title: [Severe familial hypercholesterolemia treatment].
abstract: 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.
authors.forename: Michal
authors.initials: M
authors.lastname: Vrablík
authors.forename: Tomáš
authors.initials: T
authors.lastname: Freiberger
authors.forename: Vladimír
authors.initials: V
authors.lastname: Bláha
authors.forename: Richard
authors.initials: R
authors.lastname: Češka
mesh_terms: D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D053299:Apolipoprotein B-100 / Q000235:genetics; D050197:Atherosclerosis; D001562:Benzimidazoles / Q000627:therapeutic use; D001781:Blood Component Removal / Q000379:methods*; D002352:Carrier Proteins / Q000037:antagonists & inhibitors; D008078:Cholesterol, LDL; D000069438:Ezetimibe / Q000627:therapeutic use; D015316:Genetic Therapy; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006938:Hyperlipoproteinemia Type II / Q000628:therapy*; D016031:Liver Transplantation; D009841:Oligonucleotides / Q000627:therapeutic use; D000091362:PCSK9 Inhibitors; D012307:Risk Factors; D000071449:Proprotein Convertase 9
chemical_list: D000924:Anticholesteremic Agents; D053299:Apolipoprotein B-100; D001562:Benzimidazoles; D002352:Carrier Proteins; D008078:Cholesterol, LDL; D000069438:Ezetimibe; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D009841:Oligonucleotides; D000091362:PCSK9 Inhibitors; C569471:APOB protein, human; C473731:BMS201038; C106092:microsomal triglyceride transfer protein; C524142:mipomersen; C472125:PCSK9 protein, human; D000071449:Proprotein Convertase 9