Severe familial hypercholesterolaemia: current and future management

Area of Science:

• Cardiovascular Medicine
• Genetics
• Metabolic Disorders

Background:

• Familial hypercholesterolaemia (FH) is an inherited disorder characterized by elevated low-density lipoprotein (LDL) cholesterol levels.
• This condition significantly increases the risk of premature cardiovascular disease.
• While homozygous FH is uniformly severe, heterozygous FH exhibits variable clinical expression.

Purpose of the Study:

• To review current recommendations for diagnosing and treating severe familial hypercholesterolaemia.
• To discuss available and emerging therapeutic agents for high-risk FH patients.
• To address the unmet needs in managing under-diagnosed and under-treated FH.

Main Methods:

• Review of existing clinical guidelines and treatment protocols for FH.
• Analysis of factors contributing to phenotypic variability in FH.
• Survey of current pharmacological and investigational therapies for severe FH.

Main Results:

• Severe FH, both homozygous and heterozygous forms, necessitates intensive treatment strategies.
• Significant variations in clinical presentation are influenced by LDL-cholesterol levels, mutation type, and other risk factors.
• Under-diagnosis and under-treatment remain critical issues in managing FH.

Conclusions:

• Intensified treatment and novel therapeutic approaches are crucial for managing homozygous and severe heterozygous FH.
• Addressing diagnostic and therapeutic gaps is essential for improving outcomes in high-risk FH individuals.
• Further research into alternative treatments is needed for severe FH patients.