8-Year-Olds on Statins? A New Plan Quickly Bites Back

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Published at: www.nytimes.com

Statin therapy for children

August 6, 2008

Analysis by: GLG Expert Contributor

The  potential market for treatment of lipids(cholesterol)continues to grow. Recent recommendations regarding potential for treatment of children as young as 8 are controversial, primarily because of the lack of data to demonstrate efficacy in terms of "hard" endpoints(i.e. mortality/MI)vs. morbidity of the therapy(i.e. cognitive dysfunction/growth delay). The intellectual underpinning of the rationale for drug therapy is this:diet/exercise are either inadequate and/or poorly complied with for many people, atherosclerosis starts sooner than most people realize, delaying therapy until adulthood may be too late to prevent the process(rather than simply arrest or reverse it). A very small group of people with relatively rare genetic predisposition to high cholesterol would be candidates for therapy in light of very premature cardiac event rate. In the absence of controlled trial data, we cannot assume that the beneifts of drug therapy outweigh the risks.

Don't use a dangerous fix for for a probem that may not exist!

July 21, 2008

Analysis by: GLG Expert Contributor

We do not know enough about the effects of statins over a lifetime to justify use in children. Maybe we would reduce cardiovascular mortality, maybe not.  But at what cost?  I'm talking about both financial costs and the health costs related to drug side effects.  We need a lot more information before recommending this course of action for all children with abnormal lipids. A better idea is to improve dietary habits and increase physical activity in our children.  A pill is not the answer to good health!

Starting Younger Every Day

July 18, 2008

Analysis by: GLG Expert Contributor

While I am sure that there are a few children with hereditary lipid disorders which should be treated aggressively and early with statins, the data is certainly not available to support routine treatment of every child with elevated lipid values.

A Pill For Every Mouth

July 11, 2008

Analysis by: GLG Expert Contributor

Dangers of over-medication.  Lack of long term studies.  lack of personal and parental responsibility

How to identify individuals likely to benefit from the use of Statins.

July 11, 2008

Analysis by: GLG Expert Contributor

Widespread use of statins is likely to reduce the incidence of heart attacks and strokes and reduce the process responsible: atherosclerosis. Statins are expensive and selection of individuals and children at high to moderate risk should go beyond risk stratification by standard means and use more objective evidence of early asymptomatic atherosclerosis. Such a measure is carotid intima-media thickness (IMT), a measurement that has recently had much impact on statin utilization (Vytorin and Merk/Schering-Plough).  This phenotypic marker is noninvasive and without risk. Novel risk factors such as c-Reactive Protein and even markers of inflammation are rarely seen to be abnormal in young age groups. Traditional risk factors only identify a proportion of those who are seeing early changes in the wall of their arteries.  Looking directly at the wall of the artery makes more sense.

Desperate times- desperate measures

July 11, 2008

Analysis by: GLG Expert Contributor

This recommedation is just a reflection of how out of hand the crisis of obesity and metabolic syndrome/diabetes is in our youth. We all need to wake up and do something.

Statins for Kids! It's gone too far !!!

July 10, 2008

Analysis by: GLG Expert Contributor

While statins have been proven to lower cholesterol, the absolute numbers of prevented deaths or myocardial infarctions has been poor, with the NNT (number needed to treat) at between 50-100, depending upon whom you ask.

Richard AmerlingAssociate Professor of Clinical MedicineAlbert Einstein College of Medicine

Our Kids on Statins...........Not!

July 10, 2008

With the pipeline for new drugs running dry, it is no surprise that pharmaceutical companies are looking to expand indications for existing products still under patent protection.  What better way to do this than by creating entirely new patient populations out of whole cloth?