A 10-year experience using combined lipid-lowering pharmacotherapy in children and adolescents
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María Beatriz Araujo
und
María Sol Pacce
Abstract
Background:
Current pediatric guidelines for heterozygous familial hypercholesterolemia (HeFH) propose pharmacotherapy (PT) with statins from age 8 to 10 years; however, schemes with absorption inhibitors combined with statins, could be started earlier. The aim of the study was to show the 10-year results of a combined treatment protocol.
Methods:
Prospective, descriptive and analytical study. Pediatric patients (n=70; mean age at PT initiation 9.3 years [range, 2–17.5]) with HeFH who required PT between 2005 and 2015 were included. All patients ≥10 years, with LDL >190 mg/dL or >160 mg/dL with one cardiovascular risk factor (CVRF) or >130 mg/dL with two or more CVRF; and those patients 5–10 years and with LDL-C >240 mg/dL or a family history of a cardiovascular event before 40 years, were medicated. After a period on a lipid-lowering diet (LLD), all patients were started on ezetimibe. Patients who did not achieve the treatment goal were given statins. The variables were: age, age at PT initiation, duration of PT, initial LDL-C, mean LDL-C during ezetimibe monodrug therapy, mean LDL-C during combined PT, and percentage of LDL decrease.
Results:
LDL-C levels were: Baseline: 235 mg/dL±55; after 3 months on ezetimibe: 167 mg/dL±47 (decrease: −27.62%). In 18 patients who did not reach the treatment goal atorvastatin was added and their LDL-C decreased −41.5% (p: 0.02). Overall, mean final LDL-C was 155 mg/dL±30.4 (range, 98–257) and treatment goals were reached in 74% of the patients. No severe side effects were reported.
Conclusions:
Combined and sequential treatment starting at early ages was shown to be safe and effective over this follow-up period.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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©2016 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Editorial
- Puberty – genes, environment and clinical issues
- Puberty
- Increased levels of bisphenol A (BPA) in Thai girls with precocious puberty
- Efficacy and safety of triptorelin 6-month formulation in patients with central precocious puberty
- Monitoring treatment of central precocious puberty using basal luteinizing hormone levels and practical considerations for dosing with a 3-month leuprolide acetate formulation
- Original Articles
- Association between the triglyceride to high-density lipoprotein cholesterol ratio and insulin resistance in Korean adolescents: a nationwide population-based study
- Progression from impaired glucose tolerance to type 2 diabetes in obese children and adolescents: a 3–6-year cohort study in southern Thailand
- Investigation of the inflammatory biomarkers of metabolic syndrome in adolescents
- A 10-year experience using combined lipid-lowering pharmacotherapy in children and adolescents
- Prevalence of medically treated children with ADHD and type 1 diabetes in Germany – Analysis of two representative databases
- Association of short stature with life satisfaction and self-rated health in children and adolescents: the CASPIAN-IV study
- Case Reports
- Central precocious puberty in a boy with 22q13 deletion syndrome and NOTCH-1 gene duplication
- Non-androgen secreting adrenocortical carcinoma in preadolescence: a case report and literature review
- Efficacy of growth hormone therapy in Kearns-Sayre syndrome: the KIGS experience
- A unique case of Shwachman-Diamond syndrome presenting with congenital hypopituitarism
Artikel in diesem Heft
- Frontmatter
- Editorial
- Puberty – genes, environment and clinical issues
- Puberty
- Increased levels of bisphenol A (BPA) in Thai girls with precocious puberty
- Efficacy and safety of triptorelin 6-month formulation in patients with central precocious puberty
- Monitoring treatment of central precocious puberty using basal luteinizing hormone levels and practical considerations for dosing with a 3-month leuprolide acetate formulation
- Original Articles
- Association between the triglyceride to high-density lipoprotein cholesterol ratio and insulin resistance in Korean adolescents: a nationwide population-based study
- Progression from impaired glucose tolerance to type 2 diabetes in obese children and adolescents: a 3–6-year cohort study in southern Thailand
- Investigation of the inflammatory biomarkers of metabolic syndrome in adolescents
- A 10-year experience using combined lipid-lowering pharmacotherapy in children and adolescents
- Prevalence of medically treated children with ADHD and type 1 diabetes in Germany – Analysis of two representative databases
- Association of short stature with life satisfaction and self-rated health in children and adolescents: the CASPIAN-IV study
- Case Reports
- Central precocious puberty in a boy with 22q13 deletion syndrome and NOTCH-1 gene duplication
- Non-androgen secreting adrenocortical carcinoma in preadolescence: a case report and literature review
- Efficacy of growth hormone therapy in Kearns-Sayre syndrome: the KIGS experience
- A unique case of Shwachman-Diamond syndrome presenting with congenital hypopituitarism
