Treatment of Dyslipidaemia in Children
Abstract
:1. Introduction
2. Pathophysiology
3. Paediatric Guidelines
4. Management of Dyslipidaemia in Children
4.1. Non-Pharmacological Approaches
4.2. Family-Based Approach
4.3. Pharmacological Treatment
4.3.1. Approved Pharmacological Treatment for Children
Statins
Ezetimibe and Bile Acid Sequestrants
4.3.2. Non-Approved Pharmacological Treatment for Children
Fibrates and Niacin
4.3.3. Additional Lipid-Lowering Options
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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ACCEPTABLE | BORDERLINE | HIGH | |||||
---|---|---|---|---|---|---|---|
mg/dL | Percentile | mg/dL | Percentile | mg/dL | Percentile | ||
Children and Adolescents | TC | <170 | <75th | 170–199 | 75–95th | >200 | >95th |
LDL-C | <110 | <75th | 110–129 | 75–95th | >130 | >95th | |
TG | |||||||
0–9 years | <75 | <75th | 75–99 | 75–95th | >100 | >95th | |
10–19 years | <90 | <75th | 90–129 | 75–95th | >130 | >95th | |
HDL-C | >45 | >10th | 40–45 | <40 | <10th | ||
Non-HDL-C | <120 | <75th | 120–144 | 75–95th | >145 | >95th |
Mechanism of Action | Mean LDL-C % Reduction | Currently Approval Status | Trials in Children | Studies | |
---|---|---|---|---|---|
Evolocumab | PCSK9 inhibitor | 20–55% | FH from 12 years of age | HoFH or severe HeFH from 12 years of age | Santos et al. [79] Hovingh et al. [80] Santos et al. [81] |
Alirocumab | PCSK9 inhibitor | 21–62% | FH in adults | Severe HeFH from 8 years of age | Blom et al. [82] Hartgers et al. [83] Daniels et al. [84] |
Inclisiran | Small interfering RNA directed against PCSK9 | 35–43% | Primary hypercholesterolemia or mixed dyslipidaemia in adults | Will be tested in paediatric HeFH in the ORION-16 study. | Raal et al. [85] |
Evinacumab | ANGPTL3 inhibitor | 42–51% | HoFH from 12 years of age | HoFH from 12 years old | Raal et al. [86] |
Mipomersen | Antisense APO-B synthesis inhibitor | 28% | FH from 12 years of age | HoFH and severe HeFH from 12 years of age | Blom et al. [87] Raal et al. [88] |
Lomitapide | MTTP inhibitor | 51% | FH in adults | HoFH from 7 years of age | Stefanutti [89] Ben-Omran et al. [90] Chacra et al. [91] |
Bempedoic acid | ACL inhibitor | 17–38% | Primary hypercholesterolemia or mixed dyslipidaemia in adults | Goldberg et al. [92] Ballantyne et al. [93] | |
Anacetrapib | CEPT inhibitor | 40% | Not approved | Filippatos et al. [94] Armitage et al. [95] |
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Fiorentino, R.; Chiarelli, F. Treatment of Dyslipidaemia in Children. Biomedicines 2021, 9, 1078. https://doi.org/10.3390/biomedicines9091078
Fiorentino R, Chiarelli F. Treatment of Dyslipidaemia in Children. Biomedicines. 2021; 9(9):1078. https://doi.org/10.3390/biomedicines9091078
Chicago/Turabian StyleFiorentino, Riccardo, and Francesco Chiarelli. 2021. "Treatment of Dyslipidaemia in Children" Biomedicines 9, no. 9: 1078. https://doi.org/10.3390/biomedicines9091078