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Half of Deaths From Homozygous FH Occur Before Age 32 Years: Urgent Call to Action


Core Concepts
Early diagnosis and intensive treatment are crucial for patients with homozygous familial hypercholesterolemia to prevent premature death.
Abstract
The content highlights the alarming mortality rates among patients with homozygous familial hypercholesterolemia (HoFH) and emphasizes the importance of early diagnosis and aggressive treatment to improve outcomes. Key points include: Half of HoFH patients die by age 32, with a mean age of diagnosis at 12 years. Despite treatment, patients had high LDL cholesterol levels, and 70% developed atherosclerotic cardiovascular disease by age 28. The study underscores the need for a combination of lipid-lowering therapies to reduce cholesterol levels significantly. Patients with HoFH face severe cardiovascular disease risks, necessitating early intervention and comprehensive treatment strategies. The findings call for immediate action to improve the diagnosis and management of HoFH to extend patients' lives.
Stats
Half of patients with HoFH die by age 32. 70% of HoFH patients develop atherosclerotic cardiovascular disease by age 28. Patients receiving treatment had LDL cholesterol levels of 9.4 mmol/L.
Quotes
"Patients with HoFH have severe atherosclerotic cardiovascular disease risk." - Janneke Mulder "This is something that we should focus on for these patients from the beginning." - Maciej Banach

Key Insights Distilled From

by Liam Davenpo... at www.medscape.com 05-24-2023

https://www.medscape.com/viewarticle/992391
Half of Deaths From Homozygous FH Occur Before Age 32 Years

Deeper Inquiries

How can healthcare systems improve accessibility to lipid centers for patients with HoFH?

Improving accessibility to lipid centers for patients with HoFH can be achieved through several strategies. Firstly, healthcare systems can establish specialized clinics or centers dedicated to the management of familial hypercholesterolemia, ensuring that patients have easy access to expert care. Telemedicine and virtual consultations can also be utilized to reach patients in remote areas or those who face transportation barriers. Collaborations between lipid specialists, primary care providers, and genetic counselors can help streamline the referral process and ensure timely diagnosis and treatment initiation. Additionally, raising awareness among healthcare professionals about the importance of early detection and management of HoFH can lead to more patients being identified and referred to lipid centers promptly.

What are the challenges in achieving the target reduction of 85% in LDL cholesterol levels for HoFH patients?

Achieving the target reduction of 85% in LDL cholesterol levels for HoFH patients poses several challenges. One major challenge is the limited availability and high cost of advanced lipid-lowering therapies, such as PCSK9 inhibitors, which are often necessary to achieve such significant reductions. Access barriers to these medications, including insurance coverage limitations and approval processes, can hinder patients from receiving the most effective treatments. Another challenge is the variability in individual patient responses to different lipid-lowering agents, making it difficult to predict and achieve the desired level of LDL cholesterol reduction in all patients. Adherence to complex treatment regimens and lifestyle modifications can also be challenging for some patients, impacting the effectiveness of therapy.

How can genetic research contribute to understanding the longevity of some HoFH patients compared to others?

Genetic research plays a crucial role in understanding the longevity of some HoFH patients compared to others by identifying genetic factors that may influence disease progression and outcomes. By conducting genetic studies on long-lived HoFH patients, researchers can uncover potential protective genetic mutations or variants that contribute to their extended lifespan. Understanding the genetic basis of HoFH can also help in predicting disease severity, response to treatment, and risk of complications, allowing for personalized and targeted management strategies. Furthermore, genetic research can provide insights into the underlying mechanisms of atherosclerosis and cardiovascular disease in individuals with familial hypercholesterolemia, paving the way for the development of novel therapeutic approaches and interventions tailored to specific genetic profiles.
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