Long-term effects of low-density lipoprotein apheresis using an automated dextran sulfate cellulose adsorption system

Bruce R. Gordon, Sheryl F. Kelsey, Peter C. Dau, Antonio M. Gotto, Kevin Graham, D. Roger Illingworth, Jonathan Isaacsohn, Peter H. Jones, Susan F. Leitman, Stuart D. Saal, Evan A. Stein, Thomas N. Stern, August Troendle, Robert J. Zwiener

Research output: Contribution to journalArticle

92 Scopus citations

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 far 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.

Original languageEnglish (US)
Pages (from-to)407-411
Number of pages5
JournalAmerican Journal of Cardiology
Volume81
Issue number4
DOIs
StatePublished - Feb 15 1998

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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