Treatment of refractory familial hypercholesterolemia by low-density lipoprotein apheresis using an automated dextran sulfate cellulose adsorption system

Bruce R. Gordon, Sheryl F. Kelsey, David W. Bilheimer, David C. Brown, Peter C. Dau, Antonio M. Gotto, D. Roger Illingworth, Peter H. Jones, Susan F. Leitman, James S. Prihoda, Evan A. Stein, Thomas N. Stern, James H. Zavoral, Robert J. Zwiener

Research output: Contribution to journalArticle

89 Scopus citations

Abstract

A subgroup of patients with familial hypercholesterolemia (FH) respond inadequately to standard diet and drug therapy, and are therefore at high risk for the premature development or progression of coronary artery disease. This study evaluated low-density lipoprotein (LDL) cholesterol and lipoprotein (a) removal in a multicenter, controlled trial with a new LDL apheresis procedure (Liposorber® LA-15 System). The study comprised patients with FH who had not responded adequately to diet and maximal drug therapy. There were 54 patients with heterozygous FH (45 randomized to treatment and 9 control subjects) and 10 with homozygous FH (all of whom received LDL apheresis). The study included three 6-week treatment phases and a 4-week rebound phase. Treatments were administered at 7- to 14-day intervals. Mean acute reductions in LDL cholesterol were 76% in eterozygous FH patients and 81% in homozygous ones. Time-averaged levels of LDL cholesterol were reduced 41% (243 to 143 mg/dl) in heterozygous FH patients and 53% (447 to 210 mg/dl) in homozygous ones. The substantial acute reduction of lipoprotein (a) (means: 65%, heterozygous FH; 68%, homozygous FH) has not been reported with other therapies. The Liposorber LA 15 System represents an important therapeutic option in FH patients who respond inadequately to diet and drug therapy.

Original languageEnglish (US)
Pages (from-to)1010-1016
Number of pages7
JournalThe American Journal of Cardiology
Volume70
Issue number11
DOIs
StatePublished - Oct 15 1992

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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