At present, lipoprotein apheresis, combined with high-dose statin and ezetimibe therapy, is the best available means of treating patients with homozygous and statin-refractory heterozygous familial hypercholesterolaemia (FH). However, the extent of cholesterol-lowering achieved is often insufficient to meet the targets set by current guidelines. The recent advent of three new classes of lipid-lowering agents provides new hope that the latter objective may now be achievable. These compounds act either by reducing low-density lipoprotein (LDL) production by inhibiting apolipoprotein B synthesis with an antisense oligonucleotide (mipomersen) or by inhibiting microsomal triglyceride transfer protein (lomitapide), or by enhancing LDL catabolism via monoclonal antibody-mediated inhibition of the activity of proprotein convertase subtilisin/kexin 9 (PCSK9) (evolocumab). Depending on the outcome of current trials, it seems likely that these compounds, used alone or combined with lipoprotein apheresis, will markedly improve the management of refractory FH.

Lipoprotein apheresis in the management of familial hypercholesterolaemia: historical perspective and recent advances / Stefanutti, C; Thompson, Gr. - In: CURRENT ATHEROSCLEROSIS REPORTS. - ISSN 1523-3804. - ELETTRONICO. - 17:1(2015), pp. 465-474. [10.1007/s11883-014-0465-6]

Lipoprotein apheresis in the management of familial hypercholesterolaemia: historical perspective and recent advances.

Stefanutti C
;
2015

Abstract

At present, lipoprotein apheresis, combined with high-dose statin and ezetimibe therapy, is the best available means of treating patients with homozygous and statin-refractory heterozygous familial hypercholesterolaemia (FH). However, the extent of cholesterol-lowering achieved is often insufficient to meet the targets set by current guidelines. The recent advent of three new classes of lipid-lowering agents provides new hope that the latter objective may now be achievable. These compounds act either by reducing low-density lipoprotein (LDL) production by inhibiting apolipoprotein B synthesis with an antisense oligonucleotide (mipomersen) or by inhibiting microsomal triglyceride transfer protein (lomitapide), or by enhancing LDL catabolism via monoclonal antibody-mediated inhibition of the activity of proprotein convertase subtilisin/kexin 9 (PCSK9) (evolocumab). Depending on the outcome of current trials, it seems likely that these compounds, used alone or combined with lipoprotein apheresis, will markedly improve the management of refractory FH.
2015
Low-density lipoprotein; CholesterolLDL receptor; Atherosclerosis Statin Ezetimibe; Plasmapheresis
01 Pubblicazione su rivista::01a Articolo in rivista
Lipoprotein apheresis in the management of familial hypercholesterolaemia: historical perspective and recent advances / Stefanutti, C; Thompson, Gr. - In: CURRENT ATHEROSCLEROSIS REPORTS. - ISSN 1523-3804. - ELETTRONICO. - 17:1(2015), pp. 465-474. [10.1007/s11883-014-0465-6]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/655482
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