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LDL-C calculator

A calculator to estimate (untreated) LDL cholesterol in FH based on the lipid-lowering therapy being used and to identify extremely high levels in a timely manner.

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1 in 300 people has FH

Family members have a 50% chance of having FH

FH is highly treatable

Testing for FH can be done as early as birth

Family members of FH patients can get tested for free

With FH, you can easily get insurance

Elevated Lp(a) is also an important risk factor

Explanation

Explanation of the LDL-C calculator

This tool is based on the average LDL-C reduction achieved in trials with the drugs entered and therefore reflects average results. Trial populations generally have better adherence than in everyday practice. The results of the LDL-C recalculation may be exaggerated due to reduced effectiveness or reduced patient compliance. Therefore, the tool automatically issues a warning if the calculated LDL-C exceeds 10 mmol/L. Such high values are only seen in severe (homozygous) familial hypercholesterolemia patients.

Statins: based on the average reduction in LDL-C described in1
Ezetimibe in combination with statins: based on average LDL-C reduction in the ENHANCE2 and IMPROVE-IT3 studies (20%)
Ezetimibe as monotherapy: based on a meta-analysis of randomized controlled trials (21%)
PCSK9 inhibition in combination with other lipid-lowering therapies: based on average LDL-C reduction in the FOURIER⁵ and ODDYSEY⁶ studies (53%)
PCSK9 inhibition monotherapy: based on a meta-analysis of randomized controlled trials (57%)
PCSK9 inhibition in combination with ezetimibe: based on a meta-analysis of randomized controlled trials (69%)
Bempedoic acid in combination with other lipid-lowering therapies: based on the average LDL-C reductions in the CLEAR Harmony and CLEAR Wisdom studies (18%)
Bempedoic acid without statin therapy: based on the average LDL-C reductions in the CLEAR Tranquility and CLEAR Serenity studies (25%)
Bempedoic acid in combination with ezetimibe, regardless of statin use: based on LDL-C reduction in randomized controlled trial (36%)

Sources

Besseling, J. et al. Atherosclerosis 233, 219–223 (2014)
Kastelein, J. J. P. et al. N. Engl. J. Med. 358, 1431–1443 (2008)
Cannon, C. P. et al. N. Engl. J. Med. 372, 2387–2397 (2015)
Lipinski, M. J. et al., Eur. Heart J. 37, 536–545 (2016)
Sabatine, M. S. et al. N. Engl. J. Med. 376, 1713–1722 (2017)
Schwartz, G. G. et al. N. Engl. J. Med. 379, 2097–2107 (2018)
Ballantyne, C. M. et al., Cardiovasc. Drugs Ther. 35, 853–864 (2021)
Ballantyne, C. M. et al., Eur. J. Prev. Cardiol. 27, 593–603 (2020)

Cholesterol

Collective term for fatty substances in your blood.

LDL receptor

Protein in the liver that removes LDL from the blood.

DLCN score

Score to estimate the likelihood of FH.