Severe familial hypercholesterolemia treatment

Česká verzia

Authors: Michal Vrablík ¹; Tomáš Freiberger ²; Vladimír Bláha ³; Richard Češka ¹
Authors place of work: Centrum preventivní kardiologie III. interní kliniky 1. LF UK a VFN v Praze ¹; Genetická laboratoř Centra kardiovaskulární a transplantační chirurgie, Brno ²; III. interní gerontometabolická klinika LF UK a FN Hradec Králové ³
Published in the journal: Vnitř Lék 2016; 62(11): 895-901
Category: Reviews

Summary

Familial hypercholesterolemia (FH) represents the most frequent of inborn errors of metabolism. It is a group of disorders with a codominant mode of inheritance characterized by marked elevations of LDL-cholesterol as well as atherosclerotic cardiovascular disease risk. Clinical (phenotypic) picture of FH varies widely depending on genotype and concomitant risk factors. Identification of most seriously affected FH individuals is necessary for proper clinical management. The therapeutic approach must be complex and comprehensive. The corner stone of pharmacotherapy is high-intensity statin therapy usually combined with ezetimibe (possibly complemented with bile acid sequestrant). Even this multi-drug combination do not lead majority of patients to their treatment goals. Thus, combinations with other pharmacological (PCSK9 inhibitors, apoB-100 anti-sense therapy, MTP inhibition) and non-pharmacological (LDL-apheresis, liver transplantation) approaches is being used.

Key words:
ezetimibe – LDL-apheresis – lomitapide – mipomersen – PCSK9 inhibitors – severe familial hypercholesterolemia – statins

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