Cholesterol Drugs for Kids Recommended?

[~krakatoa~ 27]

Study Strongly Suggests Some Children Receive Medication To Stem Future Heart Problems

CHICAGO, July 7, 2008

(CBS/AP) For the first time, an influential doctors group is recommending that some children as young as 8 be given cholesterol-fighting drugs to ward off future heart problems.

It is the strongest guidance ever given on the issue by the American Academy of Pediatrics, which released its new guidelines Monday. The academy also recommends low-fat milk for 1-year-olds and wider cholesterol testing.

Dr. Stephen Daniels, of the academy's nutrition committee, says the new advice is based on mounting evidence showing that damage leading to heart disease, the nation's leading killer, begins early in life.

It also stems from recent research showing that cholesterol-fighting drugs are generally safe for children, Daniels said.

Several of these drugs are approved for use in children and data show that increasing numbers are using them.

"If we are more aggressive about this in childhood, I think we can have an impact on what happens later in life ... and avoid some of these heart attacks and strokes in adulthood," Daniels said. He has worked as a consultant to Abbott Laboratories and Merck & Co., but not on matters involving their cholesterol drugs.

Drug treatment would generally be targeted for kids at least 8 years old who have too much LDL, the "bad" cholesterol, along with other risky conditions, including obesity and high blood pressure.

For overweight children with too little HDL, the "good" cholesterol, the first course of action should be weight loss, more physical activity and nutritional counseling, the academy says.

At Children's Hospital in Washington, D.C., pediatric cardiologist Craig Sable is seeing kids as young as 5 and 6 with cholesterol problems, reports CBS News correspondent Nancy Cordes

"I think the sheer number of children that are overweight, are less active, and have significant levels of cholesterol has grown exponentially since I started practicing 13 years ago," Dr. Sable said.

Pediatricians should routinely check the cholesterol of children with a family history of inherited cholesterol disease or with parents or grandparents who developed heart disease at an early age, the recommendations say. Screening also is advised for kids whose family history isn't known and those who are overweight, obese or have other heart disease risk factors.

Screening is recommended sometime after age 2 but no later than age 10, at routine checkups.

The academy's earlier advice said cholesterol drugs should only be considered in children older than 10 after they fail to lose weight. Its previous cholesterol screening recommendations also were less specific and did not include targeted ages for beginning testing.

link

Edited July 8, 2008 by krakatoa

[Sassy1natl 0]

This is the supposed cure for the "fast food" generation? Chemicals? Wow.

[one...two...tree 2,762]

That's just whacked. I can't help but wonder if Big Pharma is behind this, particularly when it's the average diet of children and lack of exercise that are the leading culprits.

[pnrmbr975 1]

Ridiculous!

If parents would feed the kids healthy food, they wouldn't be oveweight or unhealthy.

[msu17 0]

Well all parents AREN'T going to feed their kids healthy foods anytime soon. So rather than cause the child irreversible damage to their CV system, I'd rather they go on meds. Best option, no, but let's face it, there are plenty of bad parents out there who aren't going to change the way they feed and parent their children. Let's not make the kid suffer any more than they already are. It's a band-aide, not a cure.

[one...two...tree 2,762]

Doping Kids

As pharmaceutical companies push their products, more and more kids are being treated with powerful -- and untested -- adult drugs.

By Helen Cordes

For Dr. Stephen Borowitz, the most frustrating office visits are with parents of kids suffering from stomachaches and infants prone to spitting up. Often, he says, the parents already know what they want -- adult heartburn drugs such as the "purple pill," Prilosec. "I tell them about nondrug tactics that often help the symptoms," says Borowitz, a professor of pediatric gastroenterology at the University of Virginia. "But they want their kids to have the pills they've seen on TV."

Borowitz and other experts worry about the safety of using potent adult drugs to ease common childhood ailments. But their warnings are unlikely to be heeded by most doctors and parents -- thanks, in large part, to an aggressive marketing campaign by pharmaceutical companies. Nearly a quarter million children took Prilosec in 2000, according to U.S. Food and Drug Administration documents, and nearly 100,000 were prescribed similar "proton pump inhibitor" (PPI) heartburn drugs such as Prevacid, Nexium, Protonix, and Aciphex. None of these PPIs were approved for pediatric use at the time (Prevacid finally secured approval in 2002), and the FDA had warned that children taking Prilosec could face risks of pancreatitis and liver problems. Yet drugmakers have continued to fund medical conference presentations, publications, and tutorials touting PPIs as "highly effective and safe" for children. And this January, tap Pharmaceuticals (which makes a strawberry-flavored version of Prevacid) sponsored a nationwide campaign featuring best-selling baby-book author Dr. Bill Sears to publicize what it calls "one of the most common esophageal disorders in children" -- gastroesophageal reflux disease, or GERD. It's a claim that angers Borowitz, who says there is no evidence of a GERD epidemic. PPIs may be useful in a few "relatively rare" conditions, he says; but too often, "ordinary childhood problems are pathologized into a disease."

The purple pill is just one of hundreds of powerful adult drugs -- many of them not tested for pediatric use -- that are increasingly being given to children. Children's use of prescription drugs has risen by one-third since 1997, according to a recent study by Medco Health Solutions, the nation's largest prescription-management company. Last year, notes Medco public-relations director Ann Smith, prescription spending for children rose faster than spending for any other group, including seniors and baby boomers. Among the fastest-growing categories were asthma and allergy drugs and psychotropic medications such as Prozac; spending on gastrointestinal drugs, mostly PPIs, rose a full 660 percent.

"The survey was a real wake-up call," says Smith. "Children are on more drugs that we think of as adult drugs: Prilosec, anti-depressants, even arthritis drugs like Celebrex and Vioxx, which more kids are taking for sports injuries." Aricept, a drug used for Alzheimer's disease, is now being tested as a treatment for attention deficit hyperactivity disorder (ADHD), and toddlers and grade-schoolers are being given drugs similar to the adult sleeping pills Noctec and Somnos. "Probably a third of the kids I see are on at least two prescription drugs," says Borowitz, "most often a drug for ADHD and an antihistamine."

But perhaps the most remarkable statistic about children's prescriptions is that nearly 3 of 4 are for "off-label" uses -- those not approved by the FDA. Drug salespeople are prohibited from encouraging doctors to prescribe drugs off label, but the practice is widespread, says Dr. Rudolph Mueller, an internist in Jamestown, New York, and author of a book on the health care system. "The reps just say, 'I'm not supposed to be telling you this because it's not approved for this use, but...."

With more children taking more adult drugs, often in combination, dangerous side effects are on the rise. Between 1997 and 2000, the FDA received more than 7,000 reports of adverse reactions to drugs in infants and children under age two, according to a University of Maryland study. Most of the reactions were serious enough to require hospitalization, and 769 of the children died. "Adverse-reaction reports don't prove that the drug being reported caused the reaction," notes Dr. Carol Blaisdell, one of the study's authors. "But what it does show is that we need a lot more studies about drugs commonly used by children." Drugmakers have been so slow to conduct such studies that the FDA now offers an incentive program through which companies can extend a lucrative drug patent -- a benefit often worth hundreds of millions of dollars -- in exchange for agreeing to test the drug on children.

But even as some companies are beginning to fund pediatric studies, off-label uses are multiplying. University of Maryland researcher Julie Magno Zito says she was surprised to discover that anti-psychotics such as Zyprexa and Risperdal are being used to treat kids who "act out." She is also worried about the use of clonidine, a blood pressure medication that is now being given to children with ADHD, and even to "sleep resistant" babies. Clonidine is among the top five psychotropic medications used in children; yet, Zito notes, "no one is tracking what effect it may have on a child's cardiovascular system to take a drug that speeds up the heart, often along with one that slows it down." Poison centers nationwide have received increasing reports of children suffering toxic effects from clonidine, according to a recent University of Maryland School of Pharmacy study. "This is a really potent drug that can have an adverse effect at a dose as small as one pill," says the study's author, Wendy Klein-Schwartz.

Researchers have also documented a rise in adverse effects, including heart problems, in children who take drugs for attention deficit disorder, asthma, and acid reflux. And this past June, the FDA warned doctors against prescribing the anti-depressant Paxil to children because of studies showing that the drug caused an increase in suicidal thoughts.

But the way the pharmaceutical industry sees it, the trend toward increasingly powerful children's prescriptions has just begun. Noting the increase in both obesity and diabetes among children and adolescents, the trade journal Pharmafocus recently called diabetes "an ideal disease for the pharma market," and drug companies are racing to market adult obesity drugs for children. In November, the cholesterol drug Lipitor was approved for use in children from 10 to 17, and more than 1,000 teens have participated in studies for the diet drugs Meridia -- which has been linked to heart problems and deaths in adults -- and Xenical, whose side effects include reduced bowel control.

As competition for the children's prescription market has become more intense, drug companies have also ratcheted up advertising, sometimes with dubious claims: When Schering-Plough ran ads suggesting that the allergy drug Claritin would keep kids more attentive at school, the FDA reprimanded the company for "misleading" consumers. Now that Claritin's patent has expired (and generic competitors are free to make the drug), Schering-Plough is encouraging kids to switch to its new allergy drug, Clarinex, sponsoring soccer tournaments and sports equipment giveaways for inner-city kids -- even as consumer groups and medical experts complain that in many cases it's better to keep children away from allergens than to give them drugs. "People tend to want to have their problem labeled and get an easy treatment to fix it," says the University of Virginia's Borowitz. "I'm afraid our children are absorbing that attitude as well."

http://www.motherjones.com/news/outfront/2.../ma_503_01.html

Edited July 8, 2008 by Jabberwocky

[pnrmbr975 1]

Bottom-line: $$$ for these drug companies and what about the possible side effects??

Prescribing meds that will damage the liver, kidneys and heart muscle of the 8 year olds.. you would not know the true side effects until later on when the damage is irreversible? I would definitely not trust the doctors fully who are tied with the drug companies.

Is it even worth the risk? I say, no.

[Hilarious Clinton 452]

That's just whacked. I can't help but wonder if Big Pharma is behind this, particularly when it's the average diet of children and lack of exercise that are the leading culprits.

exactly....

oh maybe you wonder too much. they have a pill for that