For patients with HoFH, the larger and more consistent LDL-cholesterol-lowering efficacy of evinacumab warrants consideration of an ANGPTL3 inhibitor before initiation of a PCSK9 inhibitor, particularly in patients with null-null mutations or homozygous for LDLR, LDLRAP1, or PCSK9 (47). This evidence concerns the gene PCSK9 and homozygous familial hypercholesterolemia.