Clinical Management of Children and Young Adults with Heterozygous Familial Hypercholesterolaemia in the UK

Abstract

SUMMARYLife expectancy in familial hypercholesterolaemia (FH) has been greatly improved by the advent of statin therapy. In the UK, however, these agents are not licensed for use in children. We approached 169 physicians responsible for lipid clinics for information on their practice in young patients, and valid responses were received from 54%.A typical lipid clinic has only 3.5 patients aged under 16 with FH. In boys aged 10-15 years 65% of physicians were prepared to treat with bile acid sequestrants but only 23% with statins. There was greater reluctance to treat in girls of the same age, corresponding figures being 52% and 12%.Despite the efficacy of statins in reducing low-density-lipoprotein cholesterol, these agents are little used in children with FH. Their safety and clinical efficacy should be assessed by a randomized double-blind trial.

Treatment of familial hypercholesterolaemia in children and adolescents in the last three decades

“…There was a greater reluctance to treat girls of the same age (52% and 12%, respectively). 40 The efficacy and tolerability of pravastatin therapy in real-life setting was demonstrated to be similar to that in randomised controlled studies in 185 children, who were followed up for a mean duration of 2 years 2 months. 41 Two other placebo-controlled studies evaluated the probable adverse effects of lovastatin on adolescent familial hypercholesterolaemia patients.…”

“…A survey among physicians in 169 lipid clinics revealed that in boys aged 10–15 years 65% of physicians were prepared to treat with bile acid sequestrants, but only 23% with statins. There was a greater reluctance to treat girls of the same age (52% and 12%, respectively) 40 . The efficacy and tolerability of pravastatin therapy in real-life setting was demonstrated to be similar to that in randomised controlled studies in 185 children, who were followed up for a mean duration of 2 years 2 months 41 .…”