National Lipid Association and American Society for Preventive Cardiology Release Joint Expert Consensus on Chylomicronemia Management

The National Lipid Association (NLA), in collaboration with the American Society for Preventive Cardiology (ASPC), has released a Joint Expert Clinical Consensus providing new guidance on the recognition and management of persistent chylomicronemia — a severe and often misunderstood form of hypertriglyceridemia. The full paper is now published in the Journal of Clinical Lipidology and available here.

This consensus offers a new framework for categorizing and treating chylomicronemia, defined as a triglyceride level ≥ 1,000 mg/dL. The recommendations aim to improve outcomes for affected individuals by promoting a more personalized and pragmatic clinical approach.

Currently, patients are classified as having either familial chylomicronemia syndrome (FCS) — an ultra-rare genetic disorder affecting 1–10 per million people — or multifactorial chylomicronemia (MCS), which is far more common (1 in 500) and results from a combination of genetic and environmental factors. However, the traditional binary approach has posed challenges in diagnosis and management.

“The current approach for chylomicronemia is focused on genotype — FCS or MCS — and there are no effective treatments for patients with severe forms other than lifestyle changes and triglyceride-lowering medications with limited efficacy,” said Christie Ballantyne, MD, FNLA, President of the NLA and professor of medicine at Baylor College of Medicine.

Dr. Ballantyne, along with Daniel Gaudet, MD, PhD of Université de Montréal, served as co-senior authors of the consensus, while Seyedmohammad Saadatagah, MD, a soon-to-be cardiology fellow, and Miriam Larouche, MSc, are credited as co-first authors. The expert group includes contributors from Baylor College of Medicine and other leading institutions.

The consensus emphasizes risk stratification and clinical criteria over strict genetic classifications to better guide treatment and reduce the risk of severe complications, including pancreatitis.

“This is a step toward a more pragmatic and personalized approach in the management of chylomicronemia,” added Dr. Ballantyne. “By including this type of criteria and highlighting high-risk features, we can focus our intervention approaches and prevent severe outcomes like pancreatitis. We need a new approach, as the current system is complicated and not understood by most physicians and patients.”

The NLA and ASPC encourage clinicians, researchers, and stakeholders to review the full consensus and integrate the recommendations into practice to improve care for individuals living with persistent chylomicronemia.