The National Institute of Health and Care Excellence (NICE) has updated its clinical guideline (CG71) on the identification and management of familial hypercholesterolaemia (FH).
While most of the recommendations in the new guideline remain unchanged, there are some key updates including the use of the new lipid modifying drugs- PCSK9 inhibitors (for which NICE technology appraisal guidance exists), treatment of children and recommendations to search medical records for those who may be at risk.
The guideline also recommends that those at risk of FH should be offered DNA tests to confirm they have the condition. Previously, low-density lipoprotein cholesterol (LDL-C) levels have been used but they are not always accurate.
At the moment only 15% of the estimated 260,000 people in the UK with FH have been diagnosed, including just 600 of the 56,000 children thought to have the condition. Treatment for FH usually involves statins, which should be offered to children identified with FH by the age of ten years, says NICE.
Commenting on the Guideline, Professor Sir Nilesh Samani, Medical Director at the British Heart Foundation, said, “It’s disappointing that we have the ability to diagnose and treat people with FH, yet 85% remain undiagnosed and at risk of a potentially fatal heart attack or stroke. These new guidelines, based on the best available evidence, provide a clear approach to managing FH that could ultimately save lives.”
The updated guideline Familial hypercholesterolaemia: identification and management (CG71) is available at https://www.nice.org.uk/guidance/cg71
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