Significant gaps in awareness of familial hypercholesterolemia among physicians in selected Asia-Pacific countries: A pilot study

Pang, Jing; Sullivan, David; Harada‐Shiba, Mariko; Ding, Phillip Ya; Selvey, Sheryl; Ali, Shariq; Watts, Gerald F.

doi:10.1016/j.jacl.2014.09.011

Cited by 46 publications

(59 citation statements)

References 26 publications

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“…Often, even when these clinics exist, many family physicians are not aware of specialist clinical services and facilities for lipid disorders in their geographical area. 110 Nevertheless, regardless of who will manage patients with FH, high-intensity statin therapy is currently an established treatment of choice for this disease. If the target LDL-C level cannot be achieved with statin monotherapy-which is often the case-a combination therapy with concurrent ezetimibe or a bile-acid sequestrant can be considered.…”

Section: Resultsmentioning

confidence: 99%

Management of patients with familial hypercholesterolaemia

Reiner

2015

Nat Rev Cardiol

101

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Familial hypercholesterolaemia (FH) is an autosomal inherited disorder characterized by markedly elevated LDL-cholesterol (LDL-C) levels and an increased risk of premature atherosclerotic cardiovascular disease. Although FH is one of the most common genetic disorders, this disorder remains mostly undetected and its management is often suboptimal. High-intensity statins are standard treatment for patients with FH, but LDL-C levels in most patients treated with statin monotherapy remain above those recommended by guidelines. Combination therapy to lower LDL-C levels further-such as treatment with statins plus ezetimibe-has been successful, and combination of apheresis with high-intensity statin treatment is used in patients with homozygous FH and in those with heterozygous FH who are statin-refractory. Mipomersen, an inhibitor of apolipoprotein B-100 synthesis, and lomitapide, a microsomal triglyceride transfer protein inhibitor, reduce LDL-C levels further when added to high-intensity statin treatment in homozygous FH, but both have important adverse effects, such as increasing liver fat content. At present, PCSK9 inhibition (with alirocumab or evolocumab) is well tolerated and reduces LDL-C levels considerably in patients receiving the maximally tolerated statin treatment, and seems the most promising emerging treatment option. Nevertheless, data from outcome trials with hard end points for PCSK9 inhibitors, mipomersen, and lomitapide are still needed before these therapies become standard for patients with FH.

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Section: Resultsmentioning

confidence: 99%

Management of patients with familial hypercholesterolaemia

Reiner

2015

Nat Rev Cardiol

101

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“…Jing Pang et al reported the results of a survey to assess awareness, knowledge, and perception of FH among practicing physicians in Japan, Korea, and Taiwan. Of the 230 physicians surveyed, 47% were aware of the heritability, 27% of the prevalence, and 13% of the risk of CVD relating to FH 46) . Lack of specific criteria and guidelines in specific populations may account for the lack of knowledge of FH in this survey.…”

Section: Genotypes Of Fh Reported In Asian Populationsmentioning

confidence: 99%

Familial Hypercholesterolemia in Asian Populations

Zhou

Zhao

2016

J Atheroscler Thromb

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Familial hypercholesterolemia (FH) is the most common autosomal disorder characterized by an elevated low-density lipoprotein-cholesterol level and a high risk of premature cardiovascular disease. In this review, we summarize information on FH studies in Asian countries, focusing on mean cholesterol level, FH frequency, diagnostic criteria, genotypes, and clinical care of FH patients in Asian populations. Compared with Western countries, most Asian countries had lower mean cholesterol levels, with a significant variation between different countries. In the limited studies reported, a frequency of 1/900 was reported in Hokuriku district, Japan in 1977 and a frequency of 1/85 among Christian Lebanese in 1979. Recently, a population study in China reported frequencies of 0.47% and 0.28%. However, the different FH frequencies reported were based on different diagnostic criteria. Of 28 publications from 16 Asian countries or regions, 14 used self-defined FH criteria. Only one specific guideline for FH was available, which was developed by Japanese scientists. Six Asian countries joined the Make Early Diagnosis to Prevent Early Deaths program in the late 1990s, and the estimated diagnosis rates of FH ranged from 3% to 10% in these countries. A more recent study explored the awareness, knowledge, and perception of FH among practitioners in Japan, Korea, and Taiwan. The study found that the correct rates of these FH-related questions were low and concluded that lack of country-specific criteria and guidelines may contribute to the lack of FH knowledge in the present survey. More attention and resources should be focused on raising awareness, improving care, and increasing FH research in Asian populations. J Atheroscler Thromb, 2016; 23: 539-549.

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“…Studies on general practitioners in Australia 84) , cardiologists in the United States 85) , and physicians in the Asia-Pacific region 86) all demonstrate limited awareness of prevalence and heritability as well as an underestimation of premature CAD risk associated with FH, possibly because of the lack of FH coverage in professional curriculums. A recent study of medicine and pharmacy schools in the United States found significant gaps in the coverage of FH in their courses 87) .…”

Section: Knowledge Education and Trainingmentioning

confidence: 99%