It is a metabolic disorder which causes elevated LDL cholesterol plasma levels. The reason for Familial Hypercholesterolemia (FH) is a genetically determined and leads to LDL receptor mutation or to a mutation in the lipoprotein ApoB of LDL cholesterol. Lipoprotein a (Lp(a)), which is similar to LDL cholesterol, can also be elevated. Both are independent risk factors for atherosclerosis.
Heterozygous patients of FH have untreated LDL cholesterol levels of 200-500mg/dL, while homozygous patients can even reach levels up to 1000mg/dL and experience their first cardiac event before 20 years if the LDL cholesterol level remains untreated. Lp(a) is recognized as risk factor for atherosclerosis when reaching levels above 30mg/dL.
Apheresis is the treatment of choice for patients with:
Homozygous Familial Hypercholesterolemia
who cannot be treated sufficiently to reach the above mentioned targets by drugs for 12 months due to intolerance or incompatibility of the medication.
This procedure applies after both dietary and drug treatments have been inefficient after a period of 12 months to reach the targeted lipid level while a progressive coronary heart disease is proven.
The patients treated by lipid-apheresis have high elevated LDL cholesterol level, such as in Familiar Hypercholesterolemia, and/or are patients with elevated Lp(a). This procedure is as well appropriate therapy for progressive cardiovascular disease such as coronary heart disease, peripheral artery occlusive disease and cerebrovascular disease.
Yes medication is still needful. The apheresis treatment is additional (on the top) to established lipid lowering therapy.
Lipid apheresis is mainly performed in dialysis centers or on apheresis specialized departments, due to the fact that it is an extra-corporeal treatment with special requirements. Here, the physicians and the personnel staff are familiar with these requirements. The physician in charge has to be entitled to perform lipid apheresis.
It depends on the severity of the lipid disorder and the treatment target level depending on the risk profile. In most cases a treatment frequency of once weekly or even biweekly is sufficient.
One treatment session takes about 1.5-3 hours and is performed as outpatient care.
During Kaneka’s lipid apheresis treatment the patient’s blood circulates outside the body through the LIPOSORBER® dextran sulfate column where it effectively removes LDL cholesterol and Lp(a) from the blood or plasma and thereafter returns to the patient.
It is usually an outpatient treatment.
The LIPOSORBER® treatment is conducted for the last 20 years and therefore fulfills highest requirements. The treatment modality can be individually adjusted. It does not hurt, besides the usual needle puncture in the vein.
In Germany, the apheresis therapy has to be applied for the individual patient by the treating physician at the Kassenärztliche Vereinigung, KV, (national association of statutory health insurance physicians). The KV has to give its approval which usually has to be reapplied after one year.