1. Lipoprotein apheresis is a very efficient but time consuming and expensive method of lowering levels of LDL-C, lipoprotein(a) [Lp(a)] and other apoB-containing lipoproteins, including triglyceride (TG)-rich lipoproteins.
2. Lipoprotein apheresis is typically carried out on a weekly or biweekly schedule. Some methods utilize plasma while others use whole blood.
3. Data from the German Lipoprotein Apheresis Registry, based on over 15,000 apheresis procedures, showed a median acute reduction in LDL-C of 69% and Lp(a) of 70% in hyperlipidemic patients with cardiovascular disease (CVD).
4. The UK Lipoprotein Apheresis Registry showed that the mean reduction in interval mean LDL-C from the pre-procedure baseline was 43.24% and 37.95% for Lp(a).
5. In the ODYSSEY ESCAPE trial, treatment of FH heterozygotes undergoing lipoprotein apheresis with the PCSK9 inhibitors alirocumab resulted in an additional 54% reduction in LDL-C.
6. With respect to elevated LDL-C, there is agreement that patients with homozygous FH inadequately responsive or refractory to lipid-lowering drugs qualify for such treatment.
7. Guidelines also agree that in homozygous FH, apheresis therapy should be started as early as possible, preferably in early childhood.
Dr. SS. Iyengar is a currently associated with Manipal Hospital (Bangalore) is an Interventional Cardiologist who values shared medical decision-making and believes that input from patients and families is as vital to the process as physician input is. He specializes in the prevention, diagnosis and interventional treatment of diseases of the heart and blood vessels such as acute heart attack, heart failure, arthymia, rhythm disturbance, valvoplasty.Having done his MBBS, MD(Medicine),DM(Cardiology) from Pune University,he further went to do his fellowship from Royal College Of Physicians (U.K).
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