February 10, 2025Current Opinion in Endocrinology Diabetes and Obesity14 citationsOpen Access
An overview of persistent chylomicronemia: much more than meets the eye
Key Result
Next-generation therapies with LPL-independent mechanisms of action are effective for persistent chylomicronemia of any cause, whereas conventional LPL-dependent treatments are generally ineffective.
Structured PICO
Do next-generation therapies with LPL-independent mechanisms of action improve treatment response in patients with persistent chylomicronemia?
P
Population
Patients with severe hypertriglyceridemia presenting in the form of persistent chylomicronemia despite treatment of secondary causes and conventional lipid-lowering treatment
E
Exposure
Next-generation therapies with LPL-independent mechanisms of action
C
Comparator
Conventional LPL-dependent treatments
O
Outcome
Treatment response and risk of acute pancreatitis
This review highlights that patients with persistent chylomicronemia, regardless of genetic etiology, respond to emerging LPL-independent therapies but not to conventional treatments.
Abstract
PURPOSE OF REVIEW: The aim of this review is to provide an overview of severe hypertriglyceridemia presenting in the form of chylomicronemia that persists despite treatment of secondary causes and the use of conventional lipid-lowering treatment. RECENT FINDINGS: Persistent chylomicronemia is a rare syndromic disorder that affects carriers of bi-allelic combinations of pathogenic gene variants impairing lipoprotein lipase (LPL) activity, as well as a significant number of individuals who do not meet this genetic criterion. It is associated with a high risk of acute pancreatitis and other morbidities. Effective innovative treatments for severe hypertriglyceridemia are being developed and are becoming available. Patients with persistent chylomicronemia of any cause respond equally to next-generation therapies with LPL-independent mechanisms of action and do not generally respond to conventional LPL-dependent treatments. SUMMARY: Not all individuals with persistent chylomicronemia carry a proven pathogenic combination of gene variants that impair LPL activity. Documenting the clinical characteristics of people with persistent chylomicronemia and their response to emerging therapies is essential to correctly establish their risk trajectory and ensure equitable access to personalized treatment.