Impact of statin therapy on LDL and non-HDL cholesterol levels in subjects with heterozygous familial hypercholesterolaemia

Climent, Elisenda; Marco-Benedí, Victoria; Benaiges, David; Pintó, Xavier; Suárez-Tembra, Manuel; Plana, Núria; Lafuente, H.; Victoria, Emilio Ortega-Martínez de; Brea-Hernando, Ángel; Vila, Àlex; Civeira, Fernando; Pedro‐Botet, Juan

doi:10.1016/j.numecd.2021.01.014

Cited by 9 publications

(2 citation statements)

References 33 publications

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“…Although well tolerated and efficacious treatment options exist for management of hypercholesterolemia in children, current paediatric guidelines that include statins as the only pharmacotherapy [21,88] may not be adequate to reach goal cholesterol levels in all patients. Several studies have shown that most adults with familial hypercholesterolemia do not meet treatment goals in spite of maximally tolerated statin therapy [107 ▪ ,108–110]. Data regarding treatment outcomes in paediatric familial hypercholesterolemia patients are limited.…”

Section: Limitations and Future Directionsmentioning

confidence: 99%

Update on management of paediatric dyslipidaemia

Bansal

Kumar

Brar

2023

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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Purpose of review Atherosclerosis and associated cardiovascular risk factors originate in childhood; hence, early management of dyslipidaemia is vital. However, hypercholesterolemia remains untreated or undertreated in many youths. We review current therapies, drugs under investigation and consider potential future directions for the management of paediatric dyslipidaemia to highlight the recent evidence and new therapeutic options for future use. Recent findings Cardiovascular disease (CVD) risk factors in childhood, including dyslipidaemia, are associated with CVD risk and clinical CVD events in adulthood. Recent data show that initiation of statin therapy in childhood in children with familial hypercholesterolemia reduces the risk of CVD in adulthood. Several well tolerated and efficacious treatment options have become available in recent times for the management of dyslipidaemia in youth. Many new lipid-lowering drugs are under investigation to widen the available choices. Some of these drugs are now available for use in paediatrics, while some remain targets for future use. Summary We review available treatment options for paediatric dyslipidaemia management, discuss potential limitations and propose future directions. We also acknowledge the need for continued research in paediatrics for optimal paediatric dyslipidaemia management.

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Section: Limitations and Future Directionsmentioning

confidence: 99%

Update on management of paediatric dyslipidaemia

Bansal

Kumar

Brar

2023

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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“…11 Similarly, findings from the EURO ASPIRE V Survey in 78 centres from 16 European countries found that the recommended LDL-C target was achieved in less than half of high-CVD risk individuals on lipid-lowering medication. 18 In the FH population, previous studies of lipid-lowering therapy have primarily evaluated treatments among patients in lipid clinics or specialist registers, [19][20][21] while clinical trials have assessed LDL-C reduction associated with treatment using more specialised lipid-lowering agents such as proprotein convertase subtilisin/kexin type 9. 22 23 While it had previously been shown that less than 50% of the general population who was prescribed statins for primary CVD prevention achieved a 40% or greater reduction in LDL-C within 24 months, our study of the FH population found that 51.1% of individuals at 1 year and 56.3% of individuals at 2 years achieved this general population treatment target.…”

Section: Comparison With Previous Literaturementioning

confidence: 99%

Statin treatment and LDL-cholesterol treatment goal attainment among individuals with familial hypercholesterolaemia in primary care

et al. 2021

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ObjectivesGuidance recommends statin treatment in familial hypercholesterolaemia (FH) to achieve at least a 50% reduction in low-density lipoprotein cholesterol (LDL-C). We assessed statin prescribing rates and LDL-C treatment goal attainment among individuals with FH in primary care.MethodsUsing primary care electronic health records from the UK Clinical Practice Research Datalink, we identified adults with recorded diagnosis of FH, statin treatment and measures of LDL-C prior to (baseline) and 12 months after initiating statin treatment. The percentage change in LDL-C was determined, and then baseline and treatment characteristics were assessed by LDL-C treatment goal attainment.ResultsOf 3064 adults (mean age 50.8 years) with recorded diagnosis of FH and repeat LDL-C measures, 50% reduction in LDL-C from baseline was attained in 895 individuals (29.2%) in 12 months. Compared with those who did not attain this goal, these people were predominantly women; they were older at time of FH diagnosis (53.4 years vs 49.7 years) and first statin treatment (53.2 years vs 49.2 years) and had higher pretreatment total cholesterol (8.20 (SD 1.38) mmol/L vs 7.57 (SD 1.39) mmol/L) and pretreatment LDL-C (5.83 (SD 1.36) mmol/L vs 5.25 (SD 1.40) mmol/L). A higher proportion of individuals who attained the treatment goal was prescribed high-potency and medium-potency statins (24.3% and 71.7% vs 20.2% and 69.3%, respectively).ConclusionsLess than a third of individuals on statin treatment for FH in the community achieve recommended reductions in LDL-C. Greater awareness and optimisation of treatment for FH using higher-potency statins are needed.

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