In a clinical study conducted in patients with primary hypercholesterolemia in 2013 at 198 sites in 17 countries, evolocumab, an inhibitor of proprotein convertase subtilisin/kexin type 9 (PCSK9), has been combined with moderate- or high-intensity statin therapy and was shown to additionally reduce LDL-C levels [217]. This evidence concerns the gene PCSK9 and familial hypercholesterolemia.