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LCQ908 (pradigastat) is a potent, selective, and orally active inhibitor of diacylglycerol O-acyltransferase 1 (DGAT1), an enzyme responsible for the final step of triglyceride synthesis. By blocking DGAT1, pradigastat reduces the formation of chylomicrons in the intestine and the production of very-low-density lipoproteins (VLDL) in the liver. The combination with fish oil (omega-3 fatty acids, specifically EPA and DHA) was developed to enhance the triglyceride-lowering effect. Fish oil acts primarily as a ligand for peroxisome proliferator-activated receptor alpha (PPAR-alpha), leading to decreased hepatic triglyceride synthesis and increased fatty acid oxidation. This combination therapy was investigated by Novartis in Phase 2 clinical trials for the treatment of severe hypertriglyceridemia, aiming to provide a more effective management strategy for patients at risk of pancreatitis.
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