Do you start a statin concurrently with icosapent ethyl for patients with moderate hypertriglyceridemia and high ASCVD risk, or do you prefer to start a statin alone and monitor triglyceride levels?  

Generally, I prefer to start one treatment at a time and so would usually start with the statin first while working on other secondary causes of hypertriglyceridemia. If follow up lipid panel shows persistent hypertriglyceridemia (in a high ASCVD risk patient), I would then consider adding icosapen...

Statin therapy can lower TGs modestly (up to 20%) and are the first line therapy for ASCVD risk reduction. Therefore I usually initiate statin therapy first and reassess lipids prior to considering use of icosapent ethyl. Additionally IPE adds pill burden (need to take 4g a day), so I prefer to wait...