Statins in children and adolescents with familial hypercholesterolemia: A meta-analytic review

ABSTRACT Familial hypercholesterolemia (FH) is a genetic disorder characterized by high levels of low-density lipoprotein cholesterol (LDL-C). If left untreated during childhood, FH can result in early-onset cardiovascular disease (CVD). Statin treatment can reduce the risk of early-onset atherosclerotic CVD associated with FH. For this atherosclerosis-related condition, early therapy is essential to avoid major cardiac damage. The systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, with a comprehensive electronic search carried out across the Web of Science, EBSCO, and PubMed databases. The search terms used included combinations of keywords and medical subject headings relevant to the study objective. The search string was: statins OR familial hypercholesterolemia OR children OR adolescents OR LDL cholesterol OR cholesterol-lowering therapy OR pediatric hypercholesterolemia OR statin efficacy OR statin safety OR long-term outcomes OR cardiovascular risk OR lipid management OR growth and development. This study included 18 articles with a total sample size of 2811 participants. The findings revealed that in the group treated with statins, total cholesterol (TC), LDL-C, and triglycerides decreased by MD = −31.16 (95% confidence interval [CI]: −42.12, −20.19), MD = −14.31 (95% CI: −20.91, −7.70), and MD = −5.53 (95% CI: −6.35, −4.72), respectively. Although there was an increase in high-density lipoprotein cholesterol (HDL-C) by MD = 0.29 (95% CI: −0.45, 1.03), but the difference was not statistically significant ( P = 0.45). Statins significantly reduce TC, LDL-C, and TG in children and adolescents with FH while increasing HDL-C levels. On the other hand, this study found statin to be efficient in treating children and adolescents with familial hypercholesterolemia. Similarly, the study did not find any safety issues with statin medication. However, this study suggests future studies focusing on randomized control trials only, in order to ascertain the results obtained in this study.