FH and statins

"The main findings of this report are that, reassuringly, annual follow-up data showed no difference in average growth rate in the statin-treated children compared to the no-statin children, and none of those on statin had a clinically significant increase in measured plasma levels of CK, ALT, and AST, showing no evidence of any statin toxicity. From this perspective, our data are in keeping with the published short-term safety profile of statins in children (reviewed in the studies by Vuorio et al,16 Vuorio et al,17 and Emerson et al20). The long-term safety profile of statins in adults is well established.21, 22 The recent Dutch study reporting no CHD events in a 25-year follow-up of their treated children cohort, and evidence of greater longevity in the children than their FH parents,15is supportive of the value of early statin therapy.

As a consequence of the elevated LDL-C seen in children with HeFH from birth, by the age of 10 years, they develop atherosclerosis, detectable as a significant degree of carotid intima-media thickness as compared with their non-FH siblings.23, 24 In a randomized controlled trial of the use of pravastatin, further increase in carotid intima-media thickness was prevented.25 Based on these data, the NICE guideline (CG71) and the European consensus guidelines13 state that the use of statins should be considered in children with HeFH by the age of 10 years using clinical judgment, based on the child's LDL-C level, age of onset of CHD in the parent or relatives, and presence of other CHD risk factors. The recent European expert opinion guideline13 suggested that in childhood, an on-treatment target LDL-C of 3.5 mmol/L would be ideal"

This is the original paper