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Reviews in Cardiovascular Medicine  2014, Vol. 15 Issue (2): 109-118     DOI: 10.3909/ricm0735
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Lomitapide for the Management of Homozygous Familial Hypercholesterolemia
Emil M. deGoma
Division of Cardiovascular Medicine, Perelman School of Medicine at the University of Pennsylvania,Philadelphia, PA
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Abstract:
Homozygous familial hypercholesterolemia (HoFH) is a rare genetic disorder of low-density lipoprotein cholesterol (LDL-C) metabolism resulting in extremely elevated serum levels of LDL-C and premature atherosclerotic cardiovascular disease. Treatment typically involves multiple pharmacologic agents, as well as mechanical filtration using weekly or biweekly LDL apheresis. Despite combination lipid-lowering therapy, LDL-C levels and cardiovascular morbidity and mortality remain unacceptably high in HoFH patients. The European Commission and the US Food and Drug Administration approved the use of lomitapide, a novel medication designed to address this significant unmet need. Lomitapide is an orally administered inhibitor of microsomal triglyceride transfer protein that is indicated as an adjunct to a low-fat diet and other lipid-lowering treatments, including LDL apheresis where available for the reduction of LDL-C, total cholesterol, apolipoprotein B, and non–high-density lipoprotein cholesterol in adult patients with HoFH. The risks of transaminase elevations, hepatic steatosis, and gastrointestinal side effects, and the potential for drug interactions, require vigilant examination of the clinical and laboratory data and patient counseling prior to initiation of lomitapide, as well as regular monitoring during follow-up care. This article highlights important practical considerations for the use of lomitapide in the context of the evaluation and management of a HoFH patient case.
Key words:  Atherosclerosis      Homozygous familial hypercholesterolemia      Lomitapide      Low-density lipoprotein cholesterol      Microsomal triglyceride transfer protein     
Published:  30 June 2014     

Cite this article: 

Emil M. deGoma. Lomitapide for the Management of Homozygous Familial Hypercholesterolemia. Reviews in Cardiovascular Medicine, 2014, 15(2): 109-118.

URL: 

https://rcm.imrpress.com/EN/10.3909/ricm0735     OR     https://rcm.imrpress.com/EN/Y2014/V15/I2/109

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