A 39 year-old woman comes to your primary care center complaining of right upper quadrant abdominal pain, indigestion and nausea. She has been taking warfarin for a recent deep venous thrombosis in right lower extremity. Family history reveals that several members of her family, including her mother and a sister, suffer from an inherited metabolic disorder. On physical examination you notice yellowing of the skin and eyes; moderate hepatosplenomegaly; tenderness in the right upper quadrant, epigastric area and middle quadrant. You also notice small, nonpainful orange-red papules on his scalp, elbows and knees and a yellow-to-orange coloration of palmar and finger creases. Laboratory tests reveal elevated amylase, lipase; elevated triglyceride level of 1700 mg/dL; elevated VLDL, and elevated total cholesterol. Abdominal ultrasound revealed stones in the gallbladder. Patient was admitted to the local hospital and had a cholecystectomy. At the time of her discharge, you begin her on a triglyceride-lowering agent. Which of the following is the first-line treatment to treat this patient’s hypertriglyceridemia?
