{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T14:04:53Z","timestamp":1744121093234},"reference-count":56,"publisher":"Walter de Gruyter GmbH","issue":"0","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,1,8]]},"abstract":"Abstract<\/jats:title>Background:<\/jats:title>Current pediatric guidelines for heterozygous familial hypercholesterolemia (HeFH) propose pharmacotherapy (PT) with statins from age 8 to 10 years; however, schemes with absorption inhibitors combined with statins, could be started earlier. The aim of the study was to show the 10-year results of a combined treatment protocol.<\/jats:p><\/jats:sec>Methods:<\/jats:title>Prospective, descriptive and analytical study. Pediatric patients (n=70; mean age at PT initiation 9.3 years [range, 2\u201317.5]) with HeFH who required PT between 2005 and 2015 were included. All patients \u226510 years, with LDL >190 mg\/dL or >160 mg\/dL with one cardiovascular risk factor (CVRF) or >130 mg\/dL with two or more CVRF; and those patients 5\u201310 years and with LDL-C >240 mg\/dL or a family history of a cardiovascular event before 40 years, were medicated. After a period on a lipid-lowering diet (LLD), all patients were started on ezetimibe. Patients who did not achieve the treatment goal were given statins. The variables were: age, age at PT initiation, duration of PT, initial LDL-C, mean LDL-C during ezetimibe monodrug therapy, mean LDL-C during combined PT, and percentage of LDL decrease.<\/jats:p><\/jats:sec>Results:<\/jats:title>LDL-C levels were: Baseline: 235 mg\/dL\u00b155; after 3 months on ezetimibe: 167 mg\/dL\u00b147 (decrease: \u221227.62%). In 18 patients who did not reach the treatment goal atorvastatin was added and their LDL-C decreased \u221241.5% (p: 0.02). Overall, mean final LDL-C was 155 mg\/dL\u00b130.4 (range, 98\u2013257) and treatment goals were reached in 74% of the patients. No severe side effects were reported.<\/jats:p><\/jats:sec>Conclusions:<\/jats:title>Combined and sequential treatment starting at early ages was shown to be safe and effective over this follow-up period.<\/jats:p><\/jats:sec>","DOI":"10.1515\/jpem-2016-0117","type":"journal-article","created":{"date-parts":[[2016,10,8]],"date-time":"2016-10-08T10:01:57Z","timestamp":1475920917000},"source":"Crossref","is-referenced-by-count":2,"title":["A 10-year experience using combined lipid-lowering pharmacotherapy in children and adolescents"],"prefix":"10.1515","volume":"0","author":[{"given":"Mar\u00eda Beatriz","family":"Araujo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Sol","family":"Pacce","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","reference":[{"key":"ref321","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1126\/science.3513311","article-title":"A receptor-mediated pathway for cholesterol homeostasis","volume":"232","year":"1986","journal-title":"Science"},{"key":"ref61","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.jacl.2014.01.001","article-title":"Management of familial hypercholesterolemia in children and adolescents. 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