Recommendation of NLA Expert Panel on Treatment With PCSK9 Inhibitors Secondary Prevention FH Stable CVD + CVD RF ProgressiveCVD Age 40-79 FH Phenotype LDL-C ≥190 mg/dl (pre treatment) LDL-C ≥130 mg/dl (max. tolerated treatment) Uncontrolled RF/markers - optional Genetic confirmation - optional Max statin + Ezetimibe On treatment LDL ≥70 mg/dl On treatment Non-HDL ≥100 mg/dl Age 18-39 FH Phenotype LDL-C ≥190 mg/dl (pre treatment) LDL-C ≥130 mg/dl (max. tolerated treatment) Uncontrolled RF/markers or Genetic confirmation Very-High Risk + Statin Intolerant Statin intolerance based on NLA expert panel On treatment LDL ≥70 mg/dl Require substantial additional atherogenic cholesterol lowering Homozygous FH Unknown genotype or LDL-receptor defective LDL-C ≥70 mg/dl (max tolerated treatment )