Lipoprotein apheresis is an option for the management of patients with severe hypercholesterolaemia, including those with familial hypercholesterolaemia (FH, inherited high cholesterol), who are inadequately controlled with current pharmacotherapy. In this cohort study, serum PCSK9 levels were measured in 40 patients undergoing lipoprotein apheresis and 10 healthy controls. Lipoprotein apheresis acutely reduced PCSK9 levels (mean reduction 51%); levels subsequently returned to baseline levels 24 hours later.
The authors concluded that reduction of PCSK9 levels by apheresis may improve the effectiveness of lipid-lowering drugs. However, they make the point that monoclonal antibody therapy to PCSK9 may potentially replace lipoprotein apheresis in patients with a very high cardiovascular risk.
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Julius U, Milton M, Stoellner D, Rader D, Gordon B, Polk D, Waldmann E, Parhofer KG, Moriarty PM: Effects of lipoprotein apheresis on PCSK9 levels. Atheroscler Suppl 2015, 18:180-186. PUBMED Link http://www.ncbi.nlm.nih.gov/pubmed/25936324