This was debated at the recent British Hyperlipidaemia Association meeting
in Nottingham. A paediatrician spoke of how he gave statins to his familial
hypercholesterolaemic child patients with little apparent ill effect.
Respected elder statesmen like Gil Thompson argued there was no evidence
that delaying lipid lowering treatment until adulthood in these patients was
detrimental to their survival. The BHA guidance lies somewhere in the
middle. I must admit, I tend to agree with the Gil Thompson argument, simply
because we do not know the effect that reducing intracellular cholesterol
(remember, it affects all cells) may have on growing people. After all, we
would be struck off if we knowingly gave the drugs to a pregnant women who,
when you think about it, is simply carrying a very young growing person.
Luckly, as you know, absolute hypercholesterolaemia does not seem to be a
terrible problem until after puberty. I prefer to give resins (which are not
absorbed systemically) if I am going to give anything although compliance is
abismal.
I think even less is known about the effects of fibrates although
fenofibrate is one of the few lipid lowering drugs with a license for
children. Unless Peter Galloway knows better, I suspect the likes of type 3
hyperlipidaemia seldom manifests until adulthood.
Dr. Eric S. Kilpatrick
Consultant in Chemical Pathology
Hull Royal Infirmary
Anlaby Rd
Hull HU3 2JZ
Tel: 01482-607708/607743
----- Original Message -----
From: Sharpe, Peter Dr <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, October 04, 2000 2:57 PM
Subject: statins & fibrates in children
> Does anyone have extensive experience or advice on the use of statins &
> fibrates in children and teenagers who are at very high risk of developing
> coronary heart disease?
>
> Peter Sharpe
>
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