Key result
Novel apoC-III and ANGPTL3 therapies safely lower triglycerides alongside standard statins for ASCVD risk.
This review highlights the role of statins as the primary therapy for ASCVD risk reduction in hypertriglyceridemia, notes the lack of benefit for older adjuncts, and points to apoC-III and ANGPTL3 inhibitors as promising emerging therapies.
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Statins remain first-line for ASCVD risk reduction; leaves open the role of apoC-III and ANGPTL3 inhibitors pending randomized trials.
Hypertriglyceridemia (HTG) is a prevalent medical condition in patients with cardiometabolic risk factors and is associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD), if left undiagnosed and undertreated. Current guidelines identify HTG as a risk-enhancing factor and, as a result, recommend clinical evaluation and lifestyle-based interventions to address potential secondary causes of elevated triglyceride (TG) levels. For individuals with mild to moderate HTG at risk of ASCVD, statin therapy alone or in combination with other lipid-lowering medications known to decrease ASCVD risk are guideline-endorsed. In addition to lifestyle modifications, patients with severe HTG at risk of acute pancreatitis may benefit from fibrates, mixed formulation omega-3 fatty acids, and niacin; however, evidence does not support their use for ASCVD risk reduction in the contemporary statin era. Novel therapeutics including those that target apoC-III and ANGPTL3 have shown to be safe, well-tolerated, and effective for lowering TG levels. Given the growing burden of cardiometabolic disease and risk factors, public health and health policy strategies are urgently needed to enhance access to effective pharmacotherapies, affordable and nutritious food options, and timely health care services.
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Mszar et al. (2023) conducted a review in Hypertriglyceridemia. Lipid-lowering therapies was evaluated. Novel therapeutics targeting apoC-III and ANGPTL3 are safe and effective for lowering triglyceride levels in patients with hypertriglyceridemia, while statins remain guideline-endorsed for ASCVD risk.
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