We are moderately aggressive with the use of lipid lowering
drugs in children with heterozygous FH. We treat if cholesterol
is >8.0 mmol/l and there is a stong family history of CHD in
children aged >8 yrs. I accept totally that there is no
evidence to support this strategy. However, since there are no
trials with clinical end-points (and almost certainly there
never will be) this is not surprising. In an FH family with
early onset CHD I feel that there is a good theoretical case for
early treatment.
We have found that children tolerate resins poorly. Fenofibrate
is well tolerated and shows similar efficacy to that observed in
adults. As has been noted, it is also licensed for use in
childhood. We are currently also using atorvastatin as part of
an international multicentre clinical trial. So far as I am
aware, we are the only participating UK centre. It has so far
been both effective and safe in our hands; the trial results will
be published in due course.
Ian Young
----------------------
Professor IS Young
Department of Clinical Biochemistry
Institute of Clinical Science
Royal Victoria Hospital
Grosvenor Road
Belfast BT12 6BJ
Northern Ireland
tel: +44 2890 263106
fax: +44 2890 236143
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