Background: Familial hypercholesterolaemia (FH) is a monogenic lipid disorder that may be overlooked in the diagnostic process.
Objective: The aim of this article is to review the key areas for identification and management of FH that affect Australian general practitioners (GPs).
Discussion: Recent consensus advice on the care of patients with FH in Australia provides an opportunity for GPs to increase their awareness and skills in diagnosing and managing FH. New Medicare Benefits Schedule items for genetic testing and Pharmaceutical Benefits Scheme listing for the use of proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors offer GPs additional supports to improve the care of patients with FH. A shared-care approach between GPs and non-GP specialists with expertise in multiple disciplines offers the best option to facilitate genetic testing and management of index cases and affected family relatives. Implementation of this guidance in the primary care setting remains an ongoing challenge and needs to be embraced as a high priority.
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http://dx.doi.org/10.31128/AJGP-02-21-5836 | DOI Listing |
Curr Atheroscler Rep
January 2025
Carbohydrate and Lipid Metabolism Research Unit, Department of Medicine, University of the Witwatersrand, Johannesburg, South Africa.
Purpose Of Review: Homozygous familial hypercholesterolaemia (HoFH) is characterized by marked elevation of low-density lipoprotein cholesterol (LDLC) and premature atherosclerotic cardiovascular disease. This is a review of novel pharmacological therapies to lower LDLC in patients with HoFH.
Recent Findings: Novel therapies can be broadly divided by whether their efficacy is dependent or independent of residual low-density lipoprotein receptor (LDLR) function.
Naunyn Schmiedebergs Arch Pharmacol
January 2025
Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czech Republic.
Familial hypercholesterolemia (FH) is a relatively rare genetic disease associated with high serum cholesterol levels but also with abnormalities in blood coagulation. Novel pharmacotherapeutic approaches in FH including proprotein convertase subtilisin/kexin type 9 antibodies (PCSK9Ab) are very efficient in decreasing cholesterol levels but their impact on coagulation in FH is not yet established. Therefore, we hypothesized that these novel antidyslipidemic drugs can positively impact blood coagulation due to their more potent effect on cholesterol.
View Article and Find Full Text PDFTunis Med
December 2024
University El Manar, Faculty of Medecine of Tunis. Pediatrics and Neonatology departement, Yasminette Ben Arous, Tunisia.
Dyslipidemia in infants is a rare condition characterized by abnormal levels of lipids in the blood, such as cholesterol and triglycerides. Early diagnosis poses a challenge due to nonspecific symptoms and lipid criteria differing from adults. Through two clinical cases of familial dyslipidemia (Type 1 Familial Hypercholesterolemia and Type 2b Combined Familial Hyperlipidemia), we highlight the diagnostic and therapeutic challenges encountered in infants, emphasizing the importance of a multidisciplinary approach in care and early screening.
View Article and Find Full Text PDFClin Investig Arterioscler
December 2024
Unidad de Lípidos y Riesgo Vascular, Servicio de Endocrinología y Riesgo Vascular, Hospital del Mar, Barcelona, España. Electronic address:
Given the apparent inconsistency of having potent lipid-lowering drugs and the unacceptable rate of achievement of therapeutic goals in LDL cholesterol, it is imperative to define new strategies. In this regard, it is appropriate to detail the key points in planning to start lipid-lowering therapy, emphasizing relevant clinical aspects such as the considerable individual variability in the response to statin therapy, positioning in relation to high-potency statins versus statin+ezetimibe combination therapy, and the order of choice of lipid-lowering drugs in the therapeutic strategy. An algorithm is then proposed that ensures a personalized approach to lipid-lowering drug treatment in patients with cardiovascular disease and/or familial hypercholesterolemia with the aim of achieving the therapeutic goal in the shortest possible time, taking into account the patient's previous treatment, the funding criteria for new drugs, and the individualized goal of LDL cholesterol reduction.
View Article and Find Full Text PDFBiomark Res
December 2024
Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, 250021, China.
Proprotein convertase subtilisin/kexin type 9 (PCSK9) was first reported in 2003 and confirmed to be strongly associated with familial hypercholesterolemia. Small-molecule inhibitors targeting PCSK9 provide an effective and safe method for managing hypercholesterolemia and reducing the cardiovascular risk. In recent years, increasing evidence has indicated other important roles for PCSK9 in inflammation, tumors, and even immune regulation.
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