Efficacy and Safety of Olezarsen in Hypertriglyceridemia: An Updated Meta‐Analysis of Randomised Controlled Trials

Emara, A; Mansour, A; Aboeldahab, H; Awashra, A; Abbas, OF; Abdul-Hafez, HA; Alsubaiei, AA; AlSejari, N; Salman Saif, H; Shubietah, A; Mhanna, M

doi:10.1111/dom.70716

Lipids & metabolic liver disease

Efficacy and Safety of Olezarsen in Hypertriglyceridemia: An Updated Meta‐Analysis of Randomised Controlled Trials

Diabetes Obes MetabPublished 7 Apr 2026Systematic review and meta-analysis of randomised controlled trials

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Authors' conclusion

Olezarsen provides substantial triglyceride reduction with favourable effects on atherogenic lipoproteins and a tolerable short-term safety profile. Longer-term trials are needed to confirm cardiovascular outcomes and safety.

Study context

Population: Patients with hypertriglyceridemia in randomised controlled trials (RCTs) (PubMed, Cochrane, Scopus, Web of Science up to December 2025)
Participants: 2,676 patients6 RCTs

Comparison: Olezarsen vs placebo
Outcome: Triglycerides, mean percentage change

Methodological detailsrandom-effects models

Random-effects models

Pooled result

As reported in the abstract

Each group vs placeboMD, % (95% CI)P value

Olezarsen 50 mg

−46.61(−49.59 to −43.64)

P < 0.0001

Olezarsen 80 mg

−54.37(−61.26 to −47.48)

P < 0.0001

Further pooled results

Outcome	← Lower vs placebo ←→ Higher vs placebo →	MD (%) (95% CI)	P value
ApoC-III, mean % change50 mgvs Placebo	−100−50050	−63.51 (−74.18 to −52.84)	P < 0.0001
ApoC-III, mean % change80 mgvs Placebo	−100−50050	−66.88 (−77.91 to −55.85)	P < 0.0001
Non-HDL-C, mean % change50 mgvs Placebo	−100−50050	−21.41 (−25.12 to −17.70)	P < 0.0001
Non-HDL-C, mean % change80 mgvs Placebo	−100−50050	−25.28 (−33.99 to −16.58)	P = 0.001
LDL-C, mean % change50 mgvs Placebo	−100−50050	17.58 (0.24–34.93)	P = 0.047
	−100−50050Difference, % (linear scale)

Outcome	← Lower risk vs placebo ←→ Higher risk vs placebo →	RR (95% CI)	P value
Acute pancreatitis50 mgvs Placebo	0.050.21520	0.16 (0.05–0.48)	P = 0.001
Acute pancreatitis80 mgvs Placebo	0.050.21520	0.33 (0.14–0.76)	P = 0.009
	0.050.21520Relative risk (log scale)

Safety

Outcome	← Lower risk with olezarsen 80 mg ←→ Higher risk with olezarsen 80 mg →	RR (95% CI)	P value
ALT/AST ≥ 3 × ULNOlezarsen 80 mgvs Placebo	0.20.5125	2.56 (1.20–5.44)	P = 0.01
	0.20.5125Relative risk (log scale)

Overall adverse events

Overall adverse events comparable to placebo

Original publication

Efficacy and Safety of Olezarsen in Hypertriglyceridemia: An Updated Meta‐Analysis of Randomised Controlled Trials. Diabetes Obes Metab. Published 7 April 2026. doi:10.1111/dom.70716

Read the original article ↗

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