Statin safe in kids with high cholesterol
Pravastatin, a cholesterol-lowering drug commonly used in adults with elevated cholesterol levels is safe for use in children aged 4 or older with an inherited cholesterol disorder known as Familial hypercholesterolemia, suggest results of a study conducted in Finland.
Children with slight or moderate but not severe hypercholesterolemia can expect a “satisfactory” reduction in total and LDL (“bad”) cholesterol, the study shows, with no harmful effects on growth and development.
Familial hypercholesterolemia is caused by a mutation in a gene that normally helps control LDL levels. Patients typically develop heart and blood vessel disease as well as deposits of fatty plaques inside the arteries at a young age.
Dietary interventions aimed at normalizing cholesterol levels have proven insufficient.
Dr. Marjatta Antikainen of the University of Helsinki and colleagues assessed the safety and effectiveness of pravastatin therapy for up to 2 years in 19 girls and 11 boys between 4 and 18 years of age with hypercholesterolemia.
The subjects were assigned to a diet low in fat, saturated fat, and cholesterol, supplemented with plant stanol or sterol esters, which block absorption of cholesterol in the small intestine.
The investigators report that adherence to the low-fat diet decreased total cholesterol by about 11 percent and LDL cholesterol by about 13 percent.
Treatment with pravastatin (10 to 20 milligrams daily) also progressively lowered total cholesterol and LDL cholesterol. By 24 months of treatment, total cholesterol levels had fallen by 26 percent, while LDL had fallen by 32 percent.
Importantly, Antikainen told Reuters Health, “pravastatin was well tolerated without any significant side effects. Pravastatin did not influence normal growth and development or pubertal maturation.”
These findings confirm a previous 2-year study in which statin therapy improved the lipid profile without harming growth in a group of 8- to 18-year-olds with Familial hypercholesterolemia.
In the current study, 17 percent of the children had lipid deposits in their arteries when they entered the study and 27 percent had deposits at 12 months. This suggests to the researchers that hardening of the arteries (atherosclerosis) in individuals with familial hypercholesterolemia “may start even before puberty.”
Thus, early statin therapy “seems crucial” in these children for primary prevention of coronary heart disease, they conclude.
SOURCE: Journal of Clinical Endocrinology and Metabolism April 2005.
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