Therapy of severe familial heterozygous hypercholesterolemia by low-density lipoprotein apheresis with immunoadsorption : effects of the addition of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors to therapy

To establish whether additional therapy with 3-hydroxy-3-methylglutaryl (HMG) coenzyme A (CoA) reductase inhibitors enhances the low-density lipoprotein (LDL) cholesterol lowering effect of LDL apheresis with immunoadsorption in the treatment of patients with familial heterozygous hypercholesterolem...

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Bibliographic Details
Published in:The Clinical Investigator 1993-11, Vol.71 (11), p.908-912
Main Authors: JACOB, B. G, RICHTER, W. O, SCHWANDT, P
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Blood Component Removal - methods
Combined Modality Therapy
Female
General and cellular metabolism. Vitamins
Heterozygote
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Hyperlipoproteinemia Type II - genetics
Hyperlipoproteinemia Type II - therapy
Immunosorbent Techniques
Lipoproteins, LDL - isolation & purification
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
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Summary:To establish whether additional therapy with 3-hydroxy-3-methylglutaryl (HMG) coenzyme A (CoA) reductase inhibitors enhances the low-density lipoprotein (LDL) cholesterol lowering effect of LDL apheresis with immunoadsorption in the treatment of patients with familial heterozygous hypercholesterolemia and coronary artery disease we studied eight patients initially on immunoadsorption therapy alone for 3 years. The adding of HMG CoA reductase inhibitors decreased pretreatment LDL cholesterol from 6.76 +/- 0.98 to 4.97 +/- 0.98 mmol/l and posttreatment LDL cholesterol from 2.33 +/- 0.80 to 1.94 +/- 0.67 mmol/l and increased pre- and posttreatment high-density lipoprotein (HDL) cholesterol by 0.08 and 0.13 mmol/l respectively. The LDL/HDL ratio was reduced from 4.0 to 2.8 (prior to any therapy the ratio was 13.4). The increase in LDL cholesterol between weekly treatments was less steep under the combined therapy. At the same time the treated plasma volume during LDL apheresis could be decreased from 5070 +/- 960 to 4370 +/- 1200 ml. We conclude that in patients with severe familial heterozygous hypercholesterolemia LDL apheresis should be combined with HMG CoA reductase inhibitors.
ISSN:0941-0198
1432-1440
DOI:10.1007/BF00185602