LDL-Therasorb immunoadsorption for the treatment of severe hypercholesterolemia refractory to conventional therapy

The role of severe hypercholesterolemia (SH) as a major risk factor for coronary heart disease has been well established. Not all patients with SH can be treated sufficiently with diet and drugs. In such circumstances, extracorporeal removal of low-density lipoprotein (LDL) cholesterol is required in patients with existing atherosclerosis. The chronic regular application of extracorporeal cholesterol removal demands an efficient and selective method not influencing other plasma components. Several methods have been developed for the extracorporeal reduction of LDL cholesterol using different approaches to achieve selectivity. Today the most selective approach is the use of specific antibodies directed against apolipoprotein B-100. For 17 years, this method has been used in the therapy of patients with SH. Numerous publications demonstrate the safety and efficacy of immunoadsorption (IA) with the LDL-Therasorb System. Within an IA treatment, LDL cholesterol is reduced by 60-70%. The system, however, allows for any desired reduction in the cholesterol levels because the double column system can be alternately loaded and regenerated to enable virtually unlimited treatment of plasma. The treatable plasma quantity is not limited by the nonspecific removal of other plasma components, e.g., coagulation factors, fibrinogen, plasminogen, or immunoglobulins. In long-term studies, the influence of LDL-Therasorb IA on coronary and peripheral atherosclerotic disease has been shown to have a favorable influence on the development of stenoses. In the majority of patients, a stop of progression and even a regression of stenoses could be demonstrated.