More on Drugs to Treat Kids’s Cholesterol

I hope you read the blog I posted before this one. Were you upset? Well, the New York Times was (editorial, Sunday July 13th, 2008) and so were a lot of doctors across the country. Yes, about 13% of children have an elevated cholesterol. Yes, some of them have a genetic problem that cause the elevation. The docs who recommended these drugs for kids are saying they were misunderstood; they only intended to treat those 1/500 kids with said genetics issues. “I don’t see it as a major groundswell for the indiscriminate use of lipid-lowering drugs,” said one of the panel docs.

What do you think?

In my opinion, either the recommending docs are extremely naïve, or they are not old enough to remember (probably both) what happens in health care when a drug is first introduced “for only a few people.” For example, Listerine was introduced as a disinfectant in the Operating Room; now we all gargle it before a hot date. The purple pill for really bad ulcers was introduced when I was in Medical School to use only when everything else failed. Now, everyone takes it OTC for gastritis and reflux. I saw a commercial where they recommend it before you eat pizza…

The most glaring example is what happened to antidepressants. Only used for patients who were in really dire straights, now everyone gets it for any little “bump on the road” of life.
So, what is Big Pharma going to do with the marketing of these drugs recommended only for 1/500 kids? Is it hard to imagine that after a while, any kid having weight problems is going to be put on these drugs? What will the message be to these kids? They will soon learn, if they have not already, that any problem needs a pill. Oh, but they don’t like taking pills. Well, let’s put the drugs in their ice cream or in their jell-o…

Then there is the matter of nutrition: I still hear docs say that food will not correct a cholesterol problem. This is blatantly wrong (see blogs above.) Besides, the new field of “Nutrigenomics” (see cover issue of Discover Journal, November 2007) makes it very clear that diet may improve genetic profiles in any disease, including cholesterol problems. True, there will be a few patients, adult and children, where diet fails. In those patients, we would do well to check their thyroids, diabetic tendencies, levels of iodine, vitamin D, etc, etc, before prescribing a pill.

If so many adults are having side effects from these drugs, can you imagine what we are exposing our children to, for the rest of their lives? There is very little data on how these drugs will affect them long term. The studies we do have followed kids on these drugs for only two years. Also, we must remember that kids metabolize differently than adults. How do we know if they are going to have less/more side effects? Some docs feel these drugs may mess up kids’ hormones, especially those that regulate their development.

As I feared, the New York Times editorial reports that the American Academy of Pediatrics has received contributions from Big Pharma. Three of the docs on the recommending committee have been employed as consultants and as researchers for the drug companies that make cholesterol-lowering drugs: as always, “follow the money.”