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Statin Use in Australian Children: A Retrospective Audit of Four Pediatric Hospitals

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Abstract

Aim

The aim of this study was to perform an audit of the use of statins in Australian pediatric hospitals.

Methods

A retrospective audit of patients prescribed statins during a visit to a pediatric hospital, as in- or outpatients, was performed in four major children’s hospitals in three Australian states. Patients were identified through hospital pharmacy dispensing records. Statin use (dose, type) as well as medical history was recorded.

Results

A total of 157 patients under the age of 18 were included in the audit. The most common reasons for being prescribed a statin included history of organ transplantation, renal disease and familial hypercholesterolemia (FH). Four statins were prescribed: atorvastatin (n = 77), pravastatin (n = 45), simvastatin (n = 25) and rosuvastatin (n = 10). All statins, apart from rosuvastatin, were used in very young children (1–7 years old). Polypharmacy was common in these patients, including combinations with calcineurin inhibitors and diltiazem, which can increase systemic statin exposure. A small number of very young children were prescribed high doses of statin, based on mg/kg dosing.

Conclusions

Statins were prescribed to children younger than suggested by current Australian guidelines, with atorvastatin being the preferred statin of choice. Long-term safety studies on the use of statins in children have only included FH patients so far, who are generally healthy besides their raised lipid levels. Further long-term safety studies are needed to include the more vulnerable transplant and renal patients, identified in this audit as being prescribed statins. This can help formulate guidelines for the safest possible use of this class of drugs in the pediatric setting, including the possibility of weight-based recommendations for younger children.

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Acknowledgments

We would like to extend our sincere thanks to the Directors of Pharmacy of the children’s hospitals for granting access to their prescription databases, assisting us with human ethics applications and accommodating our research students. We would also like to thank the Medical Specialists of the Hospital outpatient clinics for granting us access to their medical records and supporting our research students. The authors acknowledge financial support from a Roche Research Grant on ‘Safety and Quality’ of medicines (Grant ID ROC1107).

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Correspondence to Ingrid C. Gelissen.

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Gelissen, I.C., Nguyen, H.L., Tiao, D.K. et al. Statin Use in Australian Children: A Retrospective Audit of Four Pediatric Hospitals. Pediatr Drugs 16, 417–423 (2014). https://doi.org/10.1007/s40272-014-0087-z

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  • DOI: https://doi.org/10.1007/s40272-014-0087-z

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