Klaus G, et al. - In pediatric homozygous (ho) familial hypercholesterolemia (FH) or compound heterozygous (c-het) FH patients, researchers assessed the efficacy of multimodal lipid-lowering treatment (LLT) including lifestyle counseling, drug treatment, and lipoprotein apheresis (LA). Findings demonstrated that next to drug therapy, regular LA represents an essential component of LLT for approaching low-density lipoprotein cholesterol (LDL-C) targets in children with hoFH or c-hetFH, which was successful only in a minority of children. No resolution was found for issues such as progression of cardiovascular disease (CVD) morbidity and resulting mortality. In order to improve outcome, there is a requirement of early and intensified multimodal LLT guided by risk factors beyond LDL-C concentration.