCE-IT (28) | Diabetic patients and patients with ASCVD | 8,179 | EPA EE | 4 | 3.5 | Mineral oil | 4.9 | 217 | 20.5 | 0.75 (0.68-0.83) |
| STRENGTH (29) | Diabetic patients, patients with ASCVD and high-risk patients | 13,078 | EPA DHA |
0.55 0.2 |
2.2 0.8 |
Corn oil | 3.2 | 240 | 18.1 | 0.99 (0.9-1.09) |
ASCEND = A Study of Cardiovascular events in diabetes; ASCVD = atherosclerotic cardiovascular disease; DHA = docosahexaenoic acid; EE = ethyl ester; EPA = eicosapentaenoic acid; FFA = free fatty acid; HR = hazard ratio; JELIS (The Japan EPA Lipid Intervention Study); LDL-C = low-density lipoprotein cholesterol; PUFAs = polyunsaturated fatty acids; TG = triglyceride; VITAL = The VITamin D and OmegA-3 Trial; REDUCE-IT = the Reduction of Cardiovascular Events with Icosopent Ethyl-Intervention Trial; STRENGTH = Outcomes Study to Assess STatin Residual Risk Reduction With EpaNova in HiGh CV Risk PatienTs With Hypertriglyceridemia.