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Evidence summaries

Statins for Children with Familial Hypercholesterolemia

Statin treatment appears to reduce both total and LDL cholesterol levels in children with familial hypercholesterolemia and it seems to be safe in the short term but long-term safety is unknown. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 9 studies with a total of 1 177 children. In general, the intervention and follow-up time was short (median 24 weeks; range from six weeks to two years). Statins reduced the mean low-density lipoprotein cholesterol concentration at all time points (moderate quality evidence). Serum aspartate and alanine aminotransferase, as well as creatinine kinase concentrations, did not differ between treated and placebo groups at any time point (low quality evidence). The risks of myopathy (low quality evidence) and clinical adverse events (moderate quality evidence) were very low and also similar in both groups. In one study simvastatin was shown to improve flow-mediated dilatation of the brachial artery (low quality evidence), and in another study treatment with pravastatin for two years induced a significant regression in carotid intima media thickness (low quality evidence).

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment).

    References

    • Vuorio A, Kuoppala J, Kovanen PT et al. Statins for children with familial hypercholesterolemia. Cochrane Database Syst Rev 2017;(7):CD006401. [PubMed]

Primary/Secondary Keywords