Abstract P071: Lipid-lowering Drugs to Achieve and Maintain Targeted LDL Levels: Experience in a Pediatric Lipid Clinic
The safety and efficacy of lipid-lowering agents among children with high low-density lipoprotein (LDL) levels has been well documented. However, long-term data of the use of these agents to achieve and maintain a preset LDL goal in a clinic setting has not been well documented. The goal of this study was to examine long-term use of lipid-lowering drugs in the clinic setting and effect on LDL when used to achieve a targeted LDL.
Methods: Data were available from a pediatric lipid clinic in rural Appalachia and included 849 observations from 74 patients who met established criteria for lipid lowering drugs, aged 2-25 years old, 50.2% male (average LDL = 151.4, sd = 52.9); IRB approved. All patients were initially started on lifestyle modification. Drug conditions were classified as N (no drugs), F (fish oil only), S (statin use only), Z (ezetimibe only), T (any two of the previous three treatments), and A (all three treatments). Achievement and maintenance was based around a goal of LDL < 130 mg/dl. SAS PROC MIX were used to test the effect of multiple lipid drugs, dosage and visit number on LDL.
Results: Dose, drug conditions, visit number were significant (p=0.025, p<0.0001, p=0.004) in predicting average LDL. As shown in Figure 1, those in the no drug condition (N) consistently presented with the highest LDL, followed by fish oil only (F), all medicines (A), statin only (S), two of the treatments (T), and ezetimibe (Z). Individuals in the no drug condition (N) had significantly higher mean LDL than all other conditions including F (p = 0.0499), A (p = 0.002), S (p= 0.01), T (p<0.0001) and Z (p < 0.0001). Individuals in the fish oil only (F) had higher LDL than T (p=0.006) and Z (p=0.026), and those in the statin only (S) had higher LDL than T (p<0.0001).
Conclusion: Higher dosage, drug condition, and more visits were related to lower LDL among patients at a pediatric lipid clinic. In terms of drug conditions, the use of statins, ezetimibe, or any combination of two drugs improved LDL particularly in relation to the fish oil only or no drug use conditions.
- © 2013 by American Heart Association, Inc.