REDUCE-IT® USA Results, in Prespecified Subgroup Analyses of Landmark REDUCE-IT Global Study, Showed Robust Cardiovascular Risk Reductions Across a Variety of Study Endpoints, Including Cardiovascular Death and All-Cause Mortality
Additional prespecified cardiovascular endpoints in which the REDUCE-IT USA subgroup showed significant relative risk reduction included myocardial infarction, cardiovascular death, and stroke, similar to the full cohort in the overall REDUCE-IT global results.1 These results were incremental to the cardiovascular risk reduction achieved by conventional therapy administered to the high-risk patients studied, including incremental to statin therapy.
In the REDUCE-IT USA subgroup, 3,146 patients (38.5% of the full trial cohort) were randomized and followed for a median of 4.9 years; 32.3% were women, 9.7% Hispanic. USA placebo patients had a higher primary endpoint event rate compared with the full cohort (67.4 versus 57.4 per 1,000 patient-years, respectively). The primary endpoint (5-point MACE) occurred in 24.7% of placebo versus 18.2% of icosapent ethyl patients (HR 0.69, 95% CI 0.59-0.80, p=0.000001); the key secondary endpoint (3-point MACE) occurred in 16.6% of placebo versus 12.1% of icosapent ethyl patients (HR 0.69, 95% CI 0.57-0.83, p=0.00008). All prespecified hierarchical primary and secondary endpoints were significantly reduced in the USA subgroup, including myocardial infarction (8.8% to 6.7%, HR 0.72, 95% CI 0.56-0.93, p=0.01), cardiovascular death (6.7% to 4.7%, HR 0.66, 95% CI 0.49-0.90, p=0.007), stroke (4.1% to 2.6%, HR 0.63, 95% CI 0.43-0.93, p=0.02), and all-cause mortality (9.8% to 7.2%, HR 0.70, 95% CI 0.55-0.90, p=0.004). In the full study cohort, there was a trend towards a reduction in all-cause mortality, with each of these other primary and secondary endpoints also achieving statistical significance in the full study cohort. Safety and tolerability findings in the USA subgroup were consistent with the full study cohort.
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