If I were Afimmune, I would only run a minimal size trial in US to show the MACE rate, which may only cost 1/2 of that of RIT.
I am behind the posts on the Epeleuton topic. Never heard it before. But I took a quick look at the molecule and company. It's a derivative of EPA, but the 15-hydroxy addition does change the tail end 2D & 3D structure of Vascepa or the original EPA. If it has similar activities as EPA in lab and trials so far, then it means at the molecular level that Epeleuton is acting on the same protein target as EPA. In short, EPeleuton has a great deal of scientific value - help researchers track down the protein target which is the holy grail in this case, just like HMGCoA reductase for statins.
That said, I am not sure it has much better commercial value than Vascepa because I imagine Epeleuton likely has a higher manufacturing cost than EPA due to the extra steps for making the 15-hydroxy group. Unless it can deliver much better results in a comparable outcome trial, it doesn't make sense to make it into a commercial product. That's probably why Amarin is not worried. Bhatt can do his research and trials as he is a scientist who lives on research and publications, not revenue and profit.
September 2 is still the fateful date for Amarin.