Safety and Tolerability of Long Lasting LDL‐apheresis in Familial Hyperlipoproteinemia

Bláha, M.; Cermanová, Melánie; Bláha, V.; Błażek, M.; Malý, J; Siroký, O; Solichová, Dagmar; Filip, Stanislav; Řeháček, Vít

doi:10.1111/j.1744-9987.2007.00450.x

Cited by 24 publications

(18 citation statements)

References 17 publications

(24 reference statements)

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“…All adverse events were thoroughly documented. In other evaluations such as Blàha et al (2007) [13] and Sachias et al (2005) [14] only the more serious reactions were reported. In the Dresden center adverse events occurred in 7.7% of all treatments.…”

Section: Discussionmentioning

confidence: 86%

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

Dittrich-Riediger

Schatz

Hohenstein

et al. 2015

Atherosclerosis Supplements

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Section: Discussionmentioning

confidence: 86%

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

Dittrich-Riediger

Schatz

Hohenstein

et al. 2015

Atherosclerosis Supplements

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“…The treatment process is assumed to decrease not only cholesterol but also important antioxidants, such as vitamin E and vitamin A (7,(13)(14)(15)(16). Additionally, other active compounds, such as enzymes, can be affected by certain methods of extracorporeal lipoprotein elimination.…”

Section: The Effect Of Ldl-apheresis and Rheohaemapheresismentioning

confidence: 99%

“…Homozygous FH patients usually fail to show any response to pharmacotherapy. LDL-apheresis has become the standard treatment for individuals homozygous for FH (7)(8)(9). In homozygous FH, statins provide a range of responses, decreasing the plasma LDL anywhere from 0% to 48%, with an average of approximately 15% for receptor-negative individuals and approximately 26% for receptor-defective individuals (5).…”

mentioning

confidence: 99%

The Effect of LDL-Apheresis and Rheohaemapheresis Treatment on Vitamin E

Solichová

Bláha

Aufartová

et al. 2015

J Nutr Sci Vitaminol

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A complete change in lifestyle, a strict diet and intensive combined pharmacotherapy (HMG CoA reductase inhibitors are the most important components) are necessary for patients with familial hypercholesterolemia (FH) and provide excellent results in most patients. Unfortunately, these measures are not sufficient for all patients (1-6). Homozygous FH patients usually fail to show any response to pharmacotherapy. LDL-apheresis has become the standard treatment for individuals homozygous for FH (7-9). In homozygous FH, statins provide a range of responses, decreasing the plasma LDL anywhere from 0% to 48%, with an average of approximately 15% for receptor-negative individuals and approximately 26% for receptor-defective individuals (5). LDL-apheresis could be offered to treat symptomatic coronary heart disease in individuals who are heterozygous FH and whose LDL remains high (.160 mg/ dL, 4.2 mmol/L) or decreases by ,40% in response to maximal medical treatment (1).Term LDL-apheresis was originally used in 1981 by Stoffel et al. (10) as an immunoadsorption elimination extracorporeal method (10). Nowadays, "LDL-apheresis" or "lipoprotein apheresis" is used for all types of extracorporeal eliminations of cholesterol. In our study we used a modification of the Stoffel and Borberg LDLapheresis-immunoadsorption method and also double filtration plasmapheresis (the primary filter is replaced by a centrifugal separator), which additionally eliminates fibrinogen and has an influence on rheological properties. For our study we will use for the first mentioned method the term "LDL-apheresis" and for the second mentioned method the term "rheohaemapheresis."LDL-apheresis is an invasive and relatively expensive but safe procedure (11, 12); it decreases cholesterol radically but it is also troubling to the patient's standard AS CR v.v.i., Olomouc, Czech Republic (Received June 26, 2014) Summary Lipid apheresis (extracorporeal lipoprotein elimination) is administered to patients with familial hypercholesterolemia who fail to respond to standard therapy. The nature of the treatment process raises the suspicion that it decreases not only cholesterol but also antioxidants. A group of 12 patients (average age 47617 y, 4 homozygous and 8 heterozygous individuals) with familial hypercholesterolemia treated by LDL-apheresis or rheohaemapheresis for 3-12 y was included in the study. In addition to cholesterol and triacylglycerol levels, vitamin E and vitamin A and also other markers of antioxidant activity were investigated. Nevertheless, the most important determined parameter was the vitamin E/cholesterol ratio in serum and lipoproteins. The results indicate that both extracorporeal elimination methods are effective and suitable ways to treat severe familial hypercholesterolemia, as the LDL fraction of cholesterol decreased by approximately 77% and 66% following LDL-apheresis and rheohaemapheresis, respectively. In addition, the serum vitamin E decreased by 54% and 57% and the decrease of the serum vitamin A was approximately 20%...

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“…Side effects occur in approximately 5.5% of patients and do not appear to differ between LA methods [144]. Vaso-vagal reactions are the most common, presenting as malaise, weakness, or transient hypotension [143]. There is a small risk of hypotension, which can occur in approximately < 1% of patients [144].…”

Section: Adverse Effects and Precautions For Ldl Apheresismentioning

confidence: 99%

“…A common transient symptom in patients is feeling tension in the legs, potentially in the hands and eyelids as well [143]. Side effects occur in approximately 5.5% of patients and do not appear to differ between LA methods [144].…”

Section: Adverse Effects and Precautions For Ldl Apheresismentioning

confidence: 99%

Role of Lipoprotein Apheresis in Cardiovascular Disease Risk Reduction

et al. 2019

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Background and Aim: Elevated low-density lipoprotein cholesterol and/or lipoprotein(a) are established risk factors for cardiovascular disease (CVD). Management of hypercholesterolemia consists of drug therapies, including statins and proprotein convertase subtilisin/kexin type 9 inhibitors. In patients with familial hypercholesterolemia (FH), lipoprotein apheresis (LA) is utilized to control lipid levels. However, LA is not currently a standard therapy for non-FH. This review summarizes the literature regarding LA therapy in CVD prevention. Methods: PubMed/MEDLINE databases were searched using the keywords “LA” and “CVD”. Citations were individually reviewed for relevance. Results: The efficacy of LA was clearly demonstrated, largely based on evidence from observational studies. In patients who are unresponsive to traditional lipid-lowering medications, LA effectively reduced serum lipoprotein levels and adverse cardiovascular events. Conclusion: It was concluded that LA is a safe and effective technique that could be considered in the management of hypercholesterolemia and future risk. Randomized control trials would further support a role for LA as a therapeutic option.

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Safety and Tolerability of Long Lasting LDL‐apheresis in Familial Hyperlipoproteinemia

Cited by 24 publications

References 17 publications

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

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

The Effect of LDL-Apheresis and Rheohaemapheresis Treatment on Vitamin E

Role of Lipoprotein Apheresis in Cardiovascular Disease Risk Reduction

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