Related Experiment Video
Updated: Jan 31, 2026
06:47
Isolation and Analysis of Plasma Lipoproteins by Ultracentrifugation
Published on: January 28, 2021
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Apheresis for severe hypercholesterolaemia and elevated lipoprotein(a)
Elisa Waldmann1, Klaus G Parhofer1
1Medical Department IV - Grosshadern, University Munich, Munich, Germany.
Pathology
|January 7, 2019
Summary
Lipoprotein apheresis effectively lowers low-density lipoprotein cholesterol (LDL-c) and lipoprotein(a) [Lp(a)] when standard treatments fail. This cardiovascular risk reduction method, while effective, requires further randomized controlled trials for definitive clinical benefit evidence.
Area of Science:
- Cardiology
- Lipidology
- Cardiovascular Medicine
Background:
- Low-density lipoprotein cholesterol (LDL-c) and lipoprotein(a) [Lp(a)] are independent cardiovascular risk factors.
- Standard treatments like lifestyle modification and medications often fail to achieve guideline-defined goals for LDL-c and Lp(a) reduction.
- Current drugs lack efficiency in lowering Lp(a) or demonstrating clinical benefit from Lp(a) reduction.
Purpose of the Study:
- To evaluate the efficacy of lipoprotein apheresis in reducing LDL-c and Lp(a) levels in patients unresponsive to standard therapies.
- To review the various apheresis systems available and their impact on lipid profiles.
- To discuss the tolerability, cost, and limitations of evidence for lipoprotein apheresis.
Main Methods:
- Review of existing literature on lipoprotein apheresis systems (e.g., HELP, DALI, dextran sulfate, lipid filtration, immunoadsorption).
- Analysis of the impact of apheresis on LDL-c and Lp(a) levels, including reduction percentages per session and mean interval concentrations.
- Discussion of Lipopac as a specific immunapheresis targeting Lp(a).
Main Results:
- Lipoprotein apheresis significantly decreases LDL-c and Lp(a) by approximately 65% per session.
- Weekly or biweekly apheresis results in approximately 30% reduction in mean interval concentrations.
- Most apheresis systems reduce both LDL-c and Lp(a), with Lipopac specifically targeting Lp(a).
Conclusions:
- Lipoprotein apheresis is a highly effective treatment for reducing LDL-c and Lp(a) in patients who do not reach treatment goals with standard therapies.
- While well-tolerated, lipoprotein apheresis is costly and time-consuming.
- Current evidence for clinical benefit is primarily observational, highlighting the need for randomized controlled trials.
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