Key result
Homozygous familial hypercholesterolemia is linked to impaired quality of life with mean EQ-5D-5L of ~0.74.
Why the study?
Health-related quality of life associated with homozygous familial hypercholesterolemia is not well characterized.
Cross-Sectional (n=24)
Yes
Homozygous familial hypercholesterolemia significantly impairs patient quality of life, and treatment with lipoprotein apheresis imposes a substantial financial and time burden on both patients and caregivers.
Answers are grounded in this paper and cite their sources.
HoFH-related HRQoL impairment supports integrated supportive care; leaves open apheresis frequency effects in larger prospective studies.
Background and Aims: Homozygous familial hypercholesterolemia (HoFH) is a rare inherited disorder characterized by dangerously high low-density lipoprotein cholesterol levels from birth, creating extreme risk of premature cardiovascular events if untreated. Health-related quality of life (HRQoL) associated with HoFH is not well characterized. Methods: Across multiple countries, patients ≥ 12 years (y) with HoFH and caregivers ≥ 18y of patients with HoFH completed an online survey between April–May 2023 and May–August 2024. HRQoL was measured for patients and caregivers using the EuroQol 5 Dimension 5 Level (EQ-5D-5L) and the EuroQol visual analogue scale (EQ-VAS). Utility values were generated based on EQ-5D-5L responses using UK, US, and country-specific tariffs. Median annual cost associated with receiving/accompanying patients to receive lipoprotein apheresis (LA) was estimated. Results: Most patients (n = 8/15) were aged 25– 34y; all caregivers (n = 9) were > 35y. Mean age at diagnosis was 6.7y (patients)/4.8y (patients of caregivers). Eleven (73%) patients/six (67%) patients of caregivers were receiving LA. EQ-5D-5L scores were lower in patients (0.74) than reported normal range for age-matched English population (0.79– 0.95 [range 18– 54y]) and average US adult score (0.85). EQ-VAS scores were lower for patients (mean 64/100) than reported US adult average score (80/100). Caregivers scored in normal range. Patients receiving LA reported lower HRQoL than patients who were not. Patients on weekly LA reported markedly lower HRQoL than those receiving it less frequently. Median annual cost associated with undergoing LA was € 4915/y (patients)/€ 5161/y (caregivers). Conclusions: HoFH substantially and negatively impacts patient HRQoL. Receiving LA, whilst efficacious, is costly and demanding on patients’ and caregivers’ time.
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Evans et al. (2026) conducted a cross-sectional in Homozygous Familial Hypercholesterolemia (n=24). Homozygous Familial Hypercholesterolemia vs. Population norms was evaluated on Health-related quality of life measured by EQ-5D-5L composite score. Homozygous familial hypercholesterolemia substantially reduced patient health-related quality of life, with patients reporting a mean EQ-5D-5L score of 0.74 compared to higher normative population scores.
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