New insights into the management of homozygous familial hypercholesterolemia patients treated with lomitapide: a single-center experience

Familial hypercholesterolemia (FH) is a genetic disease, usually with onset during childhood, characterized by elevated blood LDL cholesterol levels and potentially associated with severe cardiovascular complications. Concerning mutated genes in FH, such as LDLR, a small subset of FH patients presen...

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Main Authors: Gabriella Iannuzzo, Ilenia Lorenza Calcaterra, Marco Gentile, Claudia Stanzione, Francesca de Ruberto, Maria Donata di Taranto, Giovanna Cardiero, Giuliana Fortunato, Matteo Di Minno
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2024.1515846/full
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author Gabriella Iannuzzo
Ilenia Lorenza Calcaterra
Marco Gentile
Claudia Stanzione
Francesca de Ruberto
Maria Donata di Taranto
Giovanna Cardiero
Giuliana Fortunato
Matteo Di Minno
author_facet Gabriella Iannuzzo
Ilenia Lorenza Calcaterra
Marco Gentile
Claudia Stanzione
Francesca de Ruberto
Maria Donata di Taranto
Giovanna Cardiero
Giuliana Fortunato
Matteo Di Minno
author_sort Gabriella Iannuzzo
collection DOAJ
description Familial hypercholesterolemia (FH) is a genetic disease, usually with onset during childhood, characterized by elevated blood LDL cholesterol levels and potentially associated with severe cardiovascular complications. Concerning mutated genes in FH, such as LDLR, a small subset of FH patients presents a homozygous genotype, resulting in homozygous FH (HoFH) disease with a generally aggressive phenotype. Besides statins, ezetimibe and PCSK9 inhibitors, lomitapide (an anti-ApoB therapy) was also approved in 2012–2013 as an adjunctive treatment for HoFH. Despite its clinical efficacy, lomitapide administration should be done with caution because of the possible occurrence of side effects, such as hepatosteatosis, increased blood transaminase levels and gastrointestinal symptoms, as well as the possible deleterious interactions with other drugs. In this context, we decided to report the main available evidence on the management and monitoring of HoFH patients treated with lomitapide and to accompany this literature review with a description of our clinical experience with a subset of six HoFH patients. In conclusion, this paper aims to address an important topic for HoFH-related clinical practice that, to our knowledge, is not yet formally regulated by proper national and/or international guidelines.
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spelling doaj-art-6e844ef8b6d947a6afa027a753df2cb62024-12-24T05:10:36ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922024-12-011510.3389/fendo.2024.15158461515846New insights into the management of homozygous familial hypercholesterolemia patients treated with lomitapide: a single-center experienceGabriella Iannuzzo0Ilenia Lorenza Calcaterra1Marco Gentile2Claudia Stanzione3Francesca de Ruberto4Maria Donata di Taranto5Giovanna Cardiero6Giuliana Fortunato7Matteo Di Minno8Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Naples, ItalyDepartment of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Naples, ItalyDepartment of Molecular Medicine and Medical Biotechnologies, CEINGE Advanced Biotechnologies S.C. A.R.L, University of Naples Federico II, Naples, ItalyDepartment of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Naples, ItalyDepartment of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Naples, ItalyDepartment of Molecular Medicine and Medical Biotechnologies, CEINGE Advanced Biotechnologies S.C. A.R.L, University of Naples Federico II, Naples, ItalyDepartment of Molecular Medicine and Medical Biotechnologies, CEINGE Advanced Biotechnologies S.C. A.R.L, University of Naples Federico II, Naples, ItalyDepartment of Molecular Medicine and Medical Biotechnologies, CEINGE Advanced Biotechnologies S.C. A.R.L, University of Naples Federico II, Naples, ItalyDepartment of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Naples, ItalyFamilial hypercholesterolemia (FH) is a genetic disease, usually with onset during childhood, characterized by elevated blood LDL cholesterol levels and potentially associated with severe cardiovascular complications. Concerning mutated genes in FH, such as LDLR, a small subset of FH patients presents a homozygous genotype, resulting in homozygous FH (HoFH) disease with a generally aggressive phenotype. Besides statins, ezetimibe and PCSK9 inhibitors, lomitapide (an anti-ApoB therapy) was also approved in 2012–2013 as an adjunctive treatment for HoFH. Despite its clinical efficacy, lomitapide administration should be done with caution because of the possible occurrence of side effects, such as hepatosteatosis, increased blood transaminase levels and gastrointestinal symptoms, as well as the possible deleterious interactions with other drugs. In this context, we decided to report the main available evidence on the management and monitoring of HoFH patients treated with lomitapide and to accompany this literature review with a description of our clinical experience with a subset of six HoFH patients. In conclusion, this paper aims to address an important topic for HoFH-related clinical practice that, to our knowledge, is not yet formally regulated by proper national and/or international guidelines.https://www.frontiersin.org/articles/10.3389/fendo.2024.1515846/fullHoFHhypercholesterolemialomitapidemanagementmonitoring
spellingShingle Gabriella Iannuzzo
Ilenia Lorenza Calcaterra
Marco Gentile
Claudia Stanzione
Francesca de Ruberto
Maria Donata di Taranto
Giovanna Cardiero
Giuliana Fortunato
Matteo Di Minno
New insights into the management of homozygous familial hypercholesterolemia patients treated with lomitapide: a single-center experience
Frontiers in Endocrinology
HoFH
hypercholesterolemia
lomitapide
management
monitoring
title New insights into the management of homozygous familial hypercholesterolemia patients treated with lomitapide: a single-center experience
title_full New insights into the management of homozygous familial hypercholesterolemia patients treated with lomitapide: a single-center experience
title_fullStr New insights into the management of homozygous familial hypercholesterolemia patients treated with lomitapide: a single-center experience
title_full_unstemmed New insights into the management of homozygous familial hypercholesterolemia patients treated with lomitapide: a single-center experience
title_short New insights into the management of homozygous familial hypercholesterolemia patients treated with lomitapide: a single-center experience
title_sort new insights into the management of homozygous familial hypercholesterolemia patients treated with lomitapide a single center experience
topic HoFH
hypercholesterolemia
lomitapide
management
monitoring
url https://www.frontiersin.org/articles/10.3389/fendo.2024.1515846/full
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