Cholesterol drugs for children
There is widespread debate within the medical community about screening children for cholesterol levels, whether children should be given medication, and if so, under what circumstances. A US government panel recommended approving statins for pediatric use in Dec 2011, although the FDA has not yet changed the labeling requirements for the drugs. Critics noted that most of the panel members have ties to the pharmaceutical industry.
The medical textbooks identify familial hypercholesterolemia as a genetic condition and it has been found kids with this problem get vascular diseases at a younger age than normal. Statins would seem an obvious method of lowering cholesterol and reducing risk in these children, and doctors increasingly administer statins in this situation.
A study in the Journal of the American Medical Associaion on statin treatment of children with familial hypercholesterolemia found pravastatin was effective in reducing cholsterol levels with no adverse effects unique to adolescents or children.
A medical officer in the U.S. Public Health Service published a study in the journal Circulation in 2009 concluding that less than 1% of kids aged 12 to 17 need statins. Dr. Earl S. Ford examined epidemiological information on teen LDL cholesterol levels. The American Academy of Pediatrics guidelines recommend statins for children with LDL readings about 190 (over 160 for those with certain risk factors such as diabetes), but only 0.8% of American kids meet this criteria.
In July 2008, the American Academy of Pediatrics issued recommendations on screening overweight children for high cholesterol, and recommended statin drugs for children as young as 8 years old, when the risks are high. The AAP said all children should be tested at least once between the ages of 2 and 10 if they have a family history of obesity, high blood pressure, or diabetes.
The American Heart Association endorsed statins for some high-risk children. The American Academy of Pediatrics, the National Lipid Association, and the National Cholesterol Education Program likewise recommended statins for kids who need them.
A study published in the Journal of the American College of Cardiology suggested substantial benefits from lowering cholesterol earlier in life than current medicine usually does, especially in people with naturally high cholesterol. This does not necessarily mean that teens and young adults should be prescribed statins, but it does add backing to doctors who might want to do so.
A meta-study by the Cochrane Collaboration in 2014 found statins reduced children’s LDL-C levels 23% to 40%, and seemed to be safe, at least in the short run. There is not enough data to say whether long-run use is safe.
Doctors decide whether to give children statins based on the age of the child, the severity of dyslipidemia, and the presence of other risk factors.
Familial hypercholesterolemia is also treated by the drug lomitapide, which is not a statin. Children are sometimes given both lomutapide and a statin. Mipomersen is anther drug for this considition.
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