"with that being said, do you think its possible that Reduce-It's recent success is having an impact on expectations for BETonMACE's results?  I know that Vascepea (or whatever its called) is a fish oil with a completely different MOA than 208....but still, could Vascepea's recent success be influencing sentiment regardless?"

In REDUCE-IT, Vascepa achieved ~25% RRR for 5-point and 3-point MACE over a median follow up period of 4.9 years. That's amazing. However, REDUCE-IT had a fairly broad patient population that really only required patients to have elevated plasma triglyerides. REDUCE-IT included patients with a previous MACE event (secondary prevention) and those without prior MACE event but at elevated cardio risk (primary prevention). REDUCE-IT also was not limited to diabetics, and only 59% had diabetes. The most important distiniction is that REDUCE-IT did not require an acute coronary syndrome (ACS) event within 90 days of randomization.

BETonMACE is all diabetics, all with low -HDL (median 33 mg/dL) and all must have ACS within 90 days of randomization. BETonMACE is a MUCH higher risk group of patients than in REDUCE-IT. So far, trials that have attempted to reduce MACE indicence in a similar population (i.e. EXAMINE, ELIXA) have failed. BETonMACE could be the first trial to acheive MACE reduction in this high-risk population....a huge unmet need.

All that being said, yes I bet a lot of people will incorrectly compare REDUCE-IT to BETonMACE and not appreciate what I described above. Even if REDUCE-IT and BETonMACE achieved similar %RRR, the absolute risk reduction will be greater in BETonMACE and the number needed to treat (NNT) value will be reached at less than half of the time for BETonMACE (median treatment period 24-26 months) compared to REDUCE-IT (median treatment period 4.9 years). Hopefully, BETonMACE will achieve a %RRR far beyond 25% to mimimize these unfair comparisons.

BearDownAZ