Abstract
We present clinical practice guidelines for the diagnosis and treatment of homozygous familial hypercholesterolaemia (HoFH) in the Middle East region. While guidelines are broadly applicable in Europe, in the Middle East we experience a range of confounding factors that complicate disease management to a point whereby the European guidance cannot be applied without significant modification. Specifically, for disease prevalence, the Middle East region has an established epidemic of diabetes and metabolic syndrome that can complicate treatment and mask a clinical diagnosis of HoFH. We have also a high incidence of consanguineous marriages, which increase the risk of transmission of recessive and homozygous genetic disorders. This risk is further augmented in autosomal dominant disorders such as familial hypercholesterolaemia (FH), in which a range of defective genes can be transmitted, all of which contribute to the phenotypic expression of the disease. In terms of treatment, we do not have access to lipoprotein apheresis on the same scale as in Europe, and there remains a significant reliance on statins, ezetimibe and the older plasma exchange methods. Additionally, we do not have widespread access to anti-apolipoprotein B therapies and microsomal transfer protein inhibitors. In order to adapt existing global guidance documents on HoFH to the Middle East region, we convened a panel of experts from Oman, Saudi Arabia, UAE, Iran and Bahrain to draft a regional guidance document for HoFH. We also included selected experts from outside the region. This panel statement will form the foundation of a detailed appraisal of the current FH management in the Middle Eastern population and thereby provide a suitable set of guidelines tailored for the region.
Keywords: Homozygous familial hypercholesterolaemia, prevalence, diagnosis, treatment, genetics.
Current Vascular Pharmacology
Title:Identification and Treatment of Patients with Homozygous Familial Hypercholesterolaemia: Information and Recommendations from a Middle East Advisory Panel
Volume: 13 Issue: 6
Author(s): Abdullah Al-Ashwal, Fahad Alnouri, Hani Sabbour, Abdulraof Al-Mahfouz, Nasreen Al-Sayed, Maryam Razzaghy-Azar, Faisal Al-Allaf, Khalid Al-Waili, Yajnavalka Banerjee, Jacques Genest, Raul D. Santos and Khalid Al-Rasadi
Affiliation:
Keywords: Homozygous familial hypercholesterolaemia, prevalence, diagnosis, treatment, genetics.
Abstract: We present clinical practice guidelines for the diagnosis and treatment of homozygous familial hypercholesterolaemia (HoFH) in the Middle East region. While guidelines are broadly applicable in Europe, in the Middle East we experience a range of confounding factors that complicate disease management to a point whereby the European guidance cannot be applied without significant modification. Specifically, for disease prevalence, the Middle East region has an established epidemic of diabetes and metabolic syndrome that can complicate treatment and mask a clinical diagnosis of HoFH. We have also a high incidence of consanguineous marriages, which increase the risk of transmission of recessive and homozygous genetic disorders. This risk is further augmented in autosomal dominant disorders such as familial hypercholesterolaemia (FH), in which a range of defective genes can be transmitted, all of which contribute to the phenotypic expression of the disease. In terms of treatment, we do not have access to lipoprotein apheresis on the same scale as in Europe, and there remains a significant reliance on statins, ezetimibe and the older plasma exchange methods. Additionally, we do not have widespread access to anti-apolipoprotein B therapies and microsomal transfer protein inhibitors. In order to adapt existing global guidance documents on HoFH to the Middle East region, we convened a panel of experts from Oman, Saudi Arabia, UAE, Iran and Bahrain to draft a regional guidance document for HoFH. We also included selected experts from outside the region. This panel statement will form the foundation of a detailed appraisal of the current FH management in the Middle Eastern population and thereby provide a suitable set of guidelines tailored for the region.
Export Options
About this article
Cite this article as:
Al-Ashwal Abdullah, Alnouri Fahad, Sabbour Hani, Al-Mahfouz Abdulraof, Al-Sayed Nasreen, Razzaghy-Azar Maryam, Al-Allaf Faisal, Al-Waili Khalid, Banerjee Yajnavalka, Genest Jacques, Santos D. Raul and Al-Rasadi Khalid, Identification and Treatment of Patients with Homozygous Familial Hypercholesterolaemia: Information and Recommendations from a Middle East Advisory Panel, Current Vascular Pharmacology 2015; 13 (6) . https://dx.doi.org/10.2174/1570161113666150827125040
DOI https://dx.doi.org/10.2174/1570161113666150827125040 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
Call for Papers in Thematic Issues
Ischemic Cardiovascular Diseases: Mechanisms, Diagnosis and Therapy
Ischemic cardiovascular disease includes myocardial infarction, coronary atherosclerotic heart disease, angina pectoris, etc., constitute the leading cause of patient mortality by preventing tissues from getting sufficient oxygen and nutrients. Ischemic heart disease, as a clinical condition, is characterized by myocardial ischemia, causing an imbalance between myocardial blood supply and demand, ...read more
TREATMENT OF CARDIOVASCULAR DISEASE IN CHRONIC AND END STAGE KIDNEY DISEASE
Cardiovascular disease still remains the leading cause of death in Chronic and End Stage Kidney Disease, accounting for more than half of all deaths in dialysis patients. During the past decade, research has been focused on novel therapeutic agents that might delay or even reverse cardiovascular disease and vascular calcification, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Endothelial Dysfunction in Heart Failure: Mechanisms and Therapeutic Approaches
Current Vascular Pharmacology Angiotensin Converting Enzyme Inhibitors and Angiotensin II Receptor Antagonists in Experimental Myocarditis
Current Pharmaceutical Design Omega-3 Fatty Acids: Role in Metabolism and Cardiovascular Disease
Current Pharmaceutical Design The C242T CYBA Polymorphism as a Major Determinant of NADPH Oxidase Activity in Patients with Cardiovascular Disease
Cardiovascular & Hematological Agents in Medicinal Chemistry Therapeutic Progress and Knowledge Basis on the Natriuretic Peptide System in Heart Failure
Current Topics in Medicinal Chemistry Molecular Pathways Involved in Apoptotic Cell Death in the Injured Cochlea: Cues to Novel Therapeutic Strategies
Current Pharmaceutical Design Diamidine Activity Against Trypanosomes: The State of the Art
Current Molecular Pharmacology Quantification and Pharmacokinetics Study of Pedunculoside in Rats by Using UPLC-MS/MS
Current Pharmaceutical Analysis Gene Delivery System: A Developing Arena of Study for the New Era of Medicine
Recent Patents on DNA & Gene Sequences Stem Cell Therapy for the Treatment of Acute Myocardial Infarction and Chronic Ischemic Heart Disease
Current Pharmaceutical Biotechnology Lithium and its Neuroprotective and Neurotrophic Effects: Potential Treatment for Post-Ischemic Stroke Sequelae
Current Drug Targets Differential Regulation of microRNAs in Patients with Ischemic Stroke
Current Neurovascular Research Females Live Longer than Males: Role of Oxidative Stress
Current Pharmaceutical Design Cell and Gene Therapies in Cardiovascular Disease with Special Focus on the No Option Patient
Current Gene Therapy Potential Targets for Intervention in Radiation-Induced Heart Disease
Current Drug Targets Severe Acute Respiratory Syndrome (SARS): A Brief Review With Exploration of the Outcomes, Prognostic Factors and Sequelae
Current Respiratory Medicine Reviews Modifiable Risk Factors for Premature Atherosclerosis in Systemic Lupus Erythematosus
Vascular Disease Prevention (Discontinued) Von Willebrand Factor: Drug and Drug Target
Cardiovascular & Hematological Disorders-Drug Targets Current Role and Future Perspectives of Radioiodinated MIBG in the Evaluation of Dementia with Lewy Bodies
Current Radiopharmaceuticals Valve Endothelial Cells – Not Just Any Old Endothelial Cells
Current Vascular Pharmacology