Statin therapy in modifying lipoprotein cholesterol concentrations in children with familial hypercholesterolemia

Abstract

Overview of the topic: Familial hypercholesterolemia (FH) is a prevailing genetic condition which can be potentially fatal by causing high levels of cholesterol in the bloodstream. Children with FH are at 20 times the risk of developing complicated heart disease than those with noninherited cholesterol issues. The aim of this study was to compare the efficacy of the use of Statins in children with FH in reducing their lipoprotein profile levels. A research question was formulated in relation to this problem area: In children with Familial Hypercholesterolemia, what is the efficacy of statins in reducing their lipoprotein profile levels? PICO elements: The PICO framework was used as follows: (P) Children with Familial Hypercholesterolemia, (I) Statins, (C) Placebo, and (O) Efficacy in reducing lipoprotein profile levels. Method: Key elements of the PICO question and synonyms were utilised for the search process. Boolean operators and search tools were employed to improve the search. Databases and a manual search were employed. Limiters were applied. The inclusion criteria included systematic reviews, meta-analyses, and randomised controlled trials with children under 18 years with FH, comparing statin treatment to placebo, measuring lipoprotein levels in the English language. The exclusion criteria excluded Cohort studies and Case studies with participants over 18 years of age in foreign languages. Two systematic reviews and two RCTs were retrieved which were critically appraised utilising the CASP tool. Results: Overall, statin therapy proved to be efficient at reducing low-density lipoprotein cholesterol concentrations in children with FH. In terms of safety and tolerability, statin therapy did not negatively impact the children’s growth and sexual development. However, further research is needed to assess the lifelong safety of statins. Conclusion: This study concluded that statin therapy is an appropriate treatment for children with familial hypercholesterolemia. Nevertheless, further research in this area is required to assess long-term safety. Implications and recommendations: Based on the findings, children and adolescents presenting symptoms of FH, after extensive testing, should be treated with statins, following the European Society of Cardiology/European Atherosclerosis Society guidelines, so that present damage could be reversed whilst reducing risk of severe atherosclerotic disease in the future. A strict diet with an exercise regimen could be specifically formulated for each child to further aid in reducing LDL-C levels.