Apheresis: What Should a Clinician Know?

Area of Science:

• Cardiovascular Medicine
• Lipidology

Background:

• Apheresis has been clinically practiced for approximately 40 years for severe dyslipidemia.
• The advent of potent LDL-lowering drugs has diminished apheresis's role in common LDL-hypercholesterolemia.

Purpose of the Study:

• To review recent advancements in apheresis research.
• Focus on apheresis for elevated LDL-cholesterol and elevated lipoprotein(a).

Main Methods:

• Review of recent apheresis research.
• Analysis of apheresis efficacy in specific dyslipidemia types.

Main Results:

• Apheresis significantly reduces LDL-cholesterol, apoB, and lipoprotein(a) by ~65% per session.
• Achieves a time-averaged reduction of 30-50% in target lipids.
• Apheresis is well-tolerated, safe, and effective for specific patient groups.

Conclusions:

• Apheresis remains a vital treatment for severe dyslipidemia, particularly homozygous familial hypercholesterolemia and elevated lipoprotein(a).
• It is indicated when conventional therapies do not meet treatment targets.
• Despite being time-consuming and expensive, its safety and efficacy are well-established.