Hypertriglyceridaemia, specifically due to elevated triglyceride-rich lipoproteins (TRLs), is associated with increased risk of atherosclerotic cardiovascular disease; severe chylomicronaemia can also cause acute pancreatitis.

Treatments that target the production and clearance of TRLs mitigate these complications.

Nucleic acid-based therapies that target ANGPTL3 or apoC-III offer a new approach to lowering elevated TRLs, with preliminary studies testifying to their utility in clinical practice.

ANGPTL3 inhibition also lowers LDL particle concentration and may therefore have an overall advantage as a lipid-regulating agent.

Large clinical outcome trials are needed to confirm the efficacy, safety, cost effectiveness and clinical value of these new agents.