Atorvastatin in low-density lipoprotein apheresis-treated patients with homozygous and heterozygous familial hypercholesterolemia

Goldammer, Andreas; Wiltschnig, Stefanie; Heinz, Gottfried; Jansen, M.; Stulnig, Thomas M.; rl, Walter H. H; Derfler, Kurt

doi:10.1053/meta.2002.34016

Cited by 15 publications

(8 citation statements)

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“…Treatment intervals were not stratified by FH type and were generally consistent between countries. The majority of studies (n=13, 68.4%) reported intervals of ≤2 weeks: 4 articles reported weekly LDL‐C apheresis, 4 articles reported treatment every 1 to 2 weeks, and 5 articles reported a 2‐week interval . Of the studies that reported an interval >2 weeks, the majority reported a 3‐ to 4‐week interval and 1 observational study reported a treatment interval of 8 weeks.…”

Section: Resultsmentioning

confidence: 99%

Systematic Review of Low‐Density Lipoprotein Cholesterol Apheresis for the Treatment of Familial Hypercholesterolemia

Wang¹,

Richhariya

Gandra

et al. 2016

JAHA

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BackgroundApheresis is an important treatment for reducing low‐density lipoprotein cholesterol (LDL‐C) in patients with familial hypercholesterolemia (FH). We systematically reviewed the current literature surrounding LDL‐C apheresis for FH.Methods and ResultsElectronic databases were searched for publications of LDL‐C apheresis in patients with FH. Inclusion criteria include articles in English published in 2000–2013 that provide descriptions of practice patterns, efficacy/effectiveness, and costs related to LDL‐C apheresis in patients with FH. Data were stratified by country and FH genotype where possible. Thirty‐eight studies met the inclusion criteria: 8 open‐label clinical trials, 11 observational studies, 17 reviews/guidelines, and 2 health technology assessments. The prevalence of FH was not well characterized by country, and underdiagnosis was a barrier to FH treatment. Treatment guidelines varied by country, with some guidelines recommending LDL‐C apheresis as first‐line treatment in patients with homozygous FH and after drug therapy failure in patients with heterozygous FH. Additionally, guidelines typically recommended weekly or biweekly LDL‐C apheresis treatments conducted at apheresis centers that may last 2 to >3 hours per session. Studies reported a range for mean LDL‐C reduction after apheresis: 57–75% for patients with homozygous FH and 58–63% for patients with heterozygous FH. Calculated annual costs (in US$2015) may reach US$66 374 to US$228 956 per patient for weekly treatment.Conclusions LDL‐C apheresis treatment may be necessary for patients with FH when drug therapy is inadequate in reducing LDL‐C to target levels. While apheresis reduces LDL‐C, high per‐session costs and the frequency of guideline‐recommended treatment result in substantial annual costs, which are barriers to the optimal treatment of FH.

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Section: Resultsmentioning

confidence: 99%

Systematic Review of Low‐Density Lipoprotein Cholesterol Apheresis for the Treatment of Familial Hypercholesterolemia

Wang¹,

Richhariya

Gandra

et al. 2016

JAHA

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“…In one of our patients, vascular access for LDL-A was achieved in the same manner as in hemodialysis patients. However, while LDL-A is effective in reducing the levels of LDL-C, the effect is short-lived, and the LDL-C levels reach abnormal values within 1 or 2 weeks (13,14). On the other hand, LDL-A has pleiotropic effects, which include the improvement the vascular endothelial function by decreasing the oxidative stress responses and inhibiting nitric oxide synthesis (15), and the improvement of the rheological properties of the blood (16,17).…”

Section: Discussionmentioning

confidence: 99%

“…Hence, aside from its ability to lower the LDL-C levels, LDL-A may be more effective in alleviating arteriosclerotic disease. On the other hand, evolocumab may have the advantage of continuously maintaining low LDL-C levels, whereas these levels are expected to recover within 1 to 2 weeks after an LDL-A session (13,14). Furthermore, as of 2016, the cost of evolocumab therapy (140 mg, twice per month) in Japan amounts to approximately one-third of the cost associated with LDL-A (once per month), which represents another advantage of evolocumab therapy.…”

Section: Discussionmentioning

confidence: 99%

Two Patients with Familial Hypercholesterolemia Who Were Successfully Weaned from Low-density Lipoprotein Apheresis after Treatment with Evolocumab

et al. 2017

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Two elderly patients (a 76-year-old man and a 75-year-old woman), who had been previously diagnosed with familial hypercholesterolemia (at 58 and 48 years of age, respectively) underwent long-term treatment with oral therapy and low-density lipoprotein (LDL) apheresis. As their LDL cholesterol levels remained high (>150 mg/dL and >120 mg/dL, respectively) and their familial hypercholesterolemia was complicated with angina pectoris, we added evolocumab to their prescription. Thereafter, their LDL cholesterol levels decreased rapidly, and the patients were successfully weaned from LDL apheresis. Evolocumab therapy should thus be considered when LDL apheresis cannot achieve the target LDL cholesterol levels, though the prognosis of such treatment remains unclear.

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“…A sample size of 63 patients (2:1 ratio; alirocumab 42: placebo 21) is required to provide $85% power to detect a 33% difference in mean apheresis rates using a 2-sided significance level and assuming a standard deviation of 40%. 34…”

Section: Statistical Analysesmentioning

confidence: 99%

Alirocumab in patients with heterozygous familial hypercholesterolemia undergoing lipoprotein apheresis: Rationale and design of the ODYSSEY ESCAPE trial

Moriarty

Parhofer²,

Babirak³

et al. 2016

Journal of Clinical Lipidology

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Atorvastatin in low-density lipoprotein apheresis-treated patients with homozygous and heterozygous familial hypercholesterolemia

Cited by 15 publications

References 0 publications

Systematic Review of Low‐Density Lipoprotein Cholesterol Apheresis for the Treatment of Familial Hypercholesterolemia

Systematic Review of Low‐Density Lipoprotein Cholesterol Apheresis for the Treatment of Familial Hypercholesterolemia

Two Patients with Familial Hypercholesterolemia Who Were Successfully Weaned from Low-density Lipoprotein Apheresis after Treatment with Evolocumab

Alirocumab in patients with heterozygous familial hypercholesterolemia undergoing lipoprotein apheresis: Rationale and design of the ODYSSEY ESCAPE trial

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