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Lipoprotein apheresis affects lipoprotein particle subclasses more efficiently compared to the PCSK9 inhibitor evolocumab, a pilot study.
Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway.
Division of Internal Medicine, Nordland Hospital, Bodø, Norway.
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Occupational and Environmental Medicine Center.
Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
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2018 (English)In: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 57, no 1, p. 91-96Article in journal (Refereed) Published
Abstract [en]

Lipoprotein apheresis and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are last therapeutic resorts in patients with familial hypercholesterolemia (FH). We explored changes in lipoprotein subclasses and high-density lipoprotein (HDL) function when changing treatment from lipoprotein apheresis to PCSK9 inhibition. We measured the levels of low-density lipoprotein (LDL) and HDL particle subclasses, serum amyloid A1 (SAA1), paraoxonase-1 (PON1) activity and cholesterol efflux capacity (CEC) in three heterozygous FH patients. Concentrations of all LDL particle subclasses were reduced during apheresis (large 68.0 ± 17.5 to 16.3 ± 2.1 mg/dL, (p = 0.03), intermediate 38.3 ± 0.6 to 5.0 ± 3.5 mg/dL (p = 0.004) and small 5.0 ± 2.6 to 0.2 ± 0.1 mg/dL (p = 0.08)). There were non-significant reductions in the LDL subclasses during evolocumab treatment. There were non-significant reductions in subclasses of HDL particles during apheresis, and no changes during evolocumab treatment. CEC was unchanged throughout the study, while the SAA1/PON1 ratio was unchanged during apheresis but decreased during evolocumab treatment. In conclusion, there were significant reductions in large and intermediate size LDL particles during apheresis, and a non-significant reduction in small LDL particles. There were only non-significant reductions in the LDL subclasses during evolocumab treatment.

Place, publisher, year, edition, pages
2018. Vol. 57, no 1, p. 91-96
Keywords [en]
Cholesterol, LDL&HIPHEN, Lipoprotein apheresis, Lipoprotein particles, PCSK9-inhibition
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-146043DOI: 10.1016/j.transci.2018.01.002ISI: 000436056500022PubMedID: 29398508OAI: oai:DiVA.org:liu-146043DiVA, id: diva2:1192662
Note

Funding agencies: Amgen, Norway

Available from: 2018-03-23 Created: 2018-03-23 Last updated: 2018-10-29

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Ljunggren, Stefan AKarlsson, Helen
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