Screening and treatment of familial hypercholesterolemia in a French sample of ambulatory care patients: A retrospective longitudinal cohort study.

<h4>Background and aims</h4>Untreated Familial Hypercholesterolemia (FH) leads to premature morbidity and mortality. In France, its epidemiology and management are understudied in ambulatory care. We described the clinical profile, pharmacological management, and clinical outcomes in a F...

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Autores principales:	Jean Ferrières, Victoria Banks, Demetris Pillas, Francesco Giorgianni, Laurene Gantzer, Beranger Lekens, Lea Ricci, Margaux Dova-Boivin, Jean-Vannak Chauny, Guillermo Villa, Gaelle Désaméricq
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/fba96f92295347159007661da48c7883
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spelling	oai:doaj.org-article:fba96f92295347159007661da48c78832021-12-02T20:18:50ZScreening and treatment of familial hypercholesterolemia in a French sample of ambulatory care patients: A retrospective longitudinal cohort study.1932-620310.1371/journal.pone.0255345https://doaj.org/article/fba96f92295347159007661da48c78832021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255345https://doaj.org/toc/1932-6203<h4>Background and aims</h4>Untreated Familial Hypercholesterolemia (FH) leads to premature morbidity and mortality. In France, its epidemiology and management are understudied in ambulatory care. We described the clinical profile, pharmacological management, and clinical outcomes in a French sample of FH patients.<h4>Methods</h4>This was a retrospective longitudinal study on patients from The Health Improvement Network (THIN®) database in France, between October 2016-June 2019. Patients ≥18 years, with probable/definite FH based on the Dutch Lipid Clinic Network (DLCN) criteria were included. Baseline characteristics, lipid profile, lipid-lowering therapy (LLT), low-density lipoprotein-cholesterol (LDL-C) goal achievement; and disease management at 6-month of follow-up were analyzed.<h4>Results</h4>116 patients with probable (n = 70)/definite (n = 46) FH were included (mean age:57.8±14.0 years; 56.0% women; 9.5% with personal history of cardiovascular events); 90 patients had data available at follow-up. At baseline, 77.6% of patients had LDL-C>190 mg/dL, 27.6% were not receiving LLTs, 37.9% received statins alone, 20.7% statins with other LLTs, and 7.7% other LLTs. High-intensity statins were prescribed to 11.2% of patients, 30.2% received moderate-intensity statins, and 8.6% low-intensity statins. Only 6.0% of patients achieved LDL-C goal. At 6-month of follow-up, statins discontinuation and switching were 22.7% and 2.3%, respectively. None of the patients received proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors at baseline nor follow-up.<h4>Conclusions</h4>Despite the existence of effective LLTs, FH patients are suboptimally-treated, do not achieve LDL-C goal, and exhibit worsened pharmacological management over time. Future studies with longer follow-up periods and assessment of factors affecting LDL-C management, including lifestyle and diet, are needed.Jean FerrièresVictoria BanksDemetris PillasFrancesco GiorgianniLaurene GantzerBeranger LekensLea RicciMargaux Dova-BoivinJean-Vannak ChaunyGuillermo VillaGaelle DésaméricqPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0255345 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jean Ferrières Victoria Banks Demetris Pillas Francesco Giorgianni Laurene Gantzer Beranger Lekens Lea Ricci Margaux Dova-Boivin Jean-Vannak Chauny Guillermo Villa Gaelle Désaméricq Screening and treatment of familial hypercholesterolemia in a French sample of ambulatory care patients: A retrospective longitudinal cohort study.
description	<h4>Background and aims</h4>Untreated Familial Hypercholesterolemia (FH) leads to premature morbidity and mortality. In France, its epidemiology and management are understudied in ambulatory care. We described the clinical profile, pharmacological management, and clinical outcomes in a French sample of FH patients.<h4>Methods</h4>This was a retrospective longitudinal study on patients from The Health Improvement Network (THIN®) database in France, between October 2016-June 2019. Patients ≥18 years, with probable/definite FH based on the Dutch Lipid Clinic Network (DLCN) criteria were included. Baseline characteristics, lipid profile, lipid-lowering therapy (LLT), low-density lipoprotein-cholesterol (LDL-C) goal achievement; and disease management at 6-month of follow-up were analyzed.<h4>Results</h4>116 patients with probable (n = 70)/definite (n = 46) FH were included (mean age:57.8±14.0 years; 56.0% women; 9.5% with personal history of cardiovascular events); 90 patients had data available at follow-up. At baseline, 77.6% of patients had LDL-C>190 mg/dL, 27.6% were not receiving LLTs, 37.9% received statins alone, 20.7% statins with other LLTs, and 7.7% other LLTs. High-intensity statins were prescribed to 11.2% of patients, 30.2% received moderate-intensity statins, and 8.6% low-intensity statins. Only 6.0% of patients achieved LDL-C goal. At 6-month of follow-up, statins discontinuation and switching were 22.7% and 2.3%, respectively. None of the patients received proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors at baseline nor follow-up.<h4>Conclusions</h4>Despite the existence of effective LLTs, FH patients are suboptimally-treated, do not achieve LDL-C goal, and exhibit worsened pharmacological management over time. Future studies with longer follow-up periods and assessment of factors affecting LDL-C management, including lifestyle and diet, are needed.
format	article
author	Jean Ferrières Victoria Banks Demetris Pillas Francesco Giorgianni Laurene Gantzer Beranger Lekens Lea Ricci Margaux Dova-Boivin Jean-Vannak Chauny Guillermo Villa Gaelle Désaméricq
author_facet	Jean Ferrières Victoria Banks Demetris Pillas Francesco Giorgianni Laurene Gantzer Beranger Lekens Lea Ricci Margaux Dova-Boivin Jean-Vannak Chauny Guillermo Villa Gaelle Désaméricq
author_sort	Jean Ferrières
title	Screening and treatment of familial hypercholesterolemia in a French sample of ambulatory care patients: A retrospective longitudinal cohort study.
title_short	Screening and treatment of familial hypercholesterolemia in a French sample of ambulatory care patients: A retrospective longitudinal cohort study.
title_full	Screening and treatment of familial hypercholesterolemia in a French sample of ambulatory care patients: A retrospective longitudinal cohort study.
title_fullStr	Screening and treatment of familial hypercholesterolemia in a French sample of ambulatory care patients: A retrospective longitudinal cohort study.
title_full_unstemmed	Screening and treatment of familial hypercholesterolemia in a French sample of ambulatory care patients: A retrospective longitudinal cohort study.
title_sort	screening and treatment of familial hypercholesterolemia in a french sample of ambulatory care patients: a retrospective longitudinal cohort study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/fba96f92295347159007661da48c7883
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Screening and treatment of familial hypercholesterolemia in a French sample of ambulatory care patients: A retrospective longitudinal cohort study.

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