Adverse events of lipoprotein apheresis and immunoadsorption at the Apheresis Center at the University Hospital Dresden

Dittrich-Riediger, J.; Schatz, Ulrike; Hohenstein, Bernd; Julius, Ulrich

doi:10.1016/j.atherosclerosissup.2015.02.007

Cited by 22 publications

(22 citation statements)

References 25 publications

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“…Representative long-term safety analyses of 2 of the study sites have recently been published. 11,12 Mean plasma concentrations of creatinine and fibrinogen remained stable throughout the entire study period. The patient group included 3 hemodialysis patients, 2 of whom died in y+2 or y+3 (see the analysis of events below) and 1 patient who successfully received a kidney transplant in y+4.…”

Section: Safety Of La Treatmentmentioning

confidence: 85%

Lipoprotein Apheresis for Lipoprotein(a)-Associated Cardiovascular Disease

Roeseler

Julius

Heigl

et al. 2016

ATVB

174

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Objective— Lipoprotein(a)-hyperlipoproteinemia (Lp(a)-HLP) along with progressive cardiovascular disease has been approved as indication for regular lipoprotein apheresis (LA) in Germany since 2008. We aimed to study the long-term preventive effect of LA and to assess hypothetical clinical correlations of apolipoprotein(a) (apo(a)) by analyzing genotypes and phenotypes. Approach and Results— This prospective observational multicenter study included 170 patients with Lp(a)-HLP and progressive cardiovascular disease (48.9 years median age at diagnosis) despite other cardiovascular risk factors, including low-density lipoprotein cholesterol had maximally been treated (mean baseline low-density lipoprotein cholesterol: measured, 2.56 mmol/L [98.9 mg/dL] and corrected, 1.72 mmol/L [66.3 mg/dL]). Patients were prospectively investigated during a 5-year period about annual incidence rates of cardiovascular events. In addition, apo(a) isoforms and polymorphisms at the apo(a) gene ( LPA ) were characterized. One hundred fifty-four patients (90.6%) completed 5 years of follow-up. Mean Lp(a) concentration before commencing regular LA was 108.1 mg/dL. This was reduced by a single LA treatment by 68.1% on average. Significant decline of the mean annual cardiovascular event rate was observed from 0.58±0.53 2 years before regular LA to 0.11±0.15 thereafter ( P <0.0001); 95.3% of patients expressed at least 1 small apo(a) isoform. Small apo(a) isoform (35.2%) carrying phenotypes were not tagged by single-nucleotide polymorphisms rs10455872 or rs3798220. Conclusions— Results of 5 years of prospective follow-up confirm that LA has a lasting effect on prevention of cardiovascular events in patients with Lp(a)-HLP. Patients clinically selected by progressive cardiovascular disease were characterized by a highly frequent expression of small apo(a) isoforms. Only Lp(a) concentration seemed to comprehensively reflect Lp(a)-associated cardiovascular risk, however.

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Section: Safety Of La Treatmentmentioning

confidence: 85%

Lipoprotein Apheresis for Lipoprotein(a)-Associated Cardiovascular Disease

Roeseler

Julius

Heigl

et al. 2016

ATVB

174

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“…In some patients on regular apheresis, iron deficiency and anemia may develop, which may necessitate iron substitution. However, generally speaking, all apheresis methods are tolerated well (17). The different principles underlying the different apheresis systems are shown in Fig.…”

Section: Methodsmentioning

confidence: 99%

Lipoprotein apheresis to treat elevated lipoprotein (a)

Waldmann

Parhofer

2016

Journal of Lipid Research

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“…The average time needed for a 60-70% elimination rate of circulating LDL is approximately 2-3 h . DFPP is a well-tolerated method with minimal, or generally mild, side effects Dittrich-Riediger et al, 2015). Both pre-clinical and clinical trials were performed to prove the efficacy and safety of DFPP in this setting, and the results seem promising so far (Eckes et al, 2011).…”

Section: Extracorporeal Apheresis Systemmentioning

confidence: 99%

Extracorporeal apheresis system - A nanoparticle drugs' elimination method to enhance the benefit of cytostatic therapy in cancer patients

Filip¹,

Kubeček²,

Špaček³

et al. 2016

JAB

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ToxicityDrug delivery system a b s t r a c t Cytostatic treatment is often negatively affected by dose-limited toxicities. Novel agents, including nanoparticle-based drug delivery systems (DDS), are becoming available to overcome this problem. Despite achieving a lesser toxicity in exchange for more favorable pharmacokinetic profiles, the use of DDS is often associated with a particular toxicity profile.The accumulation of DDS in tumor tissue is much faster than in normal tissues where toxic events occur. While only a small amount of DDS is delivered to the target tissue, and accumulated there, most of the administered dose remains in circulation. The removal of this fraction, which is no longer effective, is thought to reduce toxicity. Pegylated liposomal doxorubicin (PLD) has been proven to be effective in platinum-resistant ovarian carcinoma with the reduced risk for cardiotoxicity. Once saturation in tumor tissue is achieved, prolonged circulation seems ineffective, whereas other toxicity risks (palmar-plantar erythrody sesthesia and mucositis) have been reported. Therefore, extracorporeal elimination of circulating nanoparticles using plasma filtration would probably reduce this risk of toxicity.The elimination rate could be kinetically regulated, i.e. based on individual doxorubicin pharmacokinetic variables. Plasma filtration can significantly influence the exposure to PLD (plasma concentration-time profile-AUC of PLD) and would be a suitable, well tolerated method enabling individualized, more effective and safer chemotherapy.

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Adverse events of lipoprotein apheresis and immunoadsorption at the Apheresis Center at the University Hospital Dresden

Cited by 22 publications

References 25 publications

Lipoprotein Apheresis for Lipoprotein(a)-Associated Cardiovascular Disease

Lipoprotein Apheresis for Lipoprotein(a)-Associated Cardiovascular Disease

Lipoprotein apheresis to treat elevated lipoprotein (a)

Extracorporeal apheresis system - A nanoparticle drugs' elimination method to enhance the benefit of cytostatic therapy in cancer patients

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