Selective removal of plasma low density lipoprotein with the HELP system: biweekly versus weekly therapy.
OBJECTIVE
Biweekly (once every 2 weeks) heparin-induced extracorporeal low-density lipoprotein (LDL) precipitation (HELP) therapy was evaluated for safety and efficacy in selectively reducing LDL cholesterol levels compared with weekly HELP therapy.


METHODS
Biweekly treatments were given to high-risk, diet/drug resistant hypercholesterolemic patients (n = 23) after 6 months of weekly HELP therapy. Lipids, lipoprotein cholesterol, apolipoproteins A-I and B, and fibrinogen were measured on plasma samples before and after treatment.


RESULTS
Mean plasma volume treated was 2.8 l and mean treatment duration 1.7 h. Therapy complications were minimal. In 98% of 268 biweekly HELP treatments, LDL cholesterol levels were reduced by > 30%. For patients completing 6 months of biweekly therapy following 6 months' weekly therapy (n = 23), mean LDL cholesterol levels were reduced 138.5 mg/dl (111.2 mg/dl weekly) with a time-averaged decrease from mean pre-apheresis levels of 33% for biweekly therapy (39% weekly). Mean total cholesterol (161.2 mg/dl biweekly versus 132.9 weekly) and apolipoprotein B (104.6 mg/dl versus 92.6) levels were also reduced with each treatment. Mean HDL cholesterol was reduced only 6.1 mg/dl (6.3 mg/dl weekly).


CONCLUSIONS
Biweekly HELP treatments can safely reduce LDL cholesterol levels as consistently as weekly HELP treatments. However, the higher pre-treatment LDL cholesterol levels with biweekly treatments may produce less therapeutic benefit than with weekly therapy.
Lane
D M
DM
Oklahoma Medical Research Foundation, Oklahoma City 73104, USA.
McConathy
W J
WJ
Laughlin
L O
LO
Comp
P C
PC
von Albertini
B
B
Bricker
L A
LA
Kozlovskis
P
P
Lees
R S
RS
Dorrier
C
C
D001781:Blood Component Removal / Q000379:methods*; D008078:Cholesterol, LDL / Q000097:blood*; D005112:Extracorporeal Circulation; D005260:Female; D006493:Heparin / Q000494:pharmacology; D006801:Humans; D006937:Hypercholesterolemia / Q000628:therapy*; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008722:Methods; D008875:Middle Aged
D008078:Cholesterol, LDL; D008077:Lipoproteins, LDL; D006493:Heparin