Autor(es):
Ramaswami, Uma ; Futema, Marta ; Bogsrud, Martin P. ; Holven, Kirsten B. ; Roeters van Lennep, Jeanine ; Wiegman, Albert ; Descamps, Olivier S. ; Vrablik, Michal ; Freiberger, Tomas ; Dieplinger, Hans ; Greber-Platzer, Susanne ; Hanauer-Mader, Gabriele ; Bourbon, Mafalda ; Drogari, Euridiki ; Humphries, Steve E.
Data: 2019
Identificador Persistente: http://hdl.handle.net/10400.18/6610
Origem: Repositório Científico do Instituto Nacional de Saúde
Assunto(s): Heterozygous Familial Hypercholesterolaemia; LDL-C Concentrations; Paediatric FH; Statin Treatment; Doenças Cardio e Cérebro-vasculares
Descrição
Background and aims: For children with heterozygous familial hypercholesterolaemia (HeFH), European guidelines recommend consideration of statin therapy by age 8-10 years for those with a low density lipoprotein cholesterol (LDL-C) >3.5 mmol/l, and dietary and lifestyle advice. Here we compare the characteristics and lipid levels in HeFH children from Norway, UK, Netherlands, Belgium, Czech Republic, Austria, Portugal and Greece. Methods: Fully-anonymized data were analysed at the London centre. Differences in registration and on treatment characteristics were compared by standard statistical tests. Results: Data was obtained from 3064 children. The median age at diagnosis differed significantly between countries (range 3-11 years) reflecting differences in diagnostic strategies. Mean (SD) LDL-C at diagnosis was 5.70 (±1.4) mmol/l, with 88% having LDL-C>4.0 mmol/l. The proportion of children older than 10 years at follow-up who were receiving statins varied significantly (99% in Greece, 56% in UK), as did the proportion taking Ezetimibe (0% in UK, 78% in Greece). Overall, treatment reduced LDL-C by between 28 and 57%, however, in those >10 years, 23% of on-treatment children still had LDL-C>3.5 mmol/l and 66% of those not on a statin had LDL-C>3.5 mmol/l. Conclusions: The age of HeFH diagnosis in children varies significantly across 8 countries, as does the proportion of those >10 years being treated with statin and/or ezetimibe. Approximately a quarter of the treated children and almost three quarters of the untreated children older than 10 years still have LDL-C concentrations over 3.5 mmol/l. These data suggest that many children with FH are not receiving the full potential benefit of early identification and appropriate lipid-lowering treatment according to recommendations.
