Are treatment targets for hypercholesterolemia evidence based? Systematic review and meta-analysis of randomised controlled trials

@article{Lebenthal2010AreTT,
  title={Are treatment targets for hypercholesterolemia evidence based? Systematic review and meta-analysis of randomised controlled trials},
  author={Yael Lebenthal and Andrea Horv{\'a}th and Piotr Dziechciarz and Hania Szajewska and Raanan Shamir},
  journal={Archives of Disease in Childhood},
  year={2010},
  volume={95},
  pages={673 - 680}
}
Objective Search for evidence supporting target age, level of intervention and target values for low-density lipoprotein (LDL) cholesterol levels in children with familial hypercholesterolemia. Design Systematic review and meta-analysis. PubMed, Medline, CINAHL and Cochrane Reviews databases from 1966 to 2007 were searched for articles reporting statin therapy in children and adolescents aged 8–18 years. Retrieved articles were screened for double-blind randomised controlled trials (RCTs… 
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Changes in HbA1c level and zBMI modestly impact LDL and non-HDL cholesterol and have greater impacts as children age and beyond may lead to improvements in lipid levels.
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TLDR
The results support the notion that statin therapy in children with HeFH is safe, and even though further studies are required to assess lifelong safety, statin treatment should be considered for all children aged 8 to 18 with HeHF.
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Two years of pravastatin therapy induced a significant regression of carotid atherosclerosis in children with familial hypercholesterolemia, with no adverse effects on growth, sexual maturation, hormone levels, or liver or muscle tissue.
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Key Summary Points No high-quality evidence could be found that suggests that titrating lipid therapy to recommended low-density lipoprotein (LDL) cholesterol targets is superior to empirically
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TLDR
Simvastatin significantly reduced LDL cholesterol, total cholesterol, triglyceride, VLDL cholesterol, and apolipoprotein B levels and was well tolerated in children with heFH and there was no evidence of any adverse effect of simVastatin on growth and pubertal development.
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TLDR
It is shown for the first time that early initiation of statin therapy in children with familial hypercholesterolemia might be beneficial in the prevention of atherosclerosis in adolescence.
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TLDR
Lovastatin offers an efficacious and well-tolerated treatment option for improving lipid profiles in adolescent girls with familial hypercholesterolemia and was generally safe and well tolerated.
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TLDR
The trials confirm the benefit of cholesterol-lowering therapy in high-risk patients and support the ATP III treatment goal of low-density lipoprotein cholesterol (LDL-C) <100 mg/dL, and confirm that older persons benefit from therapeutic lowering of LDL-C.
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TLDR
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