Hyperlipidemia in Children After Heart Transplantation

Singh, Tajinder P.; Naftel, David C.; Webber, Steven A.; Dupuis, Joanne; Chin, Clifford; Spicer, Robert L.; Schowengerdt, Kenneth O.; Ring, W. Steves; Morrow, W. Robert

doi:10.1016/j.healun.2006.06.003

Cited by 27 publications

(28 citation statements)

References 32 publications

(32 reference statements)

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“…In pediatric cardiac transplantation, the prevalence of CAV has been reported to be as high as 17% in one retrospective analysis. 179 Greater-than-optimal LDL concentrations (>100 mg/dL) post transplantation have been reported in 39% of pediatric patients 1 year after transplantation, 180 which can be secondary to post-transplantation steroid and immunosuppressive therapy. The addition of pravastatin therapy in pediatric cardiac transplant recipients yielded a lower incidence of CAV.…”

Section: Future Considerationsmentioning

confidence: 99%

Pediatric Statin Administration: Navigating a Frontier with Limited Data

Wagner

Abdel‐Rahman

2016

The Journal of Pediatric Pharmacology and Therapeutics

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Increasingly, children and adolescents with dyslipidemia qualify for pharmacologic intervention. As they are for adults, 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitors (statins) are the mainstay of pediatric dyslipidemia treatment when lifestyle modifications have failed. Despite the overall success of these drugs, the magnitude of variability in dose-exposure-response profiles contributes to adverse events and treatment failure. In children, the cause of treatment failures remains unclear. This review describes the updated guidelines for screening and management of pediatric dyslipidemia and statin disposition pathway to assist the provider in recognizing scenarios where alterations in dosage may be warranted to meet patients' specific needs.

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Section: Future Considerationsmentioning

confidence: 99%

Pediatric Statin Administration: Navigating a Frontier with Limited Data

Wagner

Abdel‐Rahman

2016

The Journal of Pediatric Pharmacology and Therapeutics

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“…In pediatric cardiac transplantation, the prevalance of CAV is less pronounced compared to adults, but has been reported to be as high as 17% in one retrospective analysis 34 . LDL levels >100mg/dl, greater than optimal and near adult treatment range, have been reported in 39% of pediatric patients 1 year after transplantation 35 , which can be secondary to post-transplant steroid and cyclosporine therapy. Addition of pravastatin therapy in pediatric cardiac transplant recipients yielded a lower incidence of CAV 34 .…”

Section: Evolution Of Statin Therapy In Childrenmentioning

confidence: 99%

Pediatric Pharmacogenomics

Wagner¹,

Leeder²

2012

Pediatric Clinics of North America

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Synopsis The dose-exposure-response relationship for drugs may differ in pediatric patients compared to adults due to developmental changes in processes involved in drug disposition (absorption, distribution, metabolism and excretion) and drug response. This relative knowledge deficit has complicated drug efficacy and safety labeling of drugs for pediatric use. With the legislative changes that have occurred in the US and Europe over the last 20 years, many clinical studies have been conducted to establish drug dose-exposure relationships across the pediatric age spectrum from birth to adolescence. However, genetic variation has seldom been included in these investigations. This article applies a systematic approach to determine the relative contribution of development and genetic variation on drug disposition and response using HMG-CoA reductase inhibitors as a model. Application of the approach drives the collection of information relevant to understanding the potential contribution of ontogeny and genetic variation to statin dose-exposure-response in children, and identifies important knowledge deficits to be addressed through the design of future studies.

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“…Paediatric transplant recipients have abnormal lipid profiles 27. Steroids and calcineurin inhibitors are responsible for increased low density lipoprotein, triglycerides and cholesterol, and decreased high density lipoprotein in heart transplant patients 28.…”

Section: Post-transplant Complicationsmentioning

confidence: 99%

“…Steroids and calcineurin inhibitors are responsible for increased low density lipoprotein, triglycerides and cholesterol, and decreased high density lipoprotein in heart transplant patients 28. Pravastatin has been shown to reverse this dyslipidaemia in children after transplantation,27 and reduce the development of cardiac allograft vasculopathy;29 there is also evidence of survival benefit in adult transplant recipients 30. We now routinely prescribe pravastatin to all our patients, and use lipid profile and liver function tests to monitor efficacy and side-effects.…”

Section: Post-transplant Complicationsmentioning

confidence: 99%