Guidance on the management of familial hypercholesterolaemia in Hong Kong: an expert panel consensus viewpoint

Tomlinson, Brian; Chan, Juliana C.N.; Chan, Wayne; Chen, W Wc; Chow, Francis C. C.; Li, S K; Kong, Alice P.S.; Ma, Rong; Siu, Dcw; Tan, Kathryn Choon Beng; Wong, Lai-Yung; Yeung, V. T. F.; But, B Wm; Cheung, Phoebe; Fu, Chen; Tung, Judy; Wong, Wai-Man; Yau, Ho Chung

doi:10.12809/hkmj187215

Cited by 12 publications

(6 citation statements)

References 37 publications

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“…The potential role of elevated Lp(a) in risk stratification has been acknowledged in some guidelines on the management of HeFH [135][136][137], but in not in others [50,138,139] (Table 3). Once an efficient treatment of elevated Lp(a) becomes widely available, there will be a requirement not only for risk estimation including the Lp(a)-specific contribution to total CV risk, but also for guiding the clinicians to properly monitor the efficacy and safety of the treatment of elevated Lp(a).…”

Section: Towards New Clinical Practice Guidelinesmentioning

confidence: 99%

Familial hypercholesterolemia and elevated lipoprotein(a): double heritable risk and new therapeutic opportunities

et al. 2019

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Section: Towards New Clinical Practice Guidelinesmentioning

confidence: 99%

Familial hypercholesterolemia and elevated lipoprotein(a): double heritable risk and new therapeutic opportunities

et al. 2019

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“…In 2016, Zhou and Zhao reviewed studies of FH in Asian populations 30) . The authors found that In the Asia Pacific region, specific FH guidelines have been published for Australia and New Zealand 34,35) , China 36) , Hong Kong 37) , and Japan 38,39) . Table 3 provides a summary of the key recommendations made in these guidelines regarding diagnosis, treatment, and cascade screening.…”

Section: Fh Care Gap In Asia Pacificmentioning

confidence: 99%

“…Summary of key recommendations of specific FH guidelines in the Asia Pacific region[34][35][36][37][38][39] …”

mentioning

confidence: 99%

Familial Hypercholesterolemia in Asia Pacific: A Review of Epidemiology, Diagnosis, and Management in the Region

Kalra

Chen

Deerochanawong

et al. 2021

JAT

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The official journal of the Japan Atherosclerosis Society and the Asian Pacific Society of Atherosclerosis and Vascular Diseases Review Familial hypercholesterolemia (FH) is a common genetic disease that is estimated to affect at least 15 million people in the Asia Pacific region. Affected individuals are at significantly increased risk of premature atherosclerotic cardiovascular disease. A literature review was undertaken to provide an overview of the epidemiology, diagnosis, and management of FH across the region.Currently, epidemiological data relating to FH are lacking across the Asia Pacific. Of the 15 countries and regions considered, locally conducted studies to determine FH prevalence were only identified for Australia, China, India, and Japan. Although practically all national clinical guidelines for dyslipidemia include some commentary on FH, specific guidelines on the management of FH are available for only one third of the countries and regions evaluated. Estimates of current FH diagnosis rates suggest that most affected individuals remain undiagnosed and untreated. Although innovative medications such as proprotein convertase subtilisin/ kexin type 9 inhibitors have been approved and are available in most countries and regions considered, they are currently reimbursed in only one quarter.Despite these shortcomings, there is cause for optimism. Early experience with cascade screening in Hong Kong, India, and Vietnam has proven an effective means of identifying family members of probands, as has a reverse screening of family members of children with FH in China. FH registries are gaining momentum across the region, with registries now established in almost half of the countries and regions evaluated. This review concludes with a Call to Action on FH for Asia Pacific to engage healthcare professionals, improve public awareness, and form national FH alliances, comprising all relevant healthcare professional organizations, as a platform to expedite national quality improvement programs in the management of FH.(LDL) receptor, apolipoprotein B, or proprotein convertase subtilisin/kexin type 9 (PCSK9) cause FH. FH poses a major threat to public health because affected individuals are at significantly increased risk of premature atherosclerotic cardiovascular disease (ASCVD) 1) . Untreated individuals with homozygous

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“…Clinical criteria have often been used for the diagnosis of FH [7][8][9]. These include the Simon Broome Register Group criteria, the Make Early Diagnosis to Prevent Early Deaths (MEDPED) criteria, and the Dutch Lipid Clinic Network criteria.…”

Section: Diagnosis Of Familial Hypercholesterolemiamentioning

confidence: 99%

Role of PCSK9 Inhibitors in Patients with Familial Hypercholesterolemia

2021

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Patients with familial hypercholesterolemia (FH) are at high or very high risk for cardiovascular disease. Those with heterozygous FH (HeFH) often do not reach low-density lipoprotein cholesterol (LDL-C) targets with statin and ezetimibe therapy, and those with homozygous FH (HoFH) usually require additional lipid-modifying therapies. Drugs that inhibit proprotein convertase subtilisin/ kexin type 9 (PCSK9) offer a novel approach to reduce LDL-C. The monoclonal antibodies, alirocumab and evolocumab, given by subcutaneous injection every 2 or 4 weeks produce reductions in LDL-C of 50% to 60% in patients with HeFH, allowing many of them to achieve their LDL-C goals. Patients with HoFH show a reduced and more variable LDL-C response, which appears to depend on residual LDL receptor activity, and those with receptor-negative mutations may show no response. Inclisiran is a long-acting small interfering RNA therapeutic agent that inhibits the synthesis of PCSK9. Subcutaneous doses of 300 mg can reduce LDL-C by more than 50% for at least 6 months and the responses in HeFH and HoFH patients are similar to those achieved with monoclonal antibodies. These PCSK9 inhibitors are generally well tolerated and they provide a new opportunity for effective treatment for the majority of patients with FH.

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Guidance on the management of familial hypercholesterolaemia in Hong Kong: an expert panel consensus viewpoint

Cited by 12 publications

References 37 publications

Familial hypercholesterolemia and elevated lipoprotein(a): double heritable risk and new therapeutic opportunities

Familial hypercholesterolemia and elevated lipoprotein(a): double heritable risk and new therapeutic opportunities

Familial Hypercholesterolemia in Asia Pacific: A Review of Epidemiology, Diagnosis, and Management in the Region

Role of PCSK9 Inhibitors in Patients with Familial Hypercholesterolemia

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