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Spotlight -

This Year In Medicine 2025

Opinion|Videos|January 1, 2025

Current FCS Standard-of-Care Treatment Recommendations

Author(s)Peter Toth, MD, PhD, FCCP, FESC, FAHA, FACC , James Underberg, MS, MD, FACP, FACPM, FASPC, FASH, FNLA , Erin Michos, MD, MHS, FACC, FAHA, FASE, FASPC

Key Takeaways

Delayed FCS diagnosis can lead to exacerbated cardiovascular and metabolic consequences, increasing atherosclerosis and cardiovascular disease risk.
Persistent hypertriglyceridemia from untreated FCS may result in chronic pancreatitis, diabetes, and liver disease.
Early intervention is essential to manage triglyceride levels, prevent severe complications, and improve patient outcomes.

SHOW MORE

Panelists discuss the current standard-of-care treatment recommendations for familial chylomicronemia syndrome (FCS) from an endocrinologist’s perspective, addressing the use of fibrates, omega-3 fatty acids, and statins despite their lack of approval for FCS; their typical impact on triglyceride reduction; the reasons these therapies are often ineffective in FCS; the gaps in existing treatments; and the associated risks of acute pancreatitis and hospitalization, along with potential adverse effects of these therapies.

Episodes in this series

EP. 1 Overview of FCS

EP. 1 Overview of FCS

EP. 2 Severe Hypertriglyceridemia

EP. 2 Severe Hypertriglyceridemia

EP. 3 Pathophysiology of FCS

EP. 3 Pathophysiology of FCS

EP. 4 Genetic Testing

EP. 4 Genetic Testing

EP. 5 Early Diagnosis

EP. 5 Early Diagnosis

EP. 6 Metabolic Disorders and Delayed Diagnosis

EP. 6 Metabolic Disorders and Delayed Diagnosis

EP. 7 FCS’ Affect on Quality of Life

EP. 7 FCS’ Affect on Quality of Life

EP. 8 Multidisciplinary Approach to Managing FCS

EP. 8 Multidisciplinary Approach to Managing FCS

EP. 9 Medium Chain Fatty Acids

EP. 9 Medium Chain Fatty Acids

EP. 10 Specialists’ Individual Treatment Plans for Patients With FCS: PCP

EP. 10 Specialists’ Individual Treatment Plans for Patients With FCS: PCP

EP. 11 Specialists’ Individual Treatment Plans for Patients With FCS: Pancreatic Specialist

EP. 11 Specialists’ Individual Treatment Plans for Patients With FCS: Pancreatic Specialist

EP. 12 Current FCS Standard-of-Care Treatment Recommendations

EP. 12 Current FCS Standard-of-Care Treatment Recommendations

EP. 13 APOC3 Inhibitors

EP. 13 APOC3 Inhibitors

EP. 14 Diet, Exercise, and Other Lifestyle Factors

EP. 14 Diet, Exercise, and Other Lifestyle Factors

EP. 15 FCS Patient Case study

EP. 15 FCS Patient Case study

Video content above is prompted by the following:

As an endocrinologist, what are your perspectives on current standard-of-care treatment recommendations for FCS, given there are currently no approved treatments for FCS (eg, fibrates, omega-3 fatty acids, statins)?
1. What is the typical reduction in triglycerides from using these treatments?
2. Why are standard lipid-lowering therapies typically ineffective for patients with FCS?
3. What are the gaps in existing treatments for FCS in terms of reducing triglyceride levels, and how do these gaps contribute to the risk of acute pancreatitis and the need for hospitalization?
4. What are the potential adverse effects associated with the FCS therapies we just reviewed?

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