Children with familial hypercholesterolemia who were given statins as treatment slowed the progression of their mean carotid intima media thickness after 10 years of treatment to nearly normal rates, according to research published Sept. 10 in JAMA.
D. Meeike Kusters, MD, of the Academic Medical Center in Amsterdam, and colleagues wrote their article as a follow up on previous work with familial hypercholesterolemia in children, a genetic disorder marked by high cholesterol and increased risk for early onset atherosclerosis and cardiovascular disease.
Previous studies established safety and efficacy of statins in children with short-term use. This study based in the Netherlands sought to establish safety and efficacy over a longer period of time.
A cohort of 194 patients on statins were compared to 83 siblings who did not have hypercholesterolemia and were not on statins. Eighty-four percent of the hypercholesterolemia patients were still taking lipid-lowering medications 10 years out from the initial study.
While the children with the disease still had greater mean intima media thickness than their siblings with an approximate difference of .011 mm, statin use slowed the progression of thickening walls to nearly similar rates to the unaffected siblings. The best outcomes reported appeared to have been in children who initiated therapy at an early age.
The few adverse events were reported over the intervening time, those that did occur led to discontinuation of statin use. No impacts were reported on the physical or mental growth of the children on lipid-lowering medication.
Although safety and efficacy are proven for short-term use in children, concerns about long-term use of statins in children on development still exist. This study, however, was not powered to detect rare events.
Kusters et al wrote, “More robust lipid-lowering therapy or earlier initiation of statins may be required to completely restore arterial wall morphology and avert cardiovascular events later in life in this high-risk population.”