Introduction: Coronavirus disease 2019 (COVID-19) is associated with a marked increase in the inflammatory cytokines, IL-6 and IL-18. Blood purification therapy aimed at controlling cytokines is one treatment option; however, evidence of its effectiveness is needed. Plasma exchange with dialysis (PED) is a blood purification method involving selective plasma exchange with dialysate flowing through the outer hollow fiber of the plasma separator. In this retrospective study, we investigated the efficacy of continuous PED (cPED) over 48 h in five patients with severe COVID-19.
Methods: We assessed changes in IL-6 and IL-18, as well as adiponectin (APN).
Results: There were no significant differences in changes in IL-6 and IL-18, but there was a marked improvement in cases with abnormally high IL-6 and IL-18 levels at baseline. APN, which inhibits inflammatory cytokines, was significantly elevated post-cPED.
Conclusion: Our results suggest that cPED therapy is an effective treatment for COVID-19.
{"title":"Retrospective observational study of changes in serum cytokines and adiponectin with continuous plasma exchange with dialysis therapy for severe COVID-19.","authors":"Yuya Suzuki, Hajime Nakae, Kasumi Satoh, Nobuhisa Hirasawa, Komei Kameyama, Yasuhito Irie, Toshiharu Kitamura, Tasuku Nara, Kyohei Maeno, Kenji Yoshida, Manabu Okuyama","doi":"10.1111/1744-9987.14054","DOIUrl":"10.1111/1744-9987.14054","url":null,"abstract":"<p><strong>Introduction: </strong>Coronavirus disease 2019 (COVID-19) is associated with a marked increase in the inflammatory cytokines, IL-6 and IL-18. Blood purification therapy aimed at controlling cytokines is one treatment option; however, evidence of its effectiveness is needed. Plasma exchange with dialysis (PED) is a blood purification method involving selective plasma exchange with dialysate flowing through the outer hollow fiber of the plasma separator. In this retrospective study, we investigated the efficacy of continuous PED (cPED) over 48 h in five patients with severe COVID-19.</p><p><strong>Methods: </strong>We assessed changes in IL-6 and IL-18, as well as adiponectin (APN).</p><p><strong>Results: </strong>There were no significant differences in changes in IL-6 and IL-18, but there was a marked improvement in cases with abnormally high IL-6 and IL-18 levels at baseline. APN, which inhibits inflammatory cytokines, was significantly elevated post-cPED.</p><p><strong>Conclusion: </strong>Our results suggest that cPED therapy is an effective treatment for COVID-19.</p>","PeriodicalId":23021,"journal":{"name":"Therapeutic Apheresis and Dialysis","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10124519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To investigate the effect of sodium thiosulfate (STS) on serum calcification factors in patients undergoing maintenance hemodialysis.
Methods: Forty-four Patients were randomly divided into control group (n = 22) and observation group (n = 22) by envelope method (block 4 randomization). The control group received routine treatment while observation group was treated with STS on the basis of routine treatment. The biochemical indicators, including BUN, UA, SCr, Ca2+ , P3- , calcium-phosphorus product, PTH, hs-CRP, TG, TC, HDL, LDL, and serum calcification factor MGP, FA, FGF-23, and OPG levels were compared before and after treatment.
Results: Control group had no statistically significant difference in the levels of vascular calcification factors MGP, FA, FGF-23, and OPG before and after treatment (p > 0.05). Whereas observation group had higher levels of MGP and FA, and lower levels of FGF-23 and OPG after treatment than before treatment (p < 0.05). The levels of MGP and FA in observation group were higher than those in control group, and FGF-23 and OPG were lower than those in control group (p < 0.05).
Conclusion: It is speculated that sodium thiosulfate can alleviate the progression of vascular calcification by changing the levels of calcification factors.
{"title":"Effects of sodium thiosulfate on serum calcification factors in patients undergoing maintenance hemodialysis.","authors":"Pan Liu, Xiang Xu, YuFu Wang, XiaoNa Long, XunJia Li, HongYing Peng","doi":"10.1111/1744-9987.14029","DOIUrl":"10.1111/1744-9987.14029","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effect of sodium thiosulfate (STS) on serum calcification factors in patients undergoing maintenance hemodialysis.</p><p><strong>Methods: </strong>Forty-four Patients were randomly divided into control group (n = 22) and observation group (n = 22) by envelope method (block 4 randomization). The control group received routine treatment while observation group was treated with STS on the basis of routine treatment. The biochemical indicators, including BUN, UA, SCr, Ca<sup>2+</sup> , P<sup>3-</sup> , calcium-phosphorus product, PTH, hs-CRP, TG, TC, HDL, LDL, and serum calcification factor MGP, FA, FGF-23, and OPG levels were compared before and after treatment.</p><p><strong>Results: </strong>Control group had no statistically significant difference in the levels of vascular calcification factors MGP, FA, FGF-23, and OPG before and after treatment (p > 0.05). Whereas observation group had higher levels of MGP and FA, and lower levels of FGF-23 and OPG after treatment than before treatment (p < 0.05). The levels of MGP and FA in observation group were higher than those in control group, and FGF-23 and OPG were lower than those in control group (p < 0.05).</p><p><strong>Conclusion: </strong>It is speculated that sodium thiosulfate can alleviate the progression of vascular calcification by changing the levels of calcification factors.</p>","PeriodicalId":23021,"journal":{"name":"Therapeutic Apheresis and Dialysis","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9761086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Indoxyl sulfate (IS) is a protein-bound uremic toxin that causes uremic sarcopenia. IS has poor dialysis clearance; however, the addition of a binding competitor improves its removal efficiency.
Methods: Dialysis experiments were performed using N-acetyl-l-tryptophan (L-NAT) instead of l-tryptophan (Trp) using pooled sera obtained from dialysis patients. The molecular structures of L-NAT and Trp were similar to that of IS. Therefore, we examined whether Trp and L-NAT were involved in muscle atrophy in the same manner as IS by performing culture experiments using a human myotube cell line.
Results: The removal efficiency of L-NAT was the same as that of Trp. However, L-NAT concentrations in the pooled sera increased at the end of the experiment. Trp (1 mM) decreased the area of human myocytes, similar to IS, whereas L-NAT did not.
Conclusion: L-NAT is a binding competitor with the ability to remove protein-bound IS while preventing sarcopenia.
{"title":"Effects of N-acetyl-L-tryptophan on desorption of the protein-bound uremic toxin indoxyl sulfate and effects on uremic sarcopenia.","authors":"Atsushi Ohashi, Masashi Nakatani, Hideo Hori, Shigeru Nakai, Kunihiro Tsuchida, Midori Hasegawa, Naotake Tsuboi","doi":"10.1111/1744-9987.14047","DOIUrl":"10.1111/1744-9987.14047","url":null,"abstract":"<p><strong>Introduction: </strong>Indoxyl sulfate (IS) is a protein-bound uremic toxin that causes uremic sarcopenia. IS has poor dialysis clearance; however, the addition of a binding competitor improves its removal efficiency.</p><p><strong>Methods: </strong>Dialysis experiments were performed using N-acetyl-l-tryptophan (L-NAT) instead of l-tryptophan (Trp) using pooled sera obtained from dialysis patients. The molecular structures of L-NAT and Trp were similar to that of IS. Therefore, we examined whether Trp and L-NAT were involved in muscle atrophy in the same manner as IS by performing culture experiments using a human myotube cell line.</p><p><strong>Results: </strong>The removal efficiency of L-NAT was the same as that of Trp. However, L-NAT concentrations in the pooled sera increased at the end of the experiment. Trp (1 mM) decreased the area of human myocytes, similar to IS, whereas L-NAT did not.</p><p><strong>Conclusion: </strong>L-NAT is a binding competitor with the ability to remove protein-bound IS while preventing sarcopenia.</p>","PeriodicalId":23021,"journal":{"name":"Therapeutic Apheresis and Dialysis","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10029034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Plasma exchange therapy (PE) is useful for patients with primary macroglobulinemia and multiple myeloma who present with hyperviscosity syndrome. However, hyperviscous blood may coagulate in the circuit during treatment, and in that case necessitate discontinuation of the treatment. This time, we report that we were able to prevent coagulation in the circuit by adding some ideas during the membrane separation method.
Methods: Physiological saline is injected in front of the plasma separation membrane to pre-dilute the blood, followed by filtration through the plasma separation membrane.
Results: As a result of pre-diluting with physiological saline to reduce the viscosity entering the separation membrane, it was possible to process the planned target amount.
Conclusion: In patients with hyperviscosity syndrome who showed intracircuit coagulation during plasma exchange therapy, devising a predilution method should be considered as one of the ways to continue treatment.
{"title":"Experience with pre-diluted plasma exchange therapy for hyperviscosity syndrome.","authors":"Shigeyuki Igarashi, Yasutaka Kamikawa, Syuji Ono, Gakuya Maekawa, Hiroyuki Kishigami, Kazuki Kawamura, Takumi Oonogi, Toshihiko Nagano","doi":"10.1111/1744-9987.14053","DOIUrl":"10.1111/1744-9987.14053","url":null,"abstract":"<p><strong>Introduction: </strong>Plasma exchange therapy (PE) is useful for patients with primary macroglobulinemia and multiple myeloma who present with hyperviscosity syndrome. However, hyperviscous blood may coagulate in the circuit during treatment, and in that case necessitate discontinuation of the treatment. This time, we report that we were able to prevent coagulation in the circuit by adding some ideas during the membrane separation method.</p><p><strong>Methods: </strong>Physiological saline is injected in front of the plasma separation membrane to pre-dilute the blood, followed by filtration through the plasma separation membrane.</p><p><strong>Results: </strong>As a result of pre-diluting with physiological saline to reduce the viscosity entering the separation membrane, it was possible to process the planned target amount.</p><p><strong>Conclusion: </strong>In patients with hyperviscosity syndrome who showed intracircuit coagulation during plasma exchange therapy, devising a predilution method should be considered as one of the ways to continue treatment.</p>","PeriodicalId":23021,"journal":{"name":"Therapeutic Apheresis and Dialysis","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10040026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-09-10DOI: 10.1111/1744-9987.14051
Yoshimi Fukumaki Karlsson, Gösta Berlin
{"title":"What is photopheresis? Role of extracorporeal photopheresis in the treatment of GvHD and its practice in Sweden.","authors":"Yoshimi Fukumaki Karlsson, Gösta Berlin","doi":"10.1111/1744-9987.14051","DOIUrl":"10.1111/1744-9987.14051","url":null,"abstract":"","PeriodicalId":23021,"journal":{"name":"Therapeutic Apheresis and Dialysis","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10203113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-06-29DOI: 10.1111/1744-9987.14031
Nazlı Koşunalp, Mehtap Kavurmaci
Introduction: The purpose of this study was to ascertain the levels of anxiety, despair, avoidance, and obsessions that hemodialysis patients dealt with during the pandemic.
Methods: The study was conducted with 139 hemodialysis patients. Research data "Coronavirus Anxiety Scale (CAS)," "Hospital Anxiety and Depression Scale (HAD)," "COVID-19 Avoidance Scale" (AA-COVID-19) and "Coronavirus Obsession Scale (OCS)." The data obtained from the research were analyzed using the SPSS 21 package program.
Results: The average score of the patients on the CAS scale was 0.73 ± 1.17, on the HAD-A scale was 5.94 ± 3.67, and on the HAD-D scale was 7.06 ± 3.89. The COVID-19 outbreak has consequently had a severe impact on hemodialysis patients' mental health.
Conclusion: Covid 19 epidemic, the health sector failed to protect the mental health of patients. However, new epidemics and disasters await the world in the future. In these results show that new strategies need to be developed.
{"title":"Determination of anxiety, depression, avoidance and obsessions experienced by hemodialysis patients during the COVID-19.","authors":"Nazlı Koşunalp, Mehtap Kavurmaci","doi":"10.1111/1744-9987.14031","DOIUrl":"10.1111/1744-9987.14031","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study was to ascertain the levels of anxiety, despair, avoidance, and obsessions that hemodialysis patients dealt with during the pandemic.</p><p><strong>Methods: </strong>The study was conducted with 139 hemodialysis patients. Research data \"Coronavirus Anxiety Scale (CAS),\" \"Hospital Anxiety and Depression Scale (HAD),\" \"COVID-19 Avoidance Scale\" (AA-COVID-19) and \"Coronavirus Obsession Scale (OCS).\" The data obtained from the research were analyzed using the SPSS 21 package program.</p><p><strong>Results: </strong>The average score of the patients on the CAS scale was 0.73 ± 1.17, on the HAD-A scale was 5.94 ± 3.67, and on the HAD-D scale was 7.06 ± 3.89. The COVID-19 outbreak has consequently had a severe impact on hemodialysis patients' mental health.</p><p><strong>Conclusion: </strong>Covid 19 epidemic, the health sector failed to protect the mental health of patients. However, new epidemics and disasters await the world in the future. In these results show that new strategies need to be developed.</p>","PeriodicalId":23021,"journal":{"name":"Therapeutic Apheresis and Dialysis","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10055506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-08-17DOI: 10.1111/1744-9987.14055
Takashi Wada
{"title":"The 43rd Annual Meeting of the Japanese Society for Apheresis.","authors":"Takashi Wada","doi":"10.1111/1744-9987.14055","DOIUrl":"10.1111/1744-9987.14055","url":null,"abstract":"","PeriodicalId":23021,"journal":{"name":"Therapeutic Apheresis and Dialysis","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10396727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Therapeutic Apheresis and DialysisVolume 27, Issue 6 p. 1130-1130 FORTHCOMING EVENTS Therapeutic Apheresis and Dialysis Forthcoming Events December 2023 First published: 02 November 2023 https://doi.org/10.1111/1744-9987.13882Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume27, Issue6December 2023Pages 1130-1130 RelatedInformation
{"title":"<i>Therapeutic Apheresis and Dialysis</i> Forthcoming Events December 2023","authors":"","doi":"10.1111/1744-9987.13882","DOIUrl":"https://doi.org/10.1111/1744-9987.13882","url":null,"abstract":"Therapeutic Apheresis and DialysisVolume 27, Issue 6 p. 1130-1130 FORTHCOMING EVENTS Therapeutic Apheresis and Dialysis Forthcoming Events December 2023 First published: 02 November 2023 https://doi.org/10.1111/1744-9987.13882Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume27, Issue6December 2023Pages 1130-1130 RelatedInformation","PeriodicalId":23021,"journal":{"name":"Therapeutic Apheresis and Dialysis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135973490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asahi Kasei Medical Co., Ltd. (Tokyo, Japan) is a world leader in research, development, and production of devices and systems for blood treatment and purification based on advanced membrane separation and adsorption technologies. It serves the global market with dialysis products and therapeutic apheresis devices, such as membrane type plasma separators, plasma component separators, and immunoadsorption columns. Asahi Kasei Medical’s core competence is in blood related polymer technologies, materials technologies, and blood analysis technologies. The Research and Development Division is developing next-generation products based in these technologies for fields ranging from extracorporeal therapy to organ function diagnosis and artificial organs. Now, as always, Asahi Kasei Medical is dedicated to serving and advancing medical therapy for the preservation and enhancement of human life. Website: http://www.asahikasei-medical.com
{"title":"Corporate Members.","authors":"","doi":"10.1111/1744-9987.13880","DOIUrl":"10.1111/1744-9987.13880","url":null,"abstract":"Asahi Kasei Medical Co., Ltd. (Tokyo, Japan) is a world leader in research, development, and production of devices and systems for blood treatment and purification based on advanced membrane separation and adsorption technologies. It serves the global market with dialysis products and therapeutic apheresis devices, such as membrane type plasma separators, plasma component separators, and immunoadsorption columns. Asahi Kasei Medical’s core competence is in blood related polymer technologies, materials technologies, and blood analysis technologies. The Research and Development Division is developing next-generation products based in these technologies for fields ranging from extracorporeal therapy to organ function diagnosis and artificial organs. Now, as always, Asahi Kasei Medical is dedicated to serving and advancing medical therapy for the preservation and enhancement of human life. Website: http://www.asahikasei-medical.com","PeriodicalId":23021,"journal":{"name":"Therapeutic Apheresis and Dialysis","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10150788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01Epub Date: 2023-06-14DOI: 10.1111/1744-9987.14025
Beatrice Dal Pino, Federico Bigazzi, Francesco Sbrana
Dear Editor, In Familial Hypercholesterolemia (FH), statins treatment is the first choice to lower LDL cholesterol and to reduce cardiovascular morbidity and mortality, however, up to 10% of patients treated with statins report intolerance [1]. Monoclonal antibodies against Proprotein Convertase Subtilisin/Kexin type 9 inhibitors (mAb PCSK9i) could be administered to lower LDL cholesterol in patients with muscle-related adverse events, but intolerance to mAb PCSK9i has also been described [2]. Within this context, Lipoprotein Apheresis (LA) still holds a valuable role, even in the new era of Lipid-Lowering Therapy (LLT) [2]. Inclisiran is a novel small interfering RNA-based drug (siRNA) anti-PCSK9 play a role in patients when optimal LDL-C cannot be achieved by statins and/or mAb PCSK9i [3]. We enrolled 5 patients in chronic LA (mean age 64 ± 8 years, female 60%) affected by heterozygous FH and AtheroSclerotic CardioVascular Disease (ASCVD), with history of statin intolerance and mAb PCSK9i adverse events (flue like syndrome in 3/5 patients, severe CPK increase in 1/5 patient and low therapeutic compliance in 1/5 patient). These patients, after the discontinuation of mAb PCSK9i, were assigned to inclisiran therapy (dosing schedule: 284 mg s.c. injection of at 0–90–180 days and every 6 months thereafter) and followed up for 3 months. The LA treatment was performed at bi-weekly interval by dextran-sulfate (Liposorber-LA systems; Kaneka, Osaka, Japan; 3/5 patients) or heparin-induced LDL precipitation apheresis (HELP, Plasmat Futura; B. Braun, Melsungen, Germany; 2/5 patients). After 3 months of therapy, a significant decrease in total cholesterol ( 19%), LDL cholesterol ( 27%), Apo B lipoprotein ( 24%) and triglycerides ( 13%) levels was observed without significant modification in other parameters (see Table S1). During the study period, the clinical response between inclisiran and mAb PCSK9i showed no difference (see Figure 1). One patient who achieved the recommended therapeutic target for LDL cholesterol and Lp(a) levels (respectively below 55 and 60 mg/dL, as indicated by international guidelines) discontinued LA. Adverse events were reported in 2/5 (40%) of patients: one referred transient episodes of mild difficulty to maintain concentration after 2 weeks of drug administration, another patient presented a cutaneous herpes zoster infection. No injection-site reaction was reported. In contrast to mAb PCSK9i, inclisiran inactivates PCSK9 by inhibition of its hepatic synthesis. The safety, tolerability, and efficacy of inclisiran have been studied within the ORION clinical development program who demonstrated a sustained PCSK9 suppression of about 80% and time-adjusted LDL-C reduction of approximately 50% from baseline. Furthermore, the safety profile of inclisiran was found to be comparable to that of mAb PCSK9i and the most commonly reported adverse effect was a mild-to-moderate transient injection site reaction [3]. It provides a therapeutic
{"title":"Inclisiran and lipoprotein apheresis in statin intolerance heterozygous FH patients: A case series.","authors":"Beatrice Dal Pino, Federico Bigazzi, Francesco Sbrana","doi":"10.1111/1744-9987.14025","DOIUrl":"10.1111/1744-9987.14025","url":null,"abstract":"Dear Editor, In Familial Hypercholesterolemia (FH), statins treatment is the first choice to lower LDL cholesterol and to reduce cardiovascular morbidity and mortality, however, up to 10% of patients treated with statins report intolerance [1]. Monoclonal antibodies against Proprotein Convertase Subtilisin/Kexin type 9 inhibitors (mAb PCSK9i) could be administered to lower LDL cholesterol in patients with muscle-related adverse events, but intolerance to mAb PCSK9i has also been described [2]. Within this context, Lipoprotein Apheresis (LA) still holds a valuable role, even in the new era of Lipid-Lowering Therapy (LLT) [2]. Inclisiran is a novel small interfering RNA-based drug (siRNA) anti-PCSK9 play a role in patients when optimal LDL-C cannot be achieved by statins and/or mAb PCSK9i [3]. We enrolled 5 patients in chronic LA (mean age 64 ± 8 years, female 60%) affected by heterozygous FH and AtheroSclerotic CardioVascular Disease (ASCVD), with history of statin intolerance and mAb PCSK9i adverse events (flue like syndrome in 3/5 patients, severe CPK increase in 1/5 patient and low therapeutic compliance in 1/5 patient). These patients, after the discontinuation of mAb PCSK9i, were assigned to inclisiran therapy (dosing schedule: 284 mg s.c. injection of at 0–90–180 days and every 6 months thereafter) and followed up for 3 months. The LA treatment was performed at bi-weekly interval by dextran-sulfate (Liposorber-LA systems; Kaneka, Osaka, Japan; 3/5 patients) or heparin-induced LDL precipitation apheresis (HELP, Plasmat Futura; B. Braun, Melsungen, Germany; 2/5 patients). After 3 months of therapy, a significant decrease in total cholesterol ( 19%), LDL cholesterol ( 27%), Apo B lipoprotein ( 24%) and triglycerides ( 13%) levels was observed without significant modification in other parameters (see Table S1). During the study period, the clinical response between inclisiran and mAb PCSK9i showed no difference (see Figure 1). One patient who achieved the recommended therapeutic target for LDL cholesterol and Lp(a) levels (respectively below 55 and 60 mg/dL, as indicated by international guidelines) discontinued LA. Adverse events were reported in 2/5 (40%) of patients: one referred transient episodes of mild difficulty to maintain concentration after 2 weeks of drug administration, another patient presented a cutaneous herpes zoster infection. No injection-site reaction was reported. In contrast to mAb PCSK9i, inclisiran inactivates PCSK9 by inhibition of its hepatic synthesis. The safety, tolerability, and efficacy of inclisiran have been studied within the ORION clinical development program who demonstrated a sustained PCSK9 suppression of about 80% and time-adjusted LDL-C reduction of approximately 50% from baseline. Furthermore, the safety profile of inclisiran was found to be comparable to that of mAb PCSK9i and the most commonly reported adverse effect was a mild-to-moderate transient injection site reaction [3]. It provides a therapeutic","PeriodicalId":23021,"journal":{"name":"Therapeutic Apheresis and Dialysis","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10502438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}