title: Efficacy criteria and cholesterol targets for LDL apheresis.
abstract: Low density lipoprotein (LDL) apheresis is now accepted as the treatment of choice for patients with homozygous familial hypercholesterolaemia and for heterozygotes with cardiovascular disease refractory to lipid-lowering drug therapy. However, a paucity of evidence has meant that detailed guidance on the extent of cholesterol reduction required to prevent the onset or progression of cardiovascular disease in these high risk patients is lacking. This review defines criteria for expressing the efficacy of apheresis, proposes target levels of total and LDL cholesterol for homozygotes and heterozygotes based on recent follow-up studies and suggests a scheme for monitoring cardiovascular disease in these patients. Establishing a uniform approach to data collection would facilitate the setting up of national or multi-national registers and might eventually provide the information needed to formulate evidence-based guidelines for LDL apheresis.
authors: Imperial College, Hammersmith Hospital, London W12 0NN, United Kingdom. g.thompson@imperial.ac.uk
authors: Gilbert R
authors: GR
authors: Thompson
authors: M
authors: M
authors: Barbir
authors: D
authors: D
authors: Davies
authors: P
authors: P
authors: Dobral
authors: M
authors: M
authors: Gesinde
authors: M
authors: M
authors: Livingston
authors: P
authors: P
authors: Mandry
authors: A D
authors: AD
authors: Marais
authors: S
authors: S
authors: Matthews
authors: C
authors: C
authors: Neuwirth
authors: A
authors: A
authors: Pottle
authors: C
authors: C
authors: le Roux
authors: D
authors: D
authors: Scullard
authors: C
authors: C
authors: Tyler
authors: S
authors: S
authors: Watkins
mesh_terms: D000293:Adolescent; D000328:Adult; D001781:Blood Component Removal / Q000592:standards*; D002318:Cardiovascular Diseases / Q000628:therapy; D002648:Child; D008078:Cholesterol, LDL / Q000378:metabolism*; D006579:Heterozygote; D006720:Homozygote; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000628:therapy*; D007700:Kinetics; D008055:Lipids / Q000737:chemistry; D008077:Lipoproteins, LDL / Q000378:metabolism*; D015203:Reproducibility of Results; D013997:Time Factors
chemical_list: D008078:Cholesterol, LDL; D008055:Lipids; D008077:Lipoproteins, LDL