ABC | Volume 111, Nº6, December 2018

Original Article Radaelli et al Statin treatment in children: meta-analysis Arq Bras Cardiol. 2018; 111(6):810-821 Figure 1 – Summary of evidence search and study selection. Records identified through database searching (n = 16793) Records after duplicates removed (n = 15820) Records screened (n = 15820) Full-text articles assessed for eligibility (n = 80) Studies included in qualitative synthesis (n = 15) Studies included in quantitative (meta-analysis) (n = 10) Records excluded (n = 15740) Full-text articles excluded, with reasons (n = 66) • Not pediatric (n = 39) • Not stain (n = 15) • Not RCT (n = 12) Identification Screening Eligibility Included Risk of bias in included studies Allocation Generation of sequence The generation of the allocation sequence was adequate in two studies since the sequence was computer-generated. 10,18 The remaining ten studies were described as randomized, but no further details of the process were given (Table 2). Concealment of allocation None of the included studies described how the allocation sequence was concealed from the investigators, the outcome assessors or the participants in the study (Table 2). Blinding All studies were described as double blind, indicating that participants and those participating in treatment procedures were blinded to treatment (Table 2). Incomplete outcome data From the studies included, 90% reported intention-to-treat analyses and80%described losses due to follow-upandexclusions. Effects of interventions Statins versus placebo All included studies describe the use of therapy with statins: atorvastatin, 16 lovastatin, 10,21 pravastatin, 17,18,19 rosuvastatin, 20 simvastatin 11,22 and pitavastatin. 23 The dosage and duration of treatment with statins varied between them (Table 1). The detailed analyzes are in Appendix II, III, IV, and V. Change in Total cholesterol Ten of the included studies evaluated the effect of statin therapy on the TC level. 10,11,16-23 A subgroup analysis was performed in line with the intensity of statin doses, classified according to expected LDL-cholesterol reduction effect 29 : ≤ 30% as low; 30–40%, intermediate, and ≥ 40%, high. 812