title: Long-term effects of low-density lipoprotein apheresis using an automated dextran sulfate cellulose adsorption system. Liposorber Study Group.
abstract: The short-term effectiveness of low-density lipoprotein (LDL) apheresis using a dextran sulfate cellulose adsorption column technique was previously examined in a 9-center, 22-week controlled trial in 64 patients with familial hypercholesterolemia (FH) who did not adequately respond to diet and drug therapy. Forty-nine patients (40 treatment, 9 controls) subsequently received LDL apheresis procedures as part of an optional follow-up phase. This study reports on the long-term safety, lipid lowering, and clinical efficacy of LDL apheresis for the 5-year period that includes both the initial controlled study and follow-up phase. During this time, patients received a total of 3,902 treatments of which 3,314 treatments were given during the follow-up phase. Adverse events were infrequent, occurring in 142 procedures (3.6%). Immediate reduction in LDL cholesterol was 76% both in homozygotes and in heterozygotes. Patients with homozygous FH had a progressive decrease in pretreatment LDL cholesterol level along with an increase in high-density lipoprotein (HDL) cholesterol level. There was no appreciable change in pretreatment lipoprotein level over time in heterozygotes. The rate of cardiovascular events during therapy with LDL apheresis and lipid-lowering drugs was 3.5 events per 1,000 patient-months of treatment compared with 6.3 events per 1,000 patient-months for the 5 years before LDL apheresis therapy. These findings support the long-term safety and clinical efficacy of LDL apheresis in patients with heterozygous and homozygous FH who are inadequately controlled with drug therapy.
authors.affiliation: Rogosin Institute, New York Hospital-Cornell Medical Center, New York 10021, USA.
authors.forename: B R
authors.initials: BR
authors.lastname: Gordon
authors.forename: S F
authors.initials: SF
authors.lastname: Kelsey
authors.forename: P C
authors.initials: PC
authors.lastname: Dau
authors.forename: A M
authors.initials: AM
authors.lastname: Gotto
authors.forename: K
authors.initials: K
authors.lastname: Graham
authors.forename: D R
authors.initials: DR
authors.lastname: Illingworth
authors.forename: J
authors.initials: J
authors.lastname: Isaacsohn
authors.forename: P H
authors.initials: PH
authors.lastname: Jones
authors.forename: S F
authors.initials: SF
authors.lastname: Leitman
authors.forename: S D
authors.initials: SD
authors.lastname: Saal
authors.forename: E A
authors.initials: EA
authors.lastname: Stein
authors.forename: T N
authors.initials: TN
authors.lastname: Stern
authors.forename: A
authors.initials: A
authors.lastname: Troendle
authors.forename: R J
authors.initials: RJ
authors.lastname: Zwiener
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001781:Blood Component Removal; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood*; D016264:Dextran Sulfate; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000097:blood / Q000628:therapy*; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
chemical_list: D008077:Lipoproteins, LDL; D014280:Triglycerides; D016264:Dextran Sulfate; D002784:Cholesterol