VITAL vs. REDUCE-IT
The negative results in VITAL stood in sharp contrast to the findings of the REDUCE-IT trial, presented at the same late-breaker session by Deepak Bhatt, MD, of Harvard Medical School. In REDUCE-IT, icosapent ethyl, another fish-derived product, reduced major cardiovascular events by 25% in a study of more than 8,000 high-cardiovascular-risk patients with elevated triglycerides.
Why the difference in outcomes? Among the proposed explanations were that participants in VITAL got 1 g/day of omega-3 while those in REDUCE-IT got a much higher dose of 4 g/day of iscosapent ethyl, the REDUCE-IT population was at much higher cardiovascular risk, and icosapent ethyl has a mechanism of action that’s distinct from that of conventional fish oil products.
Dr. Manson said numerous ancillary studies from VITAL are underway and will begin appearing soon. These will look at the impact of vitamin D and fish oil supplementation on cognitive function, hypertension, atrial fibrillation, autoimmune disorders, bone health, depression, kidney disease, and other issues.
Simultaneously with her presentation at the AHA scientific sessions, the VITAL results were published online (N Engl J Med. 2018 Nov 10; doi: 10.1056/NEJMoa1809944 and 10.1056/NEJMoa1811403).
The study was sponsored by the National Institutes of Health. The presenter reported having no financial conflicts.
bjancin@mdedge.com
SOURCE: Manson JE. AHA Abstr. #19539