Recent developments in pharmacotherapy for hypertriglyceridemia: what's the current state of the art?. (2nd January 2020)

• Record Type: Journal Article
• Authors: Florentin, Matilda; Kostapanos, Michael S; Anagnostis, Panagiotis; Liamis, George
• Is Part Of: Expert opinion on pharmacotherapy. Volume 21:Number 1(2020)
• Page Start: 107
• Page End: 120
• Publication Date: 2020-01-02
• Subjects: Angiopoietin-like 3 inhibitors -- docosahexaenoic acid -- eicosapentaenoic acid -- pemafibrate -- pradigastat -- tiparvovec -- triglycerides -- volanesorsen; Chemotherapy -- Periodicals; 615.5805
• DOI: 10.1080/14656566.2019.1691523
• Languages: English
• ISSNs: 1465-6566

Abstract

ABSTRACT: Introduction : Hypertriglyceridemia is associated with both the development of cardiovascular disease (CVD) when mild-to-moderate and high risk of pancreatitis when more severe. The residual CVD risk after low-density lipoprotein cholesterol (LDL-C) lowering is, in part, attributed to high triglyceride (TG) levels. Therefore, there appears to be a need for effective TG-lowering agents. Areas covered : This review presents the most recent advances in hypertriglyceridemia treatment; specifically, it discusses the results of clinical trials and critically comments on apolipoprotein C-III inhibitors, angiopoietin-like 3 inhibitors, alipogene tiparvovec, pradigastat, pemafibrate and novel formulations of omega-3 fatty acids. Expert opinion : In the era of extreme lowering of LDL-C levels with several agents, there seems to be space for novel therapeutic options to combat parameters responsible for residual CVD risk, among which are elevated TGs. Furthermore, a significant number of individuals have very high TG levels and encounter the risk of acute pancreatitis. The most recently developed TG-lowering drugs appear to have a role in both conditions; the choice is mainly based on baseline TG levels. Dyslipidemia guidelines are likely to change in the near future to include some of these agents. Of course, long-term data regarding their safety and efficacy in terms of CVD outcomes and pancreatitis are warranted.