Table 1.

Triglycerides-lowering pharmacological agents.

Drug	Action on TGs Levels
Statins	Lower TGs levels by 20% [18,54] First-line therapy
Fibrates (e.g., pemafibrate)	The most potent drugs in managing hypertriglyceridemia Produce a decrease of up to 50% in TGs concentrations [58] Pemafibrate is non-inferior to other fibrates and has a more favorable safety profile Their potency to decrease overall cardiovascular risk is modest
Omega 3 fatty acids (e.g., Icosapent Ethyl)	Demonstrated a 25% relative risk reduction in adverse cardiovascular events both in primary and secondary prevention when administrated at a high dose [63] Exert a beneficial effect on endothelial function assessed via flow-mediated dilation [66]
Ezetimibe	Produces only a slight decrease in TGs levels [59]
PCSK9 inhibitors (e.g., evolocumab)	Controversial data Reduction in VLDL, IDL, LDL, and Lp(a) levels The decrease in VLDL levels is dependent on baseline Lp(a) values [67] The lowering effect is more pronounced on VLDL2 levels than on VLDL1 [68]
Volanesorsen	A second-generation chimeric antisense therapeutic oligonucleotide that decreases plasma apoCIII and TGs levels in a dose-dependent manner [71]
Inclisiran	Small interfering RNA agent Majorly effective in reducing LDL concentration but also lowered TGs levels in ORION 9, 10, and 11 trials [72,73]
GLP-1 receptor agonists (e.g., liraglutide)	Decreases apoB48 synthesis in CMs Apparently decreased production of atherogenic remnants in diabetic patients [74]
SGLT2 inhibitors (e.g., empagliflozin)	Decrease in fasting and post-prandial TGs concentration and a flow-mediated dilation improvement [75]

TG: triglyceride; VLDL: very-low-density lipoproteins; IDL: intermediate-density lipoprotein; Lp(a): lipoprotein(a); RNA: ribonucleic acid; CMs: chylomicrons.