Severe hypertriglyceridemia is defined by triglyceride levels above 1000 mg/dL, and the main goal of treatment is to reduce the risk of acute pancreatitis[1][2][3]. It is recommended to combine the restriction of the intake of fats and simple carbohydrates in the diet with drug therapy[1][3]. Patients with levels above 500 mg/dL should receive fibrates and omega-3 fatty acids to prevent pancreatitis[3][4]. New drugs such as olesarsen have reduced the incidence of pancreatitis by 85% in patients with severe hypertriglyceridemia[2]. DR10624 at doses of 12.5–50 mg reduced triglycerides by more than 60% and liver fat by 63.5% in 79 patients with levels of 500–2000 mg/dL after 12 weeks[2]. No changes in LDL cholesterol levels were observed with olesarsen[2][4]. The basis remains a lifestyle change, including weight loss and exercise[3][4].