Oral Semaglutide Further Reduced LDL Cholesterol in a Patient with Familial Hypercholesterolemia Treated with Statins, Ezetimibe, and Evolocumab

We present the case of a woman with heterozygous familial hypercholesterolemia with a history of myocardial infarction at 53 years of age. Her initial low-density lipoprotein (LDL) cholesterol level was 312 mg/dL, which was reduced to ~50 mg/dL using statins, ezetimibe, and evolocumab. However, the patient also had diabetes, and its management gradually worsened. We introduced oral semaglutide, which contributed not only to the good management of diabetes, but also to the further reduction of LDL cholesterol in addition to intensive LDL-lowering therapies, including statins, ezetimibe, and evolocumab.