Toward an international consensus-Integrating lipoprotein apheresis and new lipid-lowering drugs

Claudia Stefanutti; Ulrich Julius; Gerald F. Watts; Mariko Harada-Shiba; Maria Cossu; Volker J. Schettler; Giustina De Silvestro; Handrean Soran; Jeanine Roeters Van Lennep; Livia Pisciotta; Hans U. Kloer; Kurt Widhalm; Patrick M. Moriarty; MIGHTY MEDIC Multinational Society

doi:10.1016/j.jacl.2017.04.114

Toward an international consensus-Integrating lipoprotein apheresis and new lipid-lowering drugs

Claudia Stefanutti, Ulrich Julius, Gerald F. Watts, Mariko Harada-Shiba, Maria Cossu, Volker J. Schettler, Giustina De Silvestro, Handrean Soran, Jeanine Roeters Van Lennep, Livia Pisciotta, Hans U. Kloer, Kurt Widhalm, Patrick M. Moriarty, MIGHTY MEDIC Multinational Society

UWA Medical School

Research output: Contribution to journal › Review article › peer-review

103 Citations (Scopus)

Abstract

BACKGROUND: Despite advances in pharmacotherapy of lipid disorders, many dyslipidemic patients do not attain sufficient lipid lowering to mitigate risk of atherosclerotic cardiovascular disease. Several classes of novel lipid-lowering agents are being evaluated to reduce atherosclerotic cardiovascular disease risk. Lipoprotein apheresis (LA) is effective in acutely lowering the plasma concentrations of atherogenic lipoproteins including low-density lipoprotein cholesterol and lipoprotein(a), and novel lipid-lowering drugs may dampen the lipid rebound effect of LA, with the possibility that LA frequency may be decreased, in some cases even be discontinued.

SOURCES OF MATERIAL: This document builds on current American Society for Apheresis guidelines and, for the first time, makes recommendations from summarized data of the emerging lipid-lowering drug classes (inhibitors of proprotein convertase subtilisin/kexin type 9 or microsomal triglyceride transfer protein, high-density lipoprotein mimetic), including the available evidence on combination therapy with LA with respect to the management of patients with dyslipidemia.

ABSTRACT OF FINDINGS: Recommendations for different indications are given based on the latest evidence. However, except for lomitapide in homozygous familial hypercholesterolemia and alirocumab/evolocumab in heterozygous familial hypercholesterolemia subjects, limited data are available on the effectiveness and safety of combination therapy. More studies on combining LA with novel lipid-lowering drugs are needed.

CONCLUSION: Novel lipid-lowering agents have potential to improve the performance of LA, but more evidence is needed. The Multidisciplinary International Group for Hemapheresis TherapY and Metabolic DIsturbances Contrast scientific society aims to establish an international registry of clinical experience on LA combination therapy to expand the evidence on this treatment in individuals at high cardiovascular disease risk. (C) 2017 National Lipid Association. Published by Elsevier Inc.

Original language	English
Pages (from-to)	858-871
Number of pages	14
Journal	Journal of Clinical Lipidology
Volume	11
Issue number	4
DOIs	https://doi.org/10.1016/j.jacl.2017.04.114
Publication status	Published - Jul 2017

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Stefanutti, C., Julius, U., Watts, G. F., Harada-Shiba, M., Cossu, M., Schettler, V. J., De Silvestro, G., Soran, H., Van Lennep, J. R., Pisciotta, L., Kloer, H. U., Widhalm, K., Moriarty, P. M., & MIGHTY MEDIC Multinational Society (2017). Toward an international consensus-Integrating lipoprotein apheresis and new lipid-lowering drugs. Journal of Clinical Lipidology, 11(4), 858-871. https://doi.org/10.1016/j.jacl.2017.04.114

@article{190e54d80707447cbbdb7069a180f53b,

title = "Toward an international consensus-Integrating lipoprotein apheresis and new lipid-lowering drugs",

abstract = "BACKGROUND: Despite advances in pharmacotherapy of lipid disorders, many dyslipidemic patients do not attain sufficient lipid lowering to mitigate risk of atherosclerotic cardiovascular disease. Several classes of novel lipid-lowering agents are being evaluated to reduce atherosclerotic cardiovascular disease risk. Lipoprotein apheresis (LA) is effective in acutely lowering the plasma concentrations of atherogenic lipoproteins including low-density lipoprotein cholesterol and lipoprotein(a), and novel lipid-lowering drugs may dampen the lipid rebound effect of LA, with the possibility that LA frequency may be decreased, in some cases even be discontinued.SOURCES OF MATERIAL: This document builds on current American Society for Apheresis guidelines and, for the first time, makes recommendations from summarized data of the emerging lipid-lowering drug classes (inhibitors of proprotein convertase subtilisin/kexin type 9 or microsomal triglyceride transfer protein, high-density lipoprotein mimetic), including the available evidence on combination therapy with LA with respect to the management of patients with dyslipidemia.ABSTRACT OF FINDINGS: Recommendations for different indications are given based on the latest evidence. However, except for lomitapide in homozygous familial hypercholesterolemia and alirocumab/evolocumab in heterozygous familial hypercholesterolemia subjects, limited data are available on the effectiveness and safety of combination therapy. More studies on combining LA with novel lipid-lowering drugs are needed.CONCLUSION: Novel lipid-lowering agents have potential to improve the performance of LA, but more evidence is needed. The Multidisciplinary International Group for Hemapheresis TherapY and Metabolic DIsturbances Contrast scientific society aims to establish an international registry of clinical experience on LA combination therapy to expand the evidence on this treatment in individuals at high cardiovascular disease risk. (C) 2017 National Lipid Association. Published by Elsevier Inc.",

keywords = "Dyslipidemia, Lipoprotein apheresis, Familial, hypercholesterolemia, Lp(a), hyperlipoproteinemia, MTP inhibition, PCSK9 inhibition, HDL mimetic, LDL-cholesterol, Lipoproteins, HOMOZYGOUS FAMILIAL HYPERCHOLESTEROLEMIA, CONVERTASE SUBTILISIN/KEXIN 9, TRIGLYCERIDE TRANSFER PROTEIN, PLACEBO-CONTROLLED TRIAL, HIGH CARDIOVASCULAR RISK, LDL-CHOLESTEROL, DOUBLE-BLIND, OPEN-LABEL, FOLLOW-UP, ATHEROSCLEROSIS SOCIETY",

author = "Claudia Stefanutti and Ulrich Julius and Watts, {Gerald F.} and Mariko Harada-Shiba and Maria Cossu and Schettler, {Volker J.} and {De Silvestro}, Giustina and Handrean Soran and {Van Lennep}, {Jeanine Roeters} and Livia Pisciotta and Kloer, {Hans U.} and Kurt Widhalm and Moriarty, {Patrick M.} and {MIGHTY MEDIC Multinational Society}",

year = "2017",

month = jul,

doi = "10.1016/j.jacl.2017.04.114",

language = "English",

volume = "11",

pages = "858--871",

journal = "Journal of Clinical Lipidology",

issn = "1933-2874",

publisher = "Academic Press",

number = "4",

}

Stefanutti, C, Julius, U, Watts, GF, Harada-Shiba, M, Cossu, M, Schettler, VJ, De Silvestro, G, Soran, H, Van Lennep, JR, Pisciotta, L, Kloer, HU, Widhalm, K, Moriarty, PM & MIGHTY MEDIC Multinational Society 2017, 'Toward an international consensus-Integrating lipoprotein apheresis and new lipid-lowering drugs', Journal of Clinical Lipidology, vol. 11, no. 4, pp. 858-871. https://doi.org/10.1016/j.jacl.2017.04.114

TY - JOUR

T1 - Toward an international consensus-Integrating lipoprotein apheresis and new lipid-lowering drugs

AU - Stefanutti, Claudia

AU - Julius, Ulrich

AU - Watts, Gerald F.

AU - Harada-Shiba, Mariko

AU - Cossu, Maria

AU - Schettler, Volker J.

AU - De Silvestro, Giustina

AU - Soran, Handrean

AU - Van Lennep, Jeanine Roeters

AU - Pisciotta, Livia

AU - Kloer, Hans U.

AU - Widhalm, Kurt

AU - Moriarty, Patrick M.

AU - MIGHTY MEDIC Multinational Society

PY - 2017/7

Y1 - 2017/7

N2 - BACKGROUND: Despite advances in pharmacotherapy of lipid disorders, many dyslipidemic patients do not attain sufficient lipid lowering to mitigate risk of atherosclerotic cardiovascular disease. Several classes of novel lipid-lowering agents are being evaluated to reduce atherosclerotic cardiovascular disease risk. Lipoprotein apheresis (LA) is effective in acutely lowering the plasma concentrations of atherogenic lipoproteins including low-density lipoprotein cholesterol and lipoprotein(a), and novel lipid-lowering drugs may dampen the lipid rebound effect of LA, with the possibility that LA frequency may be decreased, in some cases even be discontinued.SOURCES OF MATERIAL: This document builds on current American Society for Apheresis guidelines and, for the first time, makes recommendations from summarized data of the emerging lipid-lowering drug classes (inhibitors of proprotein convertase subtilisin/kexin type 9 or microsomal triglyceride transfer protein, high-density lipoprotein mimetic), including the available evidence on combination therapy with LA with respect to the management of patients with dyslipidemia.ABSTRACT OF FINDINGS: Recommendations for different indications are given based on the latest evidence. However, except for lomitapide in homozygous familial hypercholesterolemia and alirocumab/evolocumab in heterozygous familial hypercholesterolemia subjects, limited data are available on the effectiveness and safety of combination therapy. More studies on combining LA with novel lipid-lowering drugs are needed.CONCLUSION: Novel lipid-lowering agents have potential to improve the performance of LA, but more evidence is needed. The Multidisciplinary International Group for Hemapheresis TherapY and Metabolic DIsturbances Contrast scientific society aims to establish an international registry of clinical experience on LA combination therapy to expand the evidence on this treatment in individuals at high cardiovascular disease risk. (C) 2017 National Lipid Association. Published by Elsevier Inc.

AB - BACKGROUND: Despite advances in pharmacotherapy of lipid disorders, many dyslipidemic patients do not attain sufficient lipid lowering to mitigate risk of atherosclerotic cardiovascular disease. Several classes of novel lipid-lowering agents are being evaluated to reduce atherosclerotic cardiovascular disease risk. Lipoprotein apheresis (LA) is effective in acutely lowering the plasma concentrations of atherogenic lipoproteins including low-density lipoprotein cholesterol and lipoprotein(a), and novel lipid-lowering drugs may dampen the lipid rebound effect of LA, with the possibility that LA frequency may be decreased, in some cases even be discontinued.SOURCES OF MATERIAL: This document builds on current American Society for Apheresis guidelines and, for the first time, makes recommendations from summarized data of the emerging lipid-lowering drug classes (inhibitors of proprotein convertase subtilisin/kexin type 9 or microsomal triglyceride transfer protein, high-density lipoprotein mimetic), including the available evidence on combination therapy with LA with respect to the management of patients with dyslipidemia.ABSTRACT OF FINDINGS: Recommendations for different indications are given based on the latest evidence. However, except for lomitapide in homozygous familial hypercholesterolemia and alirocumab/evolocumab in heterozygous familial hypercholesterolemia subjects, limited data are available on the effectiveness and safety of combination therapy. More studies on combining LA with novel lipid-lowering drugs are needed.CONCLUSION: Novel lipid-lowering agents have potential to improve the performance of LA, but more evidence is needed. The Multidisciplinary International Group for Hemapheresis TherapY and Metabolic DIsturbances Contrast scientific society aims to establish an international registry of clinical experience on LA combination therapy to expand the evidence on this treatment in individuals at high cardiovascular disease risk. (C) 2017 National Lipid Association. Published by Elsevier Inc.

KW - Dyslipidemia

KW - Lipoprotein apheresis

KW - Familial

KW - hypercholesterolemia

KW - Lp(a)

KW - hyperlipoproteinemia

KW - MTP inhibition

KW - PCSK9 inhibition

KW - HDL mimetic

KW - LDL-cholesterol

KW - Lipoproteins

KW - HOMOZYGOUS FAMILIAL HYPERCHOLESTEROLEMIA

KW - CONVERTASE SUBTILISIN/KEXIN 9

KW - TRIGLYCERIDE TRANSFER PROTEIN

KW - PLACEBO-CONTROLLED TRIAL

KW - HIGH CARDIOVASCULAR RISK

KW - LDL-CHOLESTEROL

KW - DOUBLE-BLIND

KW - OPEN-LABEL

KW - FOLLOW-UP

KW - ATHEROSCLEROSIS SOCIETY

U2 - 10.1016/j.jacl.2017.04.114

DO - 10.1016/j.jacl.2017.04.114

M3 - Review article

C2 - 28572002

SN - 1933-2874

VL - 11

SP - 858

EP - 871

JO - Journal of Clinical Lipidology

JF - Journal of Clinical Lipidology

IS - 4

ER -

Toward an international consensus-Integrating lipoprotein apheresis and new lipid-lowering drugs

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