Toward an international consensus—Integrating lipoprotein apheresis and new lipid-lowering drugs
Year: 2017
Type: article
Abstract: BACKGROUND: Despite advances in pharmacotherapy of lipid disorders, many dyslipidemic patients do not attain sufficient lipid lowering to mitigate risk of atherosclerotic cardiovascular disease. Several classes of novel lipid-lowering agents are being evaluated to reduce atherosclerotic cardiovascular disease risk. Lipoprotein apheresis (LA) is effective in acutely lowering the plasma concentrations of atherogenic lipoproteins including low-density lipoprotein cholesterol and lipoprotein(a), and novel lipid-lowering drugs may dampen the lipid rebound effect of LA, with the possibility that LA frequency may be decreased, in some cases even be discontinued. SOURCES OF MATERIAL: This document builds on current American Society for Apheresis guidelines and, for the first time, makes recommendations from summarized data of the emerging lipid-lowering drug classes (inhibitors of proprotein convertase subtilisin/kexin type 9 or microsomal triglyceride transfer protein, high-density lipoprotein mimetic), including the available evidence on combination therapy with LA with respect to the management of patients with dyslipidemia. ABSTRACT OF FINDINGS: Recommendations for different indications are given based on the latest evidence. However, except for lomitapide in homozygous familial hypercholesterolemia and alirocumab/evolocumab in heterozygous familial hypercholesterolemia subjects, limited data are available on the effectiveness and safety of combination therapy. More studies on combining LA with novel lipid-lowering drugs are needed. CONCLUSION: Novel lipid-lowering agents have potential to improve the performance of LA, but more evidence is needed. The Multidisciplinary International Group for Hemapheresis TherapY and Metabolic DIsturbances Contrast scientific society aims to establish an international registry of clinical experience on LA combination therapy to expand the evidence on this treatment in individuals at high cardiovascular disease risk.
Source: Journal of clinical lipidology
Authors: Claudia Stefanutti, Ulrich Julius, Gerald F. Watts, Mariko Harada-Shiba, Maria Cossu, Volker J. Schettler, Giustina De Silvestro, Handrean Soran, Jeanine Roeters Van Lennep, Livia Pisciotta, Hans U. Klör, Kurt Widhalm, Patrick M. Moriarty, Giovanna D'Alessandri, Giorgio Bianciardi, Giovanna Bosco, Giulia De Fusco, Serafina Di Giacomo, Claudia Morozzi, Dario Mesce, Marco Vitale, Barbara Sovrano, Euridiki Drogari, Nils Ewald, Gianfranco Gualdi, Beate R. Jaeger, Alessandro Lanti, Piero Marson, Francesco Martino, Giuseppe Migliori, Tiziano Parasassi, Antonio Pavan, Francesco Massimo Perla, Roberto Brunelli, Giuseppina Perrone, Salvatorica Renga, Wolfgang Ries, Nicola Romano, Stefano Romeo, Mario Pergolini, Giancarlo Labbadia, Biagio Di Iorio, Tommaso De Palo, Rosanna Abbate, Rossella Marcucci, Lorella Poli, Gianluigi Ardissino, Piero Ottone, Tiziana Tison, Elda Favari, Leonardo Borgese, Manhaz Shafii, Maria Gozzer, Elena Pacella, Concetta Torromeo, Tiziana Parassassi, Andrea Berni, Ornella Guardamagna, Maria Grazia Zenti, Maria Rita Guitarrini, Daniele Berretti, Bernd Hohenstein, Samir Saheb, Bojko Bjelakovic, Helen Williams, De Luca N
Institutions: Policlinico Umberto I, Sapienza University of Rome, University Hospital Carl Gustav Carus, Technische Universität Dresden, The University of Western Australia, Royal Perth Hospital, National Cerebral and Cardiovascular Center, Azienda Ospedaliero Universitaria di Sassari, Nephrologisches Zentrum Goettingen, University of Padua, Azienda Ospedale - Università Padova, Manchester Royal Infirmary, University of Manchester, Erasmus MC, Ospedale Policlinico San Martino, University of Genoa, University of Kansas Medical Center
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,510
OpenAlex ID: W2608926410