The time is now: Achieving FH paediatric screening across Europe - The Prague Declaration.

Familial hypercholesterolaemia (FH) is the most common inherited metabolic disorder characterized by high cholesterol and if left untreated leads to premature cardiovascular disease, such as heart attacks. Treatment that begins early in life, particularly in childhood, is highly efficacious in preventing cardiovascular disease and cost-effective, thus early detection of FH is crucial. However, in Europe, less than 10% of people living with FH are diagnosed and even less receive life-saving treatment. The Prague Declaration is a call to action for national and European Union policymakers and decision-makers and a result of the Czech EU Presidency meeting on FH Paediatric Screening (early detection of inherited high cholesterol) at the Czech Senate in Prague on 6th September 2022. It builds on a considerable body of evidence which was discussed at the Technical Meeting under the auspices of the Slovenian EU Presidency in October 2021. The Prague meeting addressed the outstanding barriers to the systematic implementation of FH paediatric screening across Europe. In this article, we present the key points from the Prague meeting and concrete actions needed to move forward.

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NB is a senior advisor to FH Europe. HB receives research funding from the Instituto de Salud Carlos III, Spain (PIE16/00021 & PI17/01799, PI21/01572), Sociedad Española de Cardiología, AstraZeneca, PhaseBio and Novartis; has received consulting/speaking fees from Astra-Zeneca, Novartis, Novo Nordisk and Organon: and is a scientific advisor for MEDSCAPE-the heart.og. KID reports grants from Pfizer, Amgen, Merck Sharp & Dohme, Sanofi–Aventis, Daiichi Sankyo, and Regeneron, during the conduct of the study; and personal fees from Bayer, outside the submitted work. BAF received grants from Novartis, Amgen, Merck, Esperion Therapeutics, Pfizer; and personal fees for lectures, advisory boards, and/or consulting from Novartis, Amgen, Regeneron, Sanofi, Merck, AstraZeneca, Pfizer, Eli Lilly, Novo Nordisk, The Medicines Co, Mylan, Daiichi Sankyo, Viatris, Ionis Pharmaceuticals, dalCOR, CiVi Pharma, KrKa Phamaceuticals, American College of Cardiology, European Atherosclerosis Society, European Society of Cardiology. TF is supported by the project National Institute for Research of Metabolic and Cardiovascular Diseases (Programme EXCELES, ID Project No. LX22NPO5104) – Funded by the European Union – Next Generation EU. TF received honoraria from Sanofi, Amgen and Novartis in the last 3 years, outside the submitted work. SSG is a consultant at Esperion Therapeutics. UG and part of preparatory work for the Declaration were supported by the Slovenian Research Agency (grants No. J3-2536 and P3-0343). FJP reports grants and modest personal fees from Abbott, AstraZeneca, Boehringer Ingelheim, Bayer, Daiichi Sankyo, Novartis, Pfizer, Philips, Sanofi/Regeneron, Servier, Vifor, outside the submitted work. KKR has received honoraria for consulting, lectures from Kowa, Amgen, Regeneron Pharmaceuticals, Sanofi, Daiichi Sankyo, Pfizer, Viatris, AstraZeneca, Eli Lilly, Esperion, New Amsterdam Pharma, Novartis, Silence Therapeutics, Bayer, Boehringer Ingelheim, Novo Nordisk, SCRIBE, CRISPR, Cargene, Vaxxinity, Abbott, Resverlogix. In addition, he has received research grant support to his institution from Sanofi, Daiichi Sankyo, Amgen, Pfizer and MSD ŽR has received honoraria from Novartis. RDS honoraria related to consulting, research and/or speaker activities from: Abbott, Ache, Amgen, Amryt, Astra Zeneca, Biolab, Esperion, Eli-Lilly, Getz Pharma, Hypera Farma, Kowa, Libbs, Novo-Nordisk, Novartis, Merck, Pfizer, PTC Therapeutics and Sanofi. HS received honoraria and grants from MSD SHARP & DOHME, AMGEN, Bayer Vital GmbH, Boehringer Ingelheim, Daiichi Sankyo, Novartis, Servier, Brahms, Bristol-Myers Squibb, Medtronic, Sanofi Aventis, Synlab, Astra-Zeneca, Pfizer and Vifor. LT received honoraria from the following companies: Abbott, Amgen, Bayer, Daiichi Sankyo, Janssen, Novartis, Novo Nordisk, Sanofi, Pfizer, Recordati. AW reports research support for pharmaceutical trials of lipid-modifying agents from Amgen, Regeneron, Novartis and Silence Therapeutics. Authors declaring no conflicts of interest: MA, BB, MB, RC, ZC, KC, MD, CdB, MG, MH, NJ, TN, OM, AP, NP, BR, JR, JŠ, MS, MV, IGI.