LDL-C reduction is the main goal of HoFH management1

12x higher risk of death in HoFH patients with elevated serum cholesterol levels2
The extent of reduction of serum cholesterol achieved by a therapy is a major determinant of survival in patients with HoFH2
In a retrospective study of 133 patients with HoFH, patients with an on-treatment serum cholesterol >15.1 mmol/L were at a 12x higher risk of death from a cardiac cause than those with serum cholesterol <8.1 mmol/L.*
2023 ESC/EAS LDL-C Reduction Target Recommendations
Recommendations from the 2023 EAS Consensus Statement for LDL-C target level3
Children
< 3.0 mmol/L
Adults (>18 years old)
< 1.8 mmol/L
Adults with ASCVD or major ASCVD risk factors
< 1.4 mmol/L
ESC=European Society of Cardiology. EAS=European Atherosclerosis Society.

HoFH is typically managed with multiple treatment approaches
Lifestyle intervention, including3
- Low-saturated-fat, low-cholesterol diet
- Physical activity
- Effective management of hypertension and diabetes
- Smoking cessation
Pharmacologic treatments, plasmapheresis and, in rare circumstances for unresponsive patients, liver transplantation
ASCVD=atherosclerotic cardiovascular disease.
References
1. Brunham L et al. Can J Cardiol. 2018;35:1553-1563. 2. Thompson GR et al. Eur Heart J. 2018;39:1162-1168. 3. Cuchel M et al. Eur Heart J.
2023;44(25):2277-2291.