Lipo-protein apheresis and PCSK9-inhibitors
Research suggests a specific treatment for Homozygous Familial Hypercholesterolaemic (HoFH) pateints; a combination therapy with PCSK9-inhibitors (PCSK9-I) and lipoprotein-apheresis (LA) may have synergistic effects on circulating lipid and lipoprotein levels. The relationship with the treatment regimen mentioned above can be investigated further with larger datasets.
This review details the role of lipoprotein apheresis in the management of familial hypercholesterolaemia and discusses the potential advantages and disadvantages of its combination with PCSK9 inhibitors. Having impact on inflammation and related mediators, LA is also a potent therapeutic player. A large body of evidence is available to support this theory. On the contrary, only a few observations are available on PCSK9-I effects on inflammation.
It is quite clear that further investigation on possible direct and/or indirect pleiotropic effects of PCSK9-I on inflammatory molecules is necessary. Evidence on both arguments with regard to HoFH and HeFH are reported in short.
More information: Claudia Stefanutti et al, Lipoprotein Apheresis and PCSK9-Inhibitors. Impact on Atherogenic Lipoproteins and Anti-Inflammatory Mediators in Familial Hypercholesterolaemia, Current Pharmaceutical Design (2019). DOI: 10.2174/1381612824666181025115658