Related Experiment Videos
Niacin treatment of hypercholesterolemia in children
R B Colletti1, E J Neufeld, N K Roff
1Department of Pediatrics, University of Vermont College of Medicine, Burlington.
Insights
Niacin effectively lowers cholesterol in children with hypercholesterolemia but causes frequent side effects. Due to common adverse events, its use requires careful supervision by a lipid specialist.
Area of Science:
- Pediatric Endocrinology
- Cardiovascular Pharmacology
- Clinical Lipidology
Background:
- Hypercholesterolemia in children is a growing concern.
- Niacin is a lipid-lowering agent used in adults.
- Limited data exists on niacin's efficacy and safety in pediatric populations.
Purpose of the Study:
- To evaluate the effectiveness of niacin in treating hypercholesterolemia in children.
- To assess the adverse effects associated with niacin therapy in pediatric patients.
Main Methods:
- Retrospective review of medical records.
- Inclusion of children aged 4-14 years with severe hypercholesterolemia treated with niacin monotherapy.
- Data collected from two university hospital referral clinics between 1980 and 1991.
Main Results:
- Niacin doses above 1000 mg daily significantly reduced total cholesterol by 23% and LDL cholesterol by 30% (P < .001).
- High-density lipoprotein cholesterol and triglycerides remained unaffected.
- Adverse effects were common (76%), including reversible elevations in serum aminotransferase levels (29%).
- Niacin was discontinued in 38% of patients due to side effects like flushing and gastrointestinal distress.
Conclusions:
- Niacin demonstrates efficacy in reducing cholesterol levels in children with severe hypercholesterolemia.
- Adverse effects are frequent and can necessitate treatment discontinuation.
- Further research is needed to establish long-term safety; use should be limited to specialist supervision for severe cases.
Objective:
To determine the efficacy and adverse effects of niacin treatment of hypercholesterolemia in children.
Design:
Retrospective review.
Setting:
Two university hospital referral clinics.
Patients:
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.