Extensive pregnancy-related off-treatment time in women with familial hypercholesterolaemia

Authors

KLEVMOEN Marianne ROETERS van Lennep Jeanine BOGSRUD Martin Proven VESTERBEKKMO Elisabeth Kleivhaug PEDERSEN Eva Kristine Ringdal HOVLAND Anders MULDER Janneke W C M BREKKE Hilde Kristin IVERSEN Per Ole VACLOVA Martina VRABLIK Michal FREIBERGER Tomáš RETTERSTOL Kjetil HOLVEN Kirsten B

Year of publication 2026
Type Peer-reviewed scientific article
Magazine / Source Atherosclerosis
MU Faculty or unit

Faculty of Medicine

Citation
web https://www.sciencedirect.com/science/article/pii/S0021915026000341?pes=vor&utm_source=clarivate&getft_integrator=clarivate
Doi https://doi.org/10.1016/j.atherosclerosis.2026.120668
Keywords Familial hypercholesterolaemia; Pregnancy; Breastfeeding; Pregnancy-related off-treatment time
Description Background and aims: Women with familial hypercholesterolaemia (FH) lose substantial treatment time during their reproductive years as most lipid-lowering therapies are contraindicated from the preconception through the end of breastfeeding. We examined the duration of real-life pregnancy-related off-treatment time in 27 women with FH in Norway. Methods: Women with FH in Norway who had completed the ongoing FH-FEMINA study (ClinicalTrials.gov ID NCT05367310) were included. Women were followed from 36th week of gestation and until one year after delivery or until end of breastfeeding. Information on use of medication before, during and after the current and previous pregnancies was collected. Pregnancy-related off-treatment time was calculated from discontinuation of lipid-lowering therapy when planning pregnancy, throughout pregnancy, and after delivery. Results: The total duration of pregnancy-related off-treatment time after all childbirths (median 1, range 1-3) per woman was a median of 2.9 years (25th-75th percentile; 1.6-4.0), ranging from 0.8 to 12 years. The pregnancy itself accounted for median of 42.1% of the pregnancy-related off-treatment time, whereas the time before and after pregnancy accounted for a median of 57.9% (range 11.4% to 91.2%). When including untreated years in childhood and/or prior to diagnosis, the lifelong off-treatment time represented a median of 66.3% (range 41.9 to 100%) of lifetime without treatment. Conclusion: Early diagnosis and initiation of treatment is essential in girls with FH to compensate for pregnancy-related off-treatment time later in life. To minimize these pregnancy-related off-treatment periods, healthcare professionals should support women with FH to resume lipid-lowering therapy immediately after breastfeeding and between pregnancies. In addition, more knowledge on the potential effects of statin use during pregnancy and breastfeeding on maternal and offspring health is urgently needed.

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