MS...
I think its very difficult for these cardiologists to digest the fact there is more here than some lipid elevations...Very difficult to teach old dogs new tricks...I hope these guys don't fall into the trap of thinking because elevated trigs are a marker for elevated CVD event risk..That, that fact means if you lower the trigs that will automatically lower the CVD event risk...We know from the 2013 AdCom that FDA noted in three CVOTs that lowering trigs by DHA, Niacin, or Fibrates did not lower CVD event risk significantly..And FDA is going to be asking what is it about EPA that is different from DHA, Niacin or Fibrates..
I was there during Bhatt's presentation of the R-I results and I know how excited he was before during and after the R-I results were presented..He was excited because the results were so damned good..Really mind blowing...
Since then I am not all that impressed that he understands why the results were that good..(Sorry I know that is Heresy). It' seems these cardiolgists just can not get by the "Its all about the high lipid levels"...They (the Cardiologist do not seem to know very much about the Eicosanoid system which goes a long way of explaining the EPA's actions..Dr. Bhatt does recognize the biggest change in a molecular entity is EPA..but seemingly is unwilling to consider anything rather than it is the entity that R-I changed the most...But does not seemed to be curious about what this change brought about...
I don't mean to be disrespectful and maybe he is just holding the EPA/AA data as a hole card that he will reveal at AdCom or some time...But somehow ..I no longer think that is going to happen...And that is a shame...
":>) JL
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