Low-density lipoprotein apheresis in familial hypercholesterolemia resistant to intensive medical treatment

Medicina clínica
Cristina ArbonaJuan Francisco Ascaso

Abstract

The aim of our study is to analyze the effect and security of low-density lipoproteins (LDL) apheresis in familial hypercholesterolemia (FH) subjects who did not response to conventional intensive optimized medical treatment. Seven heterozygous FH subjects and one homozygous apoB familial defective were studied. All subjects were on secondary prevention with highest statins doses in association with other hypolipemiant drugs; the mean LDL-C reduction was 20%. All of them were treated with LDL apheresis (immunoabsorption) for a mean of 4.25 years. LDL apheresis resulted in a 68.3% decrease in LDL-C and 58.2% in apoB plasma values (P<.001). After an average of 3 years of follow-up, the cardiovascular events disappeared in 4 out of 5 symptomatic patients while in one patient the events were reduced in 75%. Four moderate side effects were reported in 820 apheresis procedures. LDL apheresis is a well-tolerated and safe treatment in FH patients who do not response to intensive conventional optimized medical treatment. The main limitation is its economical cost and low accessibility.

References

Jul 17, 2004·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Thomas Bosch, Thorsten Wendler
Mar 29, 2008·Atherosclerosis·G R Thompson, UNKNOWN HEART-UK LDL Apheresis Working Group
Feb 5, 2010·Atherosclerosis. Supplements·Ulrich JuliusStefan R Bornstein
May 11, 2010·Endocrinología y nutrición : órgano de la Sociedad Española de Endocrinología y Nutrición·Juan F Ascaso
Oct 12, 2010·Current Opinion in Lipidology·Gilbert R ThompsonKlaus G Parhofer
Aug 13, 2011·Journal of Clinical Apheresis·Jeffrey L Winters

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Citations

Sep 18, 2013·Clínica e investigación en arteriosclerosis : publicación oficial de la Sociedad Española de Arteriosclerosis·Lluís MasanaÀngels Pedragosa
Jun 19, 2013·Medicina clínica·José María Mostaza, Carlos Lahoz
Jan 8, 2018·BMJ Case Reports·José RealJuan Francisco Ascaso

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