Niacin treatment of hypercholesterolemia in children.
Palavras-chave
Resumo
OBJECTIVE
To determine the efficacy and adverse effects of niacin treatment of hypercholesterolemia in children.
METHODS
Retrospective review.
METHODS
Two university hospital referral clinics.
METHODS
All children who received single-drug niacin treatment for severe hypercholesterolemia between 1980 and 1991.
RESULTS
Twenty-one children, aged 4 to 14 years, were treated with niacin, 500 to 2250 mg daily. Pretreatment total serum cholesterol value (mean +/- SD) was 7.84 +/- 1.14 mmol/L (303 +/- 44 mg/dL), and low-density lipoprotein cholesterol value was 6.28 +/- 1.16 mmol/L (243 +/- 45 mg/dL). Niacin treatment in daily doses > 1000 mg reduced total cholesterol by 23% and low-density lipoprotein cholesterol by 30% (P < .001) but had no effect on high-density lipoprotein cholesterol and triglycerides. As in adults, reversible adverse effects were common, occurring in 16 (76%) of the 21 children. Six children (29%) had reversible dose-related elevations of serum aminotransferase levels. Niacin therapy was discontinued in 8 children (38%) because of flushing, abdominal pain, vomiting, headache, or elevated serum aminotransferase levels.
CONCLUSIONS
This study suggests that although niacin treatment in children is efficacious, adverse effects are common. Until further study demonstrates long-term safety, niacin treatment should be reserved for the closely-supervised treatment of severe hypercholesterolemia by a lipid specialist.
