Familial hypercholesterolemia
Autosomal-dominant genetic disorder of lipid metabolism with markedly elevated LDL and premature atherosclerosis. Requires aggressive lipid-lowering therapy.
ICD-10 E78.02 drugs
Also known as: FH
Drugs used for this condition
- AAtorvastatinFirst line · HMG-CoA reductase inhibitors (statins)Heterozygous FH requires high-intensity statins started early (from age 8–10 per pediatric ESC/EAS consensus). LDL target is below 2.5 mmol/L in adults without additional risk factors and below 1.8 mmol/L with them. Ezetimibe and, if needed, PCSK9 inhibitors are added when targets are not met.
- ARosuvastatinFirst line · HMG-CoA reductase inhibitors (statins)Familial hypercholesterolemia requires high-intensity statins. Rosuvastatin 20–40 mg provides the greatest LDL reduction among oral statins. If insufficient, ezetimibe is added, followed by PCSK9 inhibitors.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit