Severe hypercholesterolaemia: Therapeutic goals and eligibility criteria for LDL apheresis in Europe

Gilbert R. Thompson, Alberico Catapano, Samir Saheb, Marielle Atassi-Dumont, Mahmoud Barbir, Mats Eriksson, Bernhard Paulweber, Eric Sijbrands, Anton F. Stalenhoef, Klaus G. Parhofer

Research output: Contribution to journalArticle

Abstract

Purpose of review: Despite the use of currently available lipid-lowering therapies, a significant proportion of patients with severe hypercholesterolaemia do not reach treatment goals and consequently remain at increased risk for cardiovascular disease (CVD). On the basis of clinical experience, these patients tend to have the most severe forms of familial hypercholesterolaemia or markedly elevated LDL cholesterol (LDL-C) levels but are unable to tolerate statin therapy. Recent findings: LDL apheresis is currently the best treatment option (or treatment rescue) to bring these patients closer to therapeutic LDL objectives, and has been shown to reduce the risk of CVD along with LDL-C levels. However, criteria for LDL apheresis eligibility and the percentage of patients receiving treatment vary widely from country to country across Europe. Despite the proven benefits of LDL apheresis, access to this procedure remains limited because of its high cost and low availability, reflecting inherent limitations of this treatment modality. Summary: There is a need to both better define the patient population eligible for LDL apheresis and to create unified European guidelines governing the use of apheresis. In addition to improving access to apheresis where appropriate, new therapies are needed to further decrease LDL-C and reduce the ongoing CVD risk in patients with severe hypercholesterolaemia.

Original languageEnglish
Pages (from-to)492-498
Number of pages7
JournalCurrent Opinion in Lipidology
Volume21
Issue number6
DOIs
Publication statusPublished - Dec 2010

Keywords

  • LDL apheresis
  • LDL cholesterol
  • severe familial hypercholesterolaemia

ASJC Scopus subject areas

  • Cell Biology
  • Genetics
  • Molecular Biology
  • Cardiology and Cardiovascular Medicine
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

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    Thompson, G. R., Catapano, A., Saheb, S., Atassi-Dumont, M., Barbir, M., Eriksson, M., Paulweber, B., Sijbrands, E., Stalenhoef, A. F., & Parhofer, K. G. (2010). Severe hypercholesterolaemia: Therapeutic goals and eligibility criteria for LDL apheresis in Europe. Current Opinion in Lipidology, 21(6), 492-498. https://doi.org/10.1097/MOL.0b013e3283402f53