Recommendations for Severe Hypertriglyceridemia Treatment, are there New Strategies?

ISSN: 1875-6212 (Online)
ISSN: 1570-1611 (Print)


Volume 12, 6 Issues, 2014


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Current Vascular Pharmacology

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Dimitri P. Mikhailidis
Academic Head, Deptartment of Clinical Biochemistry
Royal Free Hospital Campus
University College London Medical School
University College London (UCL)
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Recommendations for Severe Hypertriglyceridemia Treatment, are there New Strategies?

Author(s): Theodosios D. Filippatos and Moses S. Elisaf

Affiliation: Department of Internal Medicine, School of Medicine, University of Ioannina, 45 110 Ioannina, Greece.

Abstract

This review considers drug combinations and newer treatment strategies for patients with severe hypertriglyceridemia. Hypertriglyceridemia is associated with an atherogenic metabolic profile and in most studies with increased cardiovascular disease risk. Patients with severe hypertriglyceridemia also have increased incidence of pancreatitis. All types of severe hypertriglyceridemia are associated with a reduction in lipoprotein lipase activity. Patients with severe hypertriglyceridemia and abdominal pain or pancreatitis should be hospitalized and treated with hypolipidemic drugs and, if needed, with insulin/dextrose infusion or therapeutic apheresis. Fibrates are the first-line treatment in patients with severe hypertriglyceridemia. Omega-3 fatty acids and niacin are very useful drugs for patients with hypertriglyceridemia. Statins in high doses exhibit a significant hypotriglyceridemic activity. Drugs that interfere with chylomicron production such as orlistat are also useful for hypertriglyceridemic patients. In most patients with severe hypertriglyceridemia drug combinations are needed to maintain an acceptable triglyceride concentration. Gene therapy is under development for patients with known genetic abnormalities of triglyceride metabolism. Clinicians should be vigilant for the recognition and prompt treatment of patients with severe hypertriglyceridemia aimed to avoid the serious complication of pancreatitis and to reduce their cardiovascular risk.

Keywords: Cardiovascular risk, fibrates, lipoprotein lipase, niacin, orlistat, omega-3, plasmapheresis, severe hypertriglyceridemia.

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Article Details

Volume: 12
Issue Number: 4
First Page: 598
Last Page: 616
Page Count: 19
DOI: 10.2174/15701611113119990133
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