How can genetically determined high cholesterol be treated?

How can genetically determined high cholesterol be treated?

Genetically determined high cholesterol also responds to low fat diet, exercise and medicines like statins, but incompletely. Some may need LDL apheresis. Genetically determined very high cholesterol levels are seen homozygous familial hypercholesterolemia, in which the levels may be as high as 1000 mg / dl. PCSK9 inhibitors being powerful LDL lowering agents are useful in genetically determined high cholesterol. But they have to be given as injections.

Lomitapide which reduces LDL by inhibiting the function of the microsomal triglyceride transport protein is another option. Finally there is liver transplantation, which can bring down LDL by 80% followed by rapid regression of cutaneous and tendinous xanthomas.

Reference

  1. Ishigaki Y, Kawagishi N, Hasegawa Y, Sawada S, Katagiri H, Satomi S, Oikawa S. Liver Transplantation for Homozygous Familial Hypercholesterolemia. J Atheroscler Thromb. 2019 Feb 1;26(2):121-127.QQWQ1 doi: 10.5551/jat.RV17029. Epub 2018 Dec 15. PMID: 30555131; PMCID: PMC6365147.