PCSK9 and familial hypercholesterolemia: The patient is within 20% of their clinical LDL-C goal, then ezetimibe is preferred; in contrast, for patients who need a >20% reduction in their LDL-C levels, the choice is between multiple standard agents added sequentially (e.g., ezetimibe, a bile acid sequestrant, and niacin), PCSK9 inhibitors, lomitapide or mipomersen (for patients with homozygous familial hypercholesterolemia), apheresis (if available) or complex polypharmacy.