A major clinical investigation coordinated in Israel has revealed that a new lipid-lowering treatment can cut triglyceride levels by more than half and substantially reduce the likelihood of acute pancreatitis, a life-threatening inflammatory condition. The findings, published in the New England Journal of Medicine and presented at the American Heart Association’s annual conference in the United States, mark a significant advance for patients with severe lipid disorders who have had limited therapeutic options.
Clinical Trial Shows Transformative Outcomes for High-Risk Patients
The international research effort, which included contributions from nine medical centres across Israel, was led locally by Dr Hofit Cohen of the Sheba Medical Center. Dr Cohen, who heads the Diagnostic and Treatment Service for Lipid Disorders at the Strasburger Lipid Centre, described the treatment’s impact as “life-changing” for individuals who have struggled with dangerously high triglyceride concentrations.
She highlighted the case of a 50-year-old patient who had experienced six separate hospital admissions for pancreatitis in recent years, despite strict dietary control, lifestyle modification and maximal pharmacological therapy. According to Dr Cohen, the experimental medication normalised his triglyceride levels, and he has not required emergency care since beginning treatment.
Understanding Triglycerides and Their Health Risks
Triglycerides are a form of fat transported in the bloodstream, consisting of three fatty acids bound to glycerol. After meals, the intestines produce triglycerides carried by chylomicrons, while the liver generates similar particles known as very low-density lipoproteins (VLDL). These lipid-rich molecules supply energy or are stored in body fat.
Normal levels fall below 150 mg/dL. Concentrations between 150 and 499 mg/dL are considered raised, while measurements from 500 to 999 mg/dL represent a significant elevation. Readings exceeding 1,000 mg/dL carry a substantial risk of pancreatitis in addition to their association with cardiovascular disease.
Persistently high triglycerides contribute to atherosclerosis, increasing the probability of heart attacks, strokes and peripheral vascular disease. At extremely high levels, they can trigger acute pancreatitis, a condition that may require intensive care and leave permanent damage.
Why Conventional Treatments Often Fall Short
Dr Cohen explained that severe hypertriglyceridaemia typically arises from a mixture of genetic predisposition and environmental influences. Diets high in unhealthy fats and refined carbohydrates, physical inactivity, excessive alcohol consumption, poorly controlled diabetes, kidney dysfunction, hypothyroidism, elevated cortisol levels and central obesity all play major roles. Rare inherited disorders may also impair the body’s ability to clear triglycerides, leading to dangerously high levels from a young age.
Standard therapy begins with targeted lifestyle changes: balanced eating patterns, restricting simple sugars, avoiding alcohol, regular exercise and stringent diabetes management. If cardiovascular risk is evident, statins are often added. For triglyceride levels above 500 mg/dL, clinicians frequently prescribe fibrates or high-dose omega-3 fatty acids, which can reduce levels by roughly 30% to 50%.
However, a subset of patients — particularly those whose results remain “in the thousands” — do not respond adequately. Some continue to experience recurrent pancreatitis despite strict adherence to treatment. In extreme cases, they undergo plasmapheresis, an invasive procedure that removes triglycerides mechanically from the bloodstream, often weekly or fortnightly.
A Promising Step Forward
The newly developed therapy appears to offer an alternative for patients whose condition remains unstable despite best-practice care. Although further real-world studies will be necessary to determine long-term safety and applicability, the trial led from Israel suggests that this approach could address a longstanding gap in the treatment of severe hypertriglyceridaemia.
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