PMID- 33305206
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231110
IS  - 2589-790X (Electronic)
IS  - 2589-790X (Linking)
VI  - 2
IP  - 6
DP  - 2020 Nov
TI  - Effectiveness and Safety of Statin Therapy in Children: A Real-World Clinical 
      Practice Experience.
PG  - 473-482
LID - 10.1016/j.cjco.2020.06.002 [doi]
AB  - BACKGROUND: Statin use for hypercholesterolemia in children is predominantly 
      reported from short-term clinical trials. In this study, we assess the efficacy 
      and safety of statin treatment in clinical pediatric practice. METHODS: Records 
      of all patients who began statin treatment at age <18 years and remained on 
      statins for >6 months from 5 pediatric lipid clinics were reviewed. Information 
      at baseline and from all clinic evaluations after statin initiation was recorded, 
      including lipid measurements, statin drug/dose, safety measures (anthropometry, 
      hepatic enzymes, creatine kinase levels), and symptoms. Lipid changes on statin 
      therapy were assessed from baseline to 6 +/- 3 months and from 6 +/- 3 months to last 
      follow-up with a mixed-effects model, using piecewise linear splines to describe 
      temporal changes, controlling for repeated measures, sex, and age. RESULTS: There 
      were 289 patients with median low-density lipoprotein cholesterol (LDL-C) of 5.3 
      mmol/L (interquartile range [IQR]:4.5-6.5) and mean age of 12.4 +/- 2.9 years at 
      statin initiation. Median duration of therapy was 2.7 years (IQR: 1.6-4.5) with 
      95% on statins at last evaluation. There were significant decreases in total 
      cholesterol, LDL-C, and non-high-density lipoprotein cholesterol (non-HDL-C) from 
      baseline to 6 +/- 3 months (P < 0.001) and from 6 +/-3 months to last follow-up (P < 
      0.001). Triglycerides and HDL-C were unchanged but the triglyceride to HDL-C 
      ratio decreased significantly by late follow-up. At final evaluation, median 
      LDL-C had decreased to 3.4 mmol/L (IQR:2.8-4.2). No patient had statins 
      discontinued for safety measures or symptoms. CONCLUSIONS: In real-world clinical 
      practice, intermediate-term statin treatment is effective and safe in children 
      and adolescents with severe LDL-C elevation.
CI  - (c) 2020 Canadian Cardiovascular Society. Published by Elsevier Inc.
FAU - Kavey, Rae-Ellen W
AU  - Kavey RW
AD  - Preventive Cardiology-Lipid Clinic, Golisano Children's Hospital, University of 
      Rochester Medical Center, Rochester, New York, USA.
FAU - Manlhiot, Cedric
AU  - Manlhiot C
AD  - The Labatt Family Heart Centre, The Hospital for Sick Children, Department of 
      Pediatrics, University of Toronto, Toronto, Ontario, Canada.
FAU - Runeckles, Kyle
AU  - Runeckles K
AD  - The Labatt Family Heart Centre, The Hospital for Sick Children, Department of 
      Pediatrics, University of Toronto, Toronto, Ontario, Canada.
FAU - Collins, Tanveer
AU  - Collins T
AD  - The Labatt Family Heart Centre, The Hospital for Sick Children, Department of 
      Pediatrics, University of Toronto, Toronto, Ontario, Canada.
FAU - Gidding, Samuel S
AU  - Gidding SS
AD  - Preventive Cardiology-Lipid Clinic, Nemours/Alfred I. DuPont Hospital for 
      Children, Wilmington, Delaware, USA.
FAU - Demczko, Matthew
AU  - Demczko M
AD  - Preventive Cardiology-Lipid Clinic, Nemours/Alfred I. DuPont Hospital for 
      Children, Wilmington, Delaware, USA.
FAU - Clauss, Sarah
AU  - Clauss S
AD  - Preventive Cardiology Program-Lipid Clinic, Children's National Hospital, George 
      Washington University School of Medicine and Health, Washington, DC, USA.
FAU - Harahsheh, Ashraf S
AU  - Harahsheh AS
AD  - Preventive Cardiology Program-Lipid Clinic, Children's National Hospital, George 
      Washington University School of Medicine and Health, Washington, DC, USA.
FAU - Mietus-Syder, Michele
AU  - Mietus-Syder M
AD  - Preventive Cardiology Program-Lipid Clinic, Children's National Hospital, George 
      Washington University School of Medicine and Health, Washington, DC, USA.
FAU - Khoury, Michael
AU  - Khoury M
AD  - Pediatric Lipid Clinic, The Heart Institute, Cincinnati Children's Hospital 
      Medical Center, Cincinnati, Ohio, USA.
FAU - Madsen, Nicolas
AU  - Madsen N
AD  - Pediatric Lipid Clinic, The Heart Institute, Cincinnati Children's Hospital 
      Medical Center, Cincinnati, Ohio, USA.
FAU - McCrindle, Brian W
AU  - McCrindle BW
AD  - The Labatt Family Heart Centre, The Hospital for Sick Children, Department of 
      Pediatrics, University of Toronto, Toronto, Ontario, Canada.
LA  - eng
PT  - Journal Article
DEP - 20200606
PL  - United States
TA  - CJC Open
JT  - CJC open
JID - 101763635
PMC - PMC7710927
EDAT- 2020/12/12 06:00
MHDA- 2020/12/12 06:01
PMCR- 2020/06/06
CRDT- 2020/12/11 06:05
PHST- 2020/04/26 00:00 [received]
PHST- 2020/06/01 00:00 [accepted]
PHST- 2020/12/11 06:05 [entrez]
PHST- 2020/12/12 06:00 [pubmed]
PHST- 2020/12/12 06:01 [medline]
PHST- 2020/06/06 00:00 [pmc-release]
AID - S2589-790X(20)30071-8 [pii]
AID - 10.1016/j.cjco.2020.06.002 [doi]
PST - epublish
SO  - CJC Open. 2020 Jun 6;2(6):473-482. doi: 10.1016/j.cjco.2020.06.002. eCollection 
      2020 Nov.