Application of Specific Extracorporeal Removal of Low Density Lipoprotein in Familial Hypercholesterolaemia

Stoffel, Wilhelm; Borberg, H.; Greve, Vagn

doi:10.1016/s0140-6736(81)91213-7

Cited by 267 publications

(104 citation statements)

References 21 publications

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“…Immunophoresis or immunoadsorption was one of the first apheresis techniques to be developed (10). It is based on columns in which sheep antibodies against apoB-100 eliminate apoB-100-containing particles, such as LDL, IDL, and Lp(a).…”

Section: Effect Of Lipoprotein Apheresis On Lipid Levelsmentioning

confidence: 99%

Lipoprotein apheresis to treat elevated lipoprotein (a)

Waldmann

Parhofer

2016

Journal of Lipid Research

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Section: Effect Of Lipoprotein Apheresis On Lipid Levelsmentioning

confidence: 99%

Lipoprotein apheresis to treat elevated lipoprotein (a)

Waldmann

Parhofer

2016

Journal of Lipid Research

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“…Unlike statins, apheresis also lowers Lp(a) levels. [74][75][76] Apheresis is a procedure to physically remove plasma lipoproteins from the blood using dextran sulfate cellulose adsorption (DSA), heparin-induced extracorporeal LDL cholesterol precipitation (HELP), immunoadsorption, double filtration plasmapheresis (DFPP), or direct adsorption of lipoproteins. 77 Unfortunately, many patients with FH do not achieve the desired reduction of lipoproteins with apheresis and with all methods of removing the LDL, and the LDL-C levels return to pre-treatment levels within 2 to 4 weeks.…”

Section: Therapeutic Options For Patients With Severe Ldl-c Elevationmentioning

confidence: 99%

Management of Familial Hypercholesterolemia: A Review of the Recommendations from the National Lipid Association Expert Panel on Familial Hypercholesterolemia

Robinson

2013

JMCP

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suMMaRyFamilial hypercholesterolemia (FH) is a genetic disorder of lipid metabolism that is characterized by a significant elevation in levels of low-density lipoprotein cholesterol (LDL-C), and patients are at very high risk for premature coronary heart disease (CHD). The etiology of FH includes known mutations in the gene of the LDL receptor, LDLR ; the gene of apolipoprotein B, apo B ; and the proprotein convertase subtilisin/kexin type 9 gene, PCSK9. The National Lipid Association Expert Panel on Familial Hypercholesterolemia has provided recommendations for the screening and treatment of patients with FH. Early identification and aggressive treatment of FH in individual patients, as well as screening of all first-degree relatives, are recommended to minimize the risk for premature CHD. Similar to patients with conventional hypercholesterolemia, patients with FH should receive statins as initial treatment, but patients with FH may require higher doses of statins, more potent statins, statin-based combination therapy, or adjunctive therapies. Patients with FH who have additional risk factors for, or existing, cardiovascular disease or those with an inadequate response to initial statin therapy should have access to higher doses of the most efficacious statins; statins used in combination with other LDL-C-lowering agents should also be supported by formularies; additional treatments, such as LDL-C apheresis or novel therapies, may also be required to achieve acceptable LDL-C levels. New treatment approaches include mipomersen, which was approved by the FDA in January 2013. Mipomersen is an oligonucleotide inhibitor of apolipoprotein B-100 synthesis (called an antisense inhibitor) indicated as an adjunct to lipid-lowering medications and diet to reduce LDL-C, apolipoprotein B, total cholesterol, and non-high density lipoproteincholesterol (non-HDL-C) levels in patients with homozygous FH (HoFH). The microsomal transfer protein lomitapide has also received FDA approval for use only in patients with HoFH. Other novel treatments currently in development include PCSK9 inhibitors. Therapies such as apheresis are likely more expensive than simple therapy with a statin but may be needed to achieve long-term reductions in complications from nonfatal and fatal cardiovascular events and hospitalizations related to myocardial infarction, cardiac revascularization, and stroke in FH patients. The cost-effectiveness of this more aggressive therapy has not been determined and should be studied. Utilization of published guidelines and the recommendations from the National Lipid Association will help to optimize the management of patients with FH.

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“…The term "LDL apheresis" was introduced by Stoffel et al 57 to describe the selective removal of apoB-containing lipoproteins from plasma in vivo through immunoabsorption. LDL apheresis has been used mainly for the treatment of patients with FH or with very severe CAD and high plasma LDL cholesterol levels that did not respond adequately to dietary and drug intervention.…”

Section: Ldl Apheresismentioning

confidence: 99%

Does Therapeutic Intervention Achieve Slowing of Progression or Bona Fide Regression of Atherosclerotic Lesions?

Stein

2001

ATVB

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Abstract-This review focuses on the regression of atherosclerosis in humans and experimental animals. It highlights the difficulties to determine unequivocally whether with a given therapeutic intervention, such as diet, drugs, or apheresis, the progression of lesions was curtailed or bona fide regression of atherosclerotic lesions was achieved. It seems appropriate to mention that 2 very different ways to measure regression were used in experimental animals and in humans. Regression in animals was determined mainly in the aorta or coronary arteries isolated at post mortem, and the criteria used were degree of sudanophilia and/or aortic wall thickness and cellular composition or cholesterol content. In humans, the evaluation of regression relied mainly on quantitative coronary angiography. The literature of the past decade is reviewed selectively but not exhaustively, and in some instances, a brief historical overview is given.

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Application of Specific Extracorporeal Removal of Low Density Lipoprotein in Familial Hypercholesterolaemia

Cited by 267 publications

References 21 publications

Lipoprotein apheresis to treat elevated lipoprotein (a)

Lipoprotein apheresis to treat elevated lipoprotein (a)

Management of Familial Hypercholesterolemia: A Review of the Recommendations from the National Lipid Association Expert Panel on Familial Hypercholesterolemia

Does Therapeutic Intervention Achieve Slowing of Progression or Bona Fide Regression of Atherosclerotic Lesions?

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