Professor Jan Borén, Institute of Medicine, University of Gothenburg, Sweden, welcomes the timely reframing of apoB biology presented in Professor Chris Packard’s video presentation ‘ApoB and atherosclerosis 2026: Answers and Questions‘, highlighting its importance in moving the field beyond the LDL-centric model to a more integrated view which includes the atherogenic potential and clinical significance of triglyceride-rich lipoproteins and Lp(a).
Hypertriglyceridaemia: Where next for cardiovascular outcomes trials?
Highly effective agents are now available, such as olezarsen and plozasiran, that reduce triglyceride (TG) levels by 60-70% in patients with severe hypertriglyceridaemia (sHTG >5.6-10 mmol/L or 500-880 mg/dL), and there is growing evidence of comparable reductions in patients with moderate hypertriglyceridaemia (mHTG, 1.7-5.6 mmol/L or 150 -499 mg/dL). However, evidence that TG reductions translate into positive CV outcomes is limited.
Tryngolza (olezarsen) is approved for sHTG in USA
The US Food and Drug Administration (FDA) has approved Tryngolza (olezarsen) as an adjunct to diet to reduce TG and the risk of acute pancreatitis in adults with severe hypertriglyceridaemia (sHTG), ie. TG ≥500 mg/dL.
Redemplo (plozasiran) receives EU approval for FCS treatment
Redemplo (plozasiran) has been approved by the European Commission (EC) for use as an adjunct to diet to reduce TG levels in adult patients diagnosed with familial chylomicronaemia syndrome (FCS) according to clinical criteria or genetic testing.
Plozasiran prevents recurrent pancreatitis in most severe hypertriglyceridaemia
A post hoc analysis of data from the PALISADE trial has shown that plozasiran 25 or 50 mg s.c. quarterly for 12 months reduces recurrent pancreatitis in patients with familial chylomicronaemia syndrome (FCS) with a history of acute pancreatitis (AP) and the most extreme hypertriglyceridaemia.
TRL-C level may indicate fibrate benefit for atherosclerosis risk
Statin-treated individuals with elevated triglyceride-rich lipoprotein cholesterol (TRL-C) may be more likely to benefit from additional fibrate treatment, according to results of a study of 67,662 statin-treated adults without baseline atherosclerotic cardiovascular disease (ASCVD) from the Korean National Health Insurance Service cohort.
