PMID- 10225746
OWN - NLM
STAT- MEDLINE
DCOM- 19990527
LR  - 20191103
IS  - 1091-6660 (Print)
IS  - 1091-6660 (Linking)
VI  - 1
IP  - 3
DP  - 1997 Aug
TI  - Low-density lipoprotein apheresis for prevention and regression of 
      atherosclerosis: clinical results.
PG  - 242-8
AB  - Hypercholesterolemia can be adequately controlled by appropriate diet and maximum 
      lipid lowering drug therapy in most patients. Nevertheless, there exists a group 
      of patients, including those with familial hypercholesterolemia (FH), who remain 
      at high risk for the development or progression of premature coronary heart 
      disease (CHD). For these patients additional measures such as surgery and 
      low-density lipoprotein (LDL) apheresis have to be considered. The objective of 
      this multicenter trial, which included 30 clinical centers (28 in Germany and one 
      each in Scotland and Luxembourg), was to determine if repeated LDL apheresis 
      using the Liposorber LA-15 system (Kaneka Corporation, Osaka, Japan) could lead 
      to an additional acute and time averaged lowering of total cholesterol (TC) and 
      LDL-cholesterol (LDL-C) in severely hypercholesterolemic patients whose 
      cholesterol levels could not be controlled by appropriate diet and maximum drug 
      therapy. A total of 6,798 treatments were performed on 120 patients, including 8 
      with homozygous FH, 75 with heterozygous FH, and 37 with unclassified FH or other 
      hyperlipidemias from 1988 through 1994. The mean TC and mean LDL-C levels at 
      baseline were 410.0 mg/dl and 333.9 mg/dl, respectively. LDL apheresis was 
      performed once a week or at least once every 2 weeks in all patients. During 
      treatment with the Liposorber system the mean acute percentage reduction was 
      52.6% for TC and 63.1% for LDL-C. Very low density lipoprotein cholesterol 
      (VLDL-C) and triglycerides (TG) were also substantially reduced to 60.6% and 
      47.5%, respectively. Fibrinogen, a potential risk factor for CHD, was reduced by 
      26.2%. In contrast, the mean acute reduction of high density lipoprotein (HDL) 
      was only 3.4%. During the course of the treatment, the time averaged levels of TC 
      and LDL-C were reduced by approximately 39% and 50%, respectively, compared to 
      baseline levels. The adverse events (AEs) were those generally associated with 
      extracorporeal treatments. The most common AE was hypotension, with 69 episodes 
      corresponding to 1% of all treatments reported in 44 of the 120 patients treated. 
      All other kinds of AEs occurred in less than 0.2% of the treatments. The 
      treatment with the Liposorber LA-15 system was overall well tolerated. It should 
      be noted, however, that a more severe type of hypotensive reaction associated 
      with flush, bradycardia, and dyspnea was reported in patients taking concomitant 
      angiotensin converting enzyme (ACE) inhibitor medication. Except for such 
      anaphylactoid-like reactions associated with the intake of ACE inhibitors, the 
      Liposorber LA-15 system represents a safe and effective therapeutic option for 
      patients suffering from severe hypercholesterolemia that could not be adequately 
      controlled by diet and maximum drug therapy.
FAU - Bambauer, R
AU  - Bambauer R
AD  - German Clinical Trial Group, Homburg/Saar, Germany.
FAU - Olbricht, C J
AU  - Olbricht CJ
FAU - Schoeppe, E
AU  - Schoeppe E
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - Ther Apher
JT  - Therapeutic apheresis : official journal of the International Society for 
      Apheresis and the Japanese Society for Apheresis
JID - 9706703
RN  - 0 (Cholesterol, LDL)
RN  - 97C5T2UQ7J (Cholesterol)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Arteriosclerosis/blood/etiology/*prevention & control
MH  - Blood Cell Count
MH  - *Blood Component Removal/methods
MH  - Child
MH  - Cholesterol/blood
MH  - Cholesterol, LDL/*blood
MH  - Disease Progression
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Hyperlipoproteinemia Type II/blood/complications/therapy
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Safety
EDAT- 1997/08/01 00:00
MHDA- 1999/05/04 00:01
CRDT- 1997/08/01 00:00
PHST- 1997/08/01 00:00 [pubmed]
PHST- 1999/05/04 00:01 [medline]
PHST- 1997/08/01 00:00 [entrez]
AID - 10.1111/j.1744-9987.1997.tb00145.x [doi]
PST - ppublish
SO  - Ther Apher. 1997 Aug;1(3):242-8. doi: 10.1111/j.1744-9987.1997.tb00145.x.