AstraZeneca welcomes NICE statin advice

Anglo-Swedish drug major AstraZeneca has welcomed the publication of new National Health Service guidelines for the treatment of familial hypercholesterolemia, a condition estimated to affect one in 500 people in the UK, similar to the number of type 1 diabetes cases. The advice was prepared for the National Institute for Health and Clinical Excellence (NICE) by the National Collaborating Center for Primary Care, its independent think-tank.

For the first time, the NICE states, cascade testing will be used to identify those individuals who will benefit from early treatment. Where FH is suspected, health care professionals should ask about an individual's family history, including the age at which any relatives developed heart disease and whether or not they smoked. The use of DNA and cholesterol testing will help to ensure that children, young people and adults with this condition are identified and offered timely advice and treatment.

Key recommendations from the guideline include: health care professionals should offer all people with FH a referral to a relevant specialist for confirmation of diagnosis and initiation of cascade testing; cascade testing using a combination of DNA tests and low-density lipoprotein cholesterol concentration measurement to identify affected relatives; physicians should consider prescribing a high-intensity statin to achieve a recommended reduction in LDL-C concentration of greater than 50% from baseline; and when lipid-modifying drug therapy is first considered for women and girls, the risks for future pregnancy and the fetus while taking such medications should be discussed.