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Familial hypercholesterolaemia — SCE Endocrinology MCQ

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ModerateObesity/LipidFamilial hypercholesterolaemiaSCE Endocrinology

A 49-year-old woman has LDL cholesterol 5.2 mmol/L despite maximum tolerated atorvastatin and ezetimibe. She has confirmed heterozygous familial hypercholesterolaemia and previous myocardial infarction. What is the most appropriate add-on treatment to consider?

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Correct answer: B — PCSK9 inhibitor according to eligibility

In familial hypercholesterolaemia with established cardiovascular disease and persistently high LDL despite standard therapy, PCSK9 inhibitor eligibility should be considered. Stopping therapy would increase risk. Treatment decisions depend on thresholds, tolerance and commissioning criteria.

Reference: NICE CG71; NICE TA393/TA394; BNF