家族性高コレステロール血症の小児におけるスタチンの治療:若ければ若いほど良い
Jessica Rodenburg1, Maud N Vissers, Albert Wiegman
1Academic Medical Centre, Department of Vascular Medicine, University of Amsterdam, The Netherlands.
Circulation
|August 1, 2007
まとめ
家族性高コレステロール血症の小児におけるスタチンの早期治療は,大動脈内側介質の厚さ (IMT) の進行を著しく減少させます. この長期の研究は,スタチンを早期に投与することが,青少年における動脈硬化症の予防に有益であることを確認しています.
科学分野:
- 心血管医学 心血管医学
- 小児内分泌学について
- 薬理学 薬理学とは
背景:
- 以前のランダム化試験では,プロワスタチンは,家族性高コレステロール血症の小児における頸動脈内側介質の厚さ (IMT) を逆行させることが示された.
- スタチン投与開始年齢が頸動脈IMTに与える影響を評価するために,長期フォローアップ研究が開始されました.
- 小児患者の長期スタチン治療の安全性も評価されました.
研究 の 目的:
- スタチン投与開始年齢と頸動脈IMTの関係を探求する.
- 家族性高コレステロール血症の小児におけるプラバスタチン治療の長期的な安全性と有効性を評価する.
主な方法:
- 以前のプラセボ対照試験から214人の子どもをフォローアップし,186人が分析のためのデータを提供した.
- 子供たちは,初期研究後のプラバスタチン治療 (20 mgまたは 40 mg) を継続しました.
- 頸動脈のIMT測定値と安全性パラメータ (脂質,検査) は平均4.5年間モニタリングされた.
主要な成果:
- スタチン投与開始時の年齢は,追跡後の頸動脈IMTの独立した予測因子でした.
- スタチン治療の早期開始は,より小さな頸動脈IMTと関連していました.
- 深刻な実験室での有害事象は報告されず,スタチンの治療は性成熟に影響を与えなかった.
結論:
- スタチン治療の早期開始は,青少年および若年成人における頸動脈IMTの進行を遅らせます.
- この研究は,家族性高コレステロール血症の小児におけるスタチンの早期治療が,青春期における動脈硬化症を予防する可能性があるという証拠を提供します.
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