Effect of icosapent ethyl treatment on colorectal tissue marine ω-3 polyunsaturated fatty acid levels among patients with a history of adenoma: a prospective, single-arm clinical trial.
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Chen Yufeng, Bae Sunjeong, Wang Kai, Du Mengxi, Lu Yujia, Sun Qi, Labelle Perry A, Caraballo Alexander, Lachut Kylor, Husain Alina, Hote Liza, Koehn Madeline, Prezioso Elizabeth, Reinicke Trenton, Schuck Madeline, Sethurathnam Janavi, Solowey Julia, Woo Jacqueline, Carolan Peter J, Chung Daniel C, Colizzo Francis P, Gala Manish, Khalili Hamed, Nishioka Norman S, Richter James M, Staller Kyle, Yarze Joseph C, Ma Wenjie, Pratt Daniel, Singh Amandeep, Nguyen Long H, Jacobson Brian C, Luther Jay, Kuo Braden, Dougan Michael, Rosner Bernard, Magicheva-Gupta Marina, Drew David A, Chan Andrew T, Song Mingyang
Аннотация
OBJECTIVES: This study aimed to assess the effect of IPE on changing total marine omega-3 (n-3) polyunsaturated fatty acid (PUFA) and individual fatty acid composition in colorectal tissue.
METHODS: We conducted a prospective, single-arm clinical trial of 4 g/d IPE (VASCEPA) treatment for 8 to 12 wk among patients with a recent history of adenoma. We collected pretreatment and posttreatment colorectal biopsies through flexible sigmoidoscopy and participants' diet and lifestyle via questionnaires. The primary outcome was the change in total marine ω-3 PUFA in colorectal tissue measured by gas-liquid chromatography. We examined changes in individual fatty acids exploratorily.
RESULTS: Among a total of 81 patients enrolled, 72 had paired pretreatment and posttreatment tissue fatty acid data. After intervention, the tissue composition [median (interquartile range)] of total marine ω-3 PUFA increased from 2.10% (0.96%) to 5.21% (1.97%), with a fold change of 2.40 (0.82). With a slight decrease in ω-6 PUFA [fold change = 0.96 (0.27)], the ratio of marine ω-3 to ω-6 PUFA increased [fold change = 2.58 (0.81)]. Among individual fatty acids, EPA increased the most [fold change = 5.88 (3.63)]. The cumulative amount of IPE treatment, rather than daily dosage, showed a positive correlation with changes in tissue EPA composition (Spearman's ρ = 0.23, P = 0.051). The treatment effect on tissue EPA changes appeared to be stronger for participants with lower than higher dietary EPA intake at baseline, although the interaction tests did not reach statistical significance (P for interaction = 0.26).
CONCLUSIONS: IPE treatment substantially increased incorporation of marine ω-3 PUFA, particularly EPA, into the colorectal tissue while reducing tissue ω-6 PUFA composition. This trial was registered at clinicaltrials.gov as NCT04216251.