Hypertriglyceridemia: updates from clinical trials of new agents and real-world registries

PURPOSE OF REVIEW: Hypertriglyceridemia (HTG) is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD) and acute pancreatitis (AP). Early detection and treatment are important to prevent such complications. This review briefly outlines the etiology and novel treatments of HTG and recent findings from contemporary HTG registries. RECENT FINDINGS: HTG is associated with an increased prevalence of cardiometabolic risk factors, including obesity, diabetes, and hepatic steatosis. Novel ribonucleic acid-based treatments for HTG have shown a substantial reduction in plasma triglycerides and a lower incidence of AP. A recent trial confirmed such benefit in patients with triglycerides >500 mg/dl (5.6 mmol/l), albeit with an increase in low-density lipoprotein-cholesterol, a reduction in remnant cholesterol and no change in apolipoprotein B. There is a need to harmonize the definitions of HTG and improve the care of individuals with severe HTG and familial chylomicronemia syndrome. New and evolving international registries are beginning to provide useful real-world data. SUMMARY: Patient registries for HTG have provided valuable data for understanding the link between HTG and other cardiometabolic disorders; they can inform the planning of clinical services and the translation of the findings of new and future clinical trials of triglyceride-lowering therapies.