Elevated triglyceride levels (higher than ~1000 mg/dL) are associated with an 
increased risk for pancreatitis. Apolipoprotein-CIII (apoC-III) plays a key role 
in the metabolism of triglycerides and triglyceride-rich lipoproteins. Loss of 
function mutations in the gene encoding apoC-III (APOC3) is associated with low 
triglyceride levels and a decreased risk for cardiovascular disease (CVD) while 
overexpression of APOC3 is associated with hypertriglyceridemia. Although many 
drugs such as fibrates, statins and omega-3 fatty acids modestly decrease 
triglyceride levels (and apoC-III concentrations), there are many patients who 
still have severe hypertriglyceridemia and are at increased risk for 
pancreatitis and potentially for CVD. The antisense oligonucleotide (ASO) 
against APOC3 mRNA volanesorsen (previously called ISIS 304801, ISIS-ApoCIIIRx 
and IONIS-ApoCIIIRx) robustly decreases both, apoC-III production and 
triglyceride concentrations and is being currently evaluated in phase 3 trials. 
In this narrative review, we present the currently available clinical evidence 
on the efficacy and safety of volanesorsen for the treatment of 
hypertriglyceridemia.