Statin use by children

  • Statins are prescribed to children with familial hypercholesterolaemia, to prevent high cardiovascular risk in the future. A systematic review study of this use was recently published.
  • The authors of the systematic review conclude that the use of statins by children with familial hypercholesterolaemia results in a decrease in LDL cholesterol and total cholesterol, a surrogate measure of its efficacy. 
  • One study assessed the thickness of the intima, and found a statistically significant reduction. This is, however, a surrogate parameter which is difficult to measure, and the clinical relevance of this reduction is unclear.
  • The review does not address long-term effects like the decrease of coronary stenosis and other signs of vascular damage. The authors of the review comment that the duration of the studies has been too limited, in view of the fact that these drugs have to be taken for life.
  • In the short term (<2 years), statins appear to be safe as regards side-effects, but their safety in the longer term remains unclear. Their effects on fertility or spermatogenesis are unknown.  
  • Based on the published research, the use of statins by children with familial hypercholesterolaemia cannot yet be regarded as evidence-based. This does not mean, however, that this treatment should be withheld: the high risk of future cardiovascular diseases in these children does justify early treatment with statins.

  1. Taylor F, et al. Statins for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2013, Issue 1. Art. No.:CD004816.
  2. Cholesterolsyntheseremmers. Informatorium Medicamentorum 2017. Via: kennisbank.knmp.nl.
  3. Vuorio A, et al. Statins for children with familial hypercholesterolemia. Cochrane Database  Syst Rev. 2017, Issue 7. Art. No.: CD006401.

The literature refers to the Dutch text

Authors

  • drs R.Y. Gabriels, dr T.W. de Vries