Review Open Access
Volume 1 | Issue 1 | DOI: https://doi.org/10.33696/cardiology.1.002

Lipoprotein Apheresis: First FDA Indicated Treatment for Elevated Lipoprotein(a)

  • 1Division of Clinical Pharmacology, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
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Corresponding Author

Patrick Moriarty, pmoriart@kumc.edu

Received Date: April 23, 2020

Accepted Date: May 22, 2020


Background: Elevated lipoprotein(a) [Lp(a)] is an independent risk factor for cardiovascular disease (CVD) for which no commercially available pharmacotherapy exists. Currently, lipoprotein apheresis (LA) is the only available therapeutic option for patients with elevated Lp(a) and established CVD and in 2020, the FDA revised approval criteria for LA acknowledging elevated Lp(a) in its guidelines.

Hypothesis: LA has been shown to lower Lp(a) 60-75% in a single session and to reduce major adverse cardiovascular events 61-81%. Similar results were expected in patients at our large LA center in the United States.

Methods: In 2019, we evaluated the clinical significance of Lp(a) reduction with LA therapy. Since that time, six patients have initiated treatment with similar clinical profile. Results from the original paper have been updated as well as clinical profile of the additional patients.

Results: Fourteen of our 60 LA patients who were treated bi-weekly for an elevated Lp(a) with near normal LDL-C were evaluated. Following a mean period of 4 years, CV events were reduced by 94% compared to previous CV history. A greater than 70% acute reduction in mean pre- and post-LA corrected LDL-C and Lp(a) levels.

Conclusion: LA dramatically lowers Lp(a) and has demonstrated reductions in CVD events in retrospective trials. Prospective trials are under way to confirm clinical benefit of LA. Promising new pharmacological agents that reduce Lp(a) are in development; however, LA will continue to be the only FDA-approved therapy for Lp(a) reduction until these agents become commercially available.


Lipoprotein(a), Myocardial infarction, Aortic valve stenosis, Ischemic stroke; Peripheral vascular disease

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