Severe Hypertriglyceridemia

CE / CME

Current Challenges and Emerging Treatments for the Management of Severe Hypertriglyceridemia

Physician Assistants/Physician Associates: 1.00 AAPA Category 1 CME credit

Nurses: 1.00 Nursing contact hour

Physicians: maximum of 1.00 AMA PRA Category 1 Credit

Released: January 28, 2024

Expiration: January 29, 2025

Activity

Progress
1 2
Course Completed

References

  1. US Centers for Disease Control and Prevention. Trends in elevated triglyceride in adults: United States, 2001-2012. cdc.gov/nchs/products/databriefs/db198.htm. Accessed January 8, 2024.
  2. Aberra T, Peterson ED, Pagidipati NJ, et al. The association between triglycerides and incident cardiovascular disease: What is “optimal”? J Clin Lipidol. 2020;14:438-447.e3.
  3. Virani SS, Morris PB, Agarwala A, et al. 2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2021;78:960-993.
  4. Grundy SM, Stone NJ, Bailey AL. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;139:e1082-e1143.
  5. Lowering blood cholesterol to prevent heart disease. NIH Consensus Development Conference Statement. Nutr Rev. 1985;43:283-291.
  6. Grundy SM. Summary of the second report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II). JAMA. 1993;269:3015-3023.
  7. Grundy SM. Low-density lipoprotein, non-high-density lipoprotein, and apolipoprotein B as targets of lipid-lowering therapy. Circulation. 2002;106:2526-2529.
  8. Jacobson TA, Maki KC, Orringer CE, et al. National Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia: Part 2. J Clin Lipidol. 2015;9(suppl 6):S1-S122.e1.
  9. Miller M, Stone NJ, Ballantyne C, et al. Triglycerides and cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2011;123:2292-2333.
  10. Brahm AJ, Hegele RA. Chylomicronaemia-current diagnosis and future therapies. Nat Rev Endocrinol. 2015;11:352-362.
  11. Hegele RA, Ban MR, Cao H, et al. Targeted next-generation sequencing in monogenic dyslipidemias. Curr Opin Lipidol. 2015;26:103-313.
  12. Hegele RA, Ginsberg HN, Chapman MJ, et al. European Atherosclerosis Society Consensus Panel. The polygenic nature of hypertriglyceridaemia: implications for definition, diagnosis, and management. Lancet Diabetes Endocrinol. 2014;2:655-666.
  13. Paragh G, Németh Á, Harangi M, et al. Causes, clinical findings and therapeutic options in chylomicronemia syndrome, a special form of hypertriglyceridemia. Lipids Health Dis. 2022;21:21.
  14. National Lipid Association. Clinical management of hypertriglyceridemia: state of the art 2015. lipid.org/media/2015003/1//handout.pdf. Accessed January 8, 2024.
  15. Papachristou GI. Prediction of severe acute pancreatitis: current knowledge and novel insights. World J Gastroenterol. 2008;14:6273-6275.
  16. Dixon LJ, Barnes M, Tang H, et al. Kupffer cells in the liver. Compr Physiol. 2013;3:785-797.
  17. O'Dea LSL, MacDougall J, Alexander VJ, et al. Differentiating familial chylomicronemia syndrome from multifactorial severe hypertriglyceridemia by clinical profiles. J Endocr Soc. 2019;3:2397-2410.
  18. Nawaz H, Koutroumpakis E, Easler J, et al. Elevated serum triglycerides are independently associated with persistent organ failure in acute pancreatitis. Am J Gastroenterol. 2015;110:1497-1503.
  19. Wolska A, Yang ZH, Remaley AT. Hypertriglyceridemia: new approaches in management and treatment. Curr Opin Lipidol. 2020;31:331-339.
  20. Oh RC, Trivette ET, Westerfield KL. Management of hypertriglyceridemia: common questions and answers. Am Fam Physician. 2020;102:347-354.
  21. Esan O, Wierzbicki AS. Volanesorsen in the treatment of familial chylomicronemia syndrome or hypertriglyceridaemia: design, development and place in therapy. Drug Des Devel Ther. 2020;14:2623-2636.
  22. Volanesorsen [summary of product characteristics]. Dublin, Ireland: Akcea Therapeutics Ireland; 2022.
  23. Rosenson RS, Gaudet D, Ballantyne CM, et al. Evinacumab in severe hypertriglyceridemia with or without lipoprotein lipase pathway mutations: a phase 2 randomized trial. Nat Med. 2023;29:729-737.
  24. Bhatt DL, Bays HE, Miller M, et al. The FGF21 analog pegozafermin in severe hypertriglyceridemia: a randomized phase 2 trial. Nat Med. 2023;29:1782-1792.
  25. Gouni-Berthold I, Alexander VJ, Yang Q, et al. Efficacy and safety of volanesorsen in patients with multifactorial chylomicronaemia (COMPASS): a multicentre, double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Diabetes Endocrinol. 2021;9:264-275.
  26. Tardif JC, Karwatowska-Prokopczuk E, Amour ES, et al. Apolipoprotein C-III reduction in subjects with moderate hypertriglyceridaemia and at high cardiovascular risk. Eur Heart J. 2022;43:1401-1412.
  27. Bhatt DL, Steg PG, Miller M, et al. Cardiovascular Risk reduction with icosapent ethyl for hypertriglyceridemia. N Engl J Med. 2019;380:11-22.
  28. Gaudet D, Brisson D, Tremblay K, et al. Targeting APOC3 in the familial chylomicronemia syndrome. N Engl J Med. 2014;371:2200-2206.
  29. Paquette M, Bernard S, Hegele RA, Baass A. Chylomicronemia: differences between familial chylomicronemia syndrome and multifactorial chylomicronemia. Atherosclerosis. 2019;283:137-142.
  30. Gotto AM Jr. Interrelationship of triglycerides with lipoproteins and high-density lipoproteins. Am J Cardiol. 1990;66:20A-23A.
  31. Bijvoet SM, Bruin T, Kastelein JJ. The familial hyperchylomicronaemia syndrome. Neth J Med. 1993;42:36-44.
  32. Gaudet D, Stevenson M, Komari N, et al. The burden of familial chylomicronemia syndrome in Canadian patients. Lipids Health Dis. 2020;19:120.
  33. Gaudet D, de Wal J, Tremblay K, et al. Review of the clinical development of alipogene tiparvovec gene therapy for lipoprotein lipase deficiency. Atheroscler Suppl. 2010;11:55-60.
  34. Gaudet D, Blom D, Bruckert E, et al. Acute pancreatitis is highly prevalent and complications can be fatal in patients with familial chylomicronemia: results from a survey of lipidologist. J Clin Lipidol. 2016;10:680-681
  35. Nøjgaard C, Becker U, Matzen P, et al. Progression from acute to chronic pancreatitis: prognostic factors, mortality, and natural course. Pancreas. 2011;40:1195-200.
  36. Yadav D, O’Connell M, Papachristou GI. Natural history following the first attack of acute pancreatitis. Am J Gastroenterol. 2012;107:1096-1103.
  37. Ewald N, Hardt PD. Diagnosis and treatment of diabetes mellitus in chronic pancreatitis. World J Gastroenterol. 2013;19:7276-7281.
  38. Sisman G, Erzin Y, Hatemi I, et al. Familial chylomicronemia syndrome related chronic pancreatitis: a single-center study. Hepatobiliary Pancreat Dis Int. 2014;13:209-214.
  39. Wild R, Weedin EA, Gill EA. Women’s health considerations for lipid management. Cardiol Clin. 2015;33:217-231.
  40. Wiznitzer A, Mayer A, Novack V, et al. Association of lipid levels during gestation with preeclampsia and gestational diabetes mellitus: a population-based study. Am J Obstet Gynecol. 2009;201:482.e1-e8.
  41. Davidson M, Stevenson M, Hsieh A, et al. The burden of familial chylomicronemia syndrome: interim results from the IN-FOCUS study. Expert Rev Cardiovasc Ther. 2017;15:415-423.
  42. Davidson M, Stevenson M, Hsieh A, et al. The burden of familial chylomicronemia syndrome: results from the global IN-FOCUS study. J Clin Lipidol. 2018;12:898-907.e2.
  43. Stroes E, Moulin P, Parhofer KG, et al. Diagnostic algorithm for familial chylomicronemia syndrome. Atheroscler Suppl. 2017;23:1-7.
  44. Tremblay K, Méthot J, Brisson D, et al. Etiology and risk of lactescent plasma and severe hypertriglyceridemia. J Clin Lipidol. 2011;5:37-44.
  45. Christian JB, Bourgeois NE, Lowe KA. Prevalence, clinical characteristics and treatment patterns of low high-density lipoprotein cholesterol in the US population: National Health and Nutrition Examination Survey 2005-2008. J Cardiovasc Med (Hagerstown). 2011;12:714-722.
  46. Goldberg RB, Chait A. A comprehensive update on the chylomicronemia syndrome. Front Endocrinol (Lausanne). 2020;23;11:593931
  47. Rygiel K. Hypertriglyceridemia - common causes, prevention and treatment strategies. Curr Cardiol Rev. 2018;14:67-76.
  48. Rahalkar AR, Hegele RA. Monogenic pediatric dyslipidemias: classification, genetics and clinical spectrum. Mol Genet Metab. 2008;93:282-294.
  49. Williams L, Rhodes KS, Karmally W, et al. Familial chylomicronemia syndrome: bringing to life dietary recommendations throughout the life span. J Clin Lipidol. 2018;12:908-919.
  50. Witztum JL, Gaudet D, Freedman SD, et al. Volanesorsen and triglyceride levels in familial chylomicronemia syndrome. N Engl J Med. 2019;381:531-542.
  51. PR Newswire. Ionis announces positive olezarsen topline results from phase 3 study in people with familial chylomicronemia syndrome. prnewswire.com/news-releases/ionis-announces-positive-olezarsen-topline-results-from-phase-3-study-in-people-with-familial-chylomicronemia-syndrome-301938328.html. Accessed January 8, 2024.