Table 3.

Suggested treatment regime for SHGT

Acute treatment in SHTG (TG > 1,000 mg/dL)	Long-term treatment for the prevention of SHTG episodes (TG levels to be reached 300–500 mg/dL)
Apheresis until plasma TG level < 1,000 mg/dL	Dietary measurements
MCT and omega-3-FA in combination	< 20 g LC-FA/day, abstinence of alcohol
	Adding omega-3-FA (> 3 g EPA + DHA)
	Adding fibrates to omega-3-FA
	Adding nicotinic acid to fibrates, omega-3-FA
	Considering recurrent episodes of plasmapheresis

Note carefully that conventional treatment of any comorbidity, e.g., pancreatitis is imperative as well as screening for secondary causes of HTG and treatment of the underlying disease

SHTG severe hypertriglyceridemia;TG triglycerdies;FA fatty acids;MCT medium-chain triglycerides;LC-FA long-chain fatty acids;EPA eicosapentaenoic acid;DHA docosahexaenoic acid