UP-TO-DATE article and MINERAL OIL
“This is the second time today I've called out outright, easily disprovable lies--the first was someone saying that an UpToDate article said to avoid Vascepa because of the mineral oil issue. “
I can call you out on this one.
Yes the authors said not to prescribe Vascepa due to mineral oil.
Maybe you need to sharpen your reading comprehension skills.
First let me post the old UP TO DATE article where it is clearly stated the trial is not good enough because of limitations caused by mineral oil.
This was fist published in November 2018. This was a pop up uodate on the topic.
Authors:Robert S Rosenson, MDJohn JP Kastelein, MD, PhD, FESCSection Editor:Mason W Freeman, MDDeputy Editors:Jane Givens, MDGordon M Saperia, MD, FACC
Contributor Disclosures
Fish oil and cardiovascular outcomes in patients with hypertriglyceridemia (November 2018)
The role of highly purified fish oil in patients with increased cardiovascular risk has been uncertain. In REDUCE-IT, a randomized trial of over 8000 statin-treated patients with elevated triglyceride levels and either established cardiovascular disease or diabetes plus other cardiovascular risk factors, supplementation with 4 g/day icosapent ethyl (a highly purified eicosapentaenoic acid), compared with mineral oil as placebo control, reduced the risk of the composite primary outcome of major cardiovascular events [1]. Because of limitations in this trial (eg, mineral oil may not be a true placebo), confirmation of these findings from ongoing trials is needed before a firm recommendation can be made about the role of fish oil supplementation in this patient population. (See "Hypertriglyceridemia", section on 'Fish oil'
THiS PART BELLOW is from the latest uptodate article which they updated on January 23rd after our emails to the editor. You said they did not mention mineral oil limitations . Did you really read this?
It is quite obvious that the authors edited the article and made is much worse then the prior version. I will not extend my uptodate membership
Authors:Robert S Rosenson, MDJohn JP Kastelein, MD,
Lies from up to date article
Cardiovascular disease risk reduction — Despite the clinical trial evidence linking hypertriglyceridemia to CVD risk reduction (see 'Triglycerides and CVD risk' above), most of our contributors rarely start drug therapy to lower cardiovascular risk, as there is limited evidence that targeting hypertriglyceridemia improves CVD outcomes. ( Lie number 1)
In REDUCE-IT, a randomized trial designed to evaluate the effect of fish oil therapy on cardiovascular disease outcomes in patients with hypertriglyceridemia, a highly purified fish oil (icosapent ethyl) was found to have some effect.
(Some effect? This is done on purpose to decrease significance or Recuce-it triial. Mineral oil part of creating doubt and please don’t prescribe Vascepa because of study limitations (mineral oil)
Limitations of the REDUCE-IT trial include concerns that mineral oil may have caused the increases in atherogenic lipoproteins and C-reactive proteins in the control group and thus did not function as a true placebo. These adverse effects of mineral oil may have raised the risk of cardiovascular events in the control group and may partially account for the favorable risk reduction observed in the treatment group. If so, the true cardiovascular effect of icosapent ethyl may be less than observed in the trial. Another concern is that rates of new-onset atrial fibrillation were significantly higher in the treatment group (5.3 versus 3.9 percent).
(Again mentioned limitations the study clearly identified as mineral oil. He is convinced MO caused LDL and CRP cjanges in the placebo group ).
The authors and editors of this topic are divided regarding recommendations for use of icosapent ethyl, based on the limitations of the trial. If a fish oil capsule is to be considered for reduction of cardiovascular risk in patients with mild hypertriglyceridemia (149 to 500 mg/dL), we support the use of icosapent ethyl based on the results of REDUCE-IT, if it is used in combination with a statin as in the study population. However, further evaluation of the efficacy and safety of these findings from ongoing trials is recommended before a firm recommendation can be
Finishing the article with the word “however” clearly established their bias when writing this article.
So this is from current uptodate article.
So yes you are being called out.
You said you had read the same article and saw nothing about mineral oil when the whole doubt narrative is clearly stated as mineral oil.
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