Raise expectations by aiming lower in familial chylomicronaemia syndrome (FCS)1

Aiming for and achieving triglyceride levels ≤10 mmol/L (880 mg/dL) could improve outcomes in people with FCS1

Aim for the guideline triglyceride level1

FCS is rare but reducing the risk of acute pancreatitis should not be. Lowering people’s triglycerides to the guideline level of ≤10 mmol/L (880 mg/dL) lowers their risk of acute pancreatitis1–3

Achieving and sustaining triglycerides below the threshold for acute pancreatitis risk should become the standard of care in FCS. However, many people remain above this level despite existing conventional approaches (e.g., fibrates, statins, and omega-3 fatty acids)1,4–6

GUIDELINES SUPPORT the ≤10 mmol/L (880 mg/dL) triglyceride level1

The 2019 European Society of Cardiology and European Atherosclerosis Society guidelines (ESC/EAS) identify that triglycerides ≤10 mmol/L (880 mg/dL) reduce the risk of acute pancreatitis1

The 2025 EAS/ESC Focused Update of the 2019 Guidelines for the management of dyslipidaemias provides a new recommendation for the management of FCS7

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Not an actual patient

Targeted treatment is an option for people with fcs8–10

Conventional triglyceride-lowering approaches are focused on increasing lipoprotein lipase activity. However, given the lack of functional lipoprotein lipase activity in people with FCS, increased apolipoprotein C-III levels primarily lead to further increased triglyceride levels via lipoprotein lipase-independent pathways11,12

As a result, most people do not achieve the guideline triglyceride level of ≤10 mmol/L (880 mg/dL), leaving them at high risk of acute pancreatitis1,5,10,11

Apolipoprotein C-III is a recognised target for specialist therapies aiming to lower triglycerides in people with FCS. Volanesorsen is an EU-approved antisense oligonucleotide that targets hepatic apolipoprotein C-III mRNA. It is approved for the treatment of genetically confirmed FCS2,4,9

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The more we can lower triglyceride levels, the more we can lower the risk of acute pancreatitis in people with FCS3

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Abbreviations

AP, acute pancreatitis; EU, European Union; FCS, Familial Chylomicronaemia Syndrome; mRNA, messenger ribonucleic acid; TG, triglyceride.

Show References Expand Collapse

  1. Mach F, Baigent C, et al. Eur Heart J. 2020;41(1):111–88.
  2. Goldberg RB, Chait A, et al. Front Endocrinol (Lausanne). 2020;11:593931.
  3. Sanchez RJ, Ge W, et al. Lipids Health Dis. 2021;20(1):72.
  4. Larouche MB, Watts GFC, et al. Curr Opin Endocrinol Diabetes Obes. 2025;32(2):75–88.
  5. Gouni-Berthold I. J Endocr Soc. 2020;4(2):bvz037.
  6. Falko JM. Endocr Pract. 2018;24(8):756–63.
  7. Mach F, Koskinas KC, et al. Eur Heart J. 2025;ehaf190.
  8. Paragh G, Németh Á, et al. Lipids Health Dis. 2022;21:21.
  9. Spagnuolo CM, Hegele RA, et al. Expert Rev Endocrinol Metab. 2024;19(4):299–306.
  10. Wolska A, Yang ZH, et al. Curr Opin Lipidol. 2020;31(6):331–9.
  11. Davidson M, Stevenson M, et al. J Clin Lipidol. 2018;12(4):898–907.
  12. Witztum JL, Tsimikas S, et al. J Clin Lipidol. 2023;17(3):342–55.

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