Enlicitide (Lipfendra – Merck), an oral proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitor, has been approved by the FDA to reduce low-density lipoprotein cholesterol (LDL-C) in adults with hypercholesterolemia, including heterozygous familial hypercholesterolemia (HeFH). It is the first oral PCSK9 inhibitor to be approved in the US; the other FDA-approved PCSK9 inhibitors (alirocumab [Praluent], evolocumab [Repatha], and lerodalcibep [Lerochol]) and the PCSK9-directed small interfering RNA inclisiran (Leqvio) are injected subcutaneously. Lipfendra was approved under...

The National Cholesterol Education Program recommends that LDL-C be lowered to less than 100 mg/dL (2.6 mmol/L) and considers a value <70 mg/dL (1.8 mmol/L) a reasonable goal for patients at very high risk.

Adults with persistent fasting triglyceride levels ≥150 mg/dL are considered to have hypertriglyceridemia; when levels are ≥500 mg/dL, it is considered severe. Hypertriglyceridemia is associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD); severe hypertriglyceridemia increases the risk of acute pancreatitis.

Recently published multisociety guidelines for the management of dyslipidemia emphasize early identification and treatment of dyslipidemia to reduce the lifetime risk of atherosclerotic cardiovascular disease (ASCVD) and death.