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Cited by 59Lipid metabolism and disordersLipoproteins and Cardiovascular HealthPancreatitis Pathology and Treatment

Updates in Drug Treatment of Severe Hypertriglyceridemia

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Gouni-Berthold, Ioanna, Schwarz, Jonas, Berthold, Heiner K.·2023·Current Atherosclerosis Reports
DOI 10.1007/s11883-023-01140-zPMC PMC10564803
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Abstract

Purpose of Review: To provide an insight into the new pharmacological options for the treatment of severe hypertriglyceridemia (sHTG). Recent Findings: sHTG is difficult to treat. The majority of the traditional pharmacological agents available have limited success in both robustly decreasing triglyceride levels and/or in reducing the incidence of acute pancreatitis (AP), the most severe complication of sHTG. Therapeutic options with novel mechanisms of action have been developed, such as antisense oligonucleotides (ASO) and small interfering RNA (siRNA) targeting APOC3 and ANGPTL3 . The review discusses also 2 abandoned drugs for sHTG treatment, evinacumab and vupanorsen. Summary: The ASO targeting APOC3 , volanesorsen, is approved for use in patients with familial chylomicronemia syndrome (FCS) in Europe. Olezarsen, an N-acetylgalactosamine (GalNAc)-conjugated ASO with the same target, seems to have a better safety and efficacy profile. siRNA targeting APOC3 and ANGPTL3 , namely ARO-APOC3 and ARO-ANG3, are also promising for the treatment of sHTG. However, the ultimate clinical goal of any sHTG treatment, the decrease in the risk of AP, has not been definitively achieved till now by any pharmacotherapy, either approved or in development.

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  • Pharmacological therapies such as fibrates, statins, niacin, and omega-3 fatty acids, as well as lifestyle adjustments, are currently available therapeutic options for controlling hypertriglyceridemia, but often have drawbacks regarding effectiveness, tolerability, and ability to significantly reduce triglyceride levels necessary to lower cardiovascular risk.

    “Pharmacological therapies such as fibrates, statins, niacin, and omega-3 fatty acids, as well as lifestyle adjustments, are currently available therapeutic options for controlling hypertriglyceridemia. Nevertheless, these therapies often have drawbacks regarding their effectiveness, tolerability, and ability to significantly reduce triglyceride levels necessary to lower cardiovascular risk [4,5].”

    From Efficacy and safety of Olezarsen in treating hypertriglyceridemia: a systematic review and meta-analysis of randomized controlled trials (2025) · cites this paper as [5]

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Cited by

Sorted by citations

Authors
Gouni-Berthold, I., Schwarz, J., & Berthold, H. K.
Affiliations
  • University of Cologne (DE)
  • Bielefeld University (DE)
ORCID
Venue
Current Atherosclerosis Reports
Publisher
Springer Science and Business Media LLC
Published
2023-08-29
Volume
25
Issue
10
Pages
701-709
ISSN
  • 1523-3804 (ISSN-L)
  • 1534-6242
DOI
10.1007/s11883-023-01140-z
PMC
PMC10564803
OpenAlex
W4386254364
Cited by
59
References
9
Citations by year
2026: 11 · 2025: 24 · 2024: 24
FWCI
3.11
Type
journal article
Language
en
Open access
Licence
Locations
  • Current Atherosclerosis Reports (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
Universitätsklinikum Köln
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
Keywords
severe hypertriglyceridemia, acute pancreatitis, antisense oligonucleotides, siRNA, apolipoprotein C-III, ANGPTL3, volanesorsen, olezarsen, evinacumab, familial chylomicronemia syndrome, triglyceride-lowering therapy
MeSH terms
Angiopoietin-Like Protein 3, Acute Disease, Humans, Oligonucleotides, Pancreatitis, Triglycerides, Hypertriglyceridemia, Oligonucleotides, Antisense, RNA, Small Interfering, Apolipoprotein C-III

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