omega-3-acid ethyl esters + HMG-CoA reductase inhibitor

A combination therapy consisting of **omega-3-acid ethyl esters** (mainly ethyl esters of eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) and an **HMG-CoA reductase inhibitor** (statin; e.g., simvastatin, atorvastatin, or rosuvastatin). Administered together, this combination is used primarily for adults with hypertriglyceridemia who have persistently elevated triglyceride levels despite statin therapy. **Omega-3-acid ethyl esters** work mainly by reducing hepatic triglyceride synthesis and increasing triglyceride clearance, through inhibition of acyl-CoA:1,2-diacylglycerol acyltransferase, increased β-oxidation, and upregulation of lipoprotein lipase activity. **HMG-CoA reductase inhibitors** lower cholesterol by competitively inhibiting the enzyme HMG-CoA reductase, which is the rate-limiting step in cholesterol biosynthesis. The combination demonstrates additive effects in lowering triglycerides and non-HDL cholesterol, with statins as the primary lipid-lowering backbone and omega-3-acid ethyl esters as adjunct therapy to further reduce triglycerides in patients with high cardiovascular risk.