And with a flourish, to boot!
The cameo blogger of Gooznews — and occasional commenter, here, posting under the handle “PM” (ever-on-point!) — has revealed her true identity — do go see Gooz’s, right here, for the down-low!
She has laid out a case for why — even if Schering’s cholesterol management drug is effective at lowering LDL in children — we ought to be decidely circumspect about using it too-widely. As ever, very-cogent analysis, there — a snippet of which appears below:
. . . .Curiously, the authors do not mention the ENHANCE trial, in which adding ezetimibe to a statin did not slow the growth of thickness of the carotid arteries in adults with the same genetic disorder. However, the authors admit that achievement of these aggressive LDL goals in kids with heFH “has not been demonstrated to provide long-term reduction in cardiovascular risk” but rather is based on “expert opinion.” To translate that into plain English, the LDL goals in the AHA and AAP guidelines are arbitrary rather than being based on any evidence that achieving these goals lowers the risk that these children will have heart attacks as adults. . . .
First, diet and exercise. If inadequate, then statins. If still inadequate, then Vytorin or Zetia — but only then. And PM (per her below comment)? “I would go further than that and say that ezetimibe should not be prescribed at all except in clinical trials. . . .”