Brief history of low-density lipoprotein apheresis.

Abstract

Low-density lipoprotein (LDL) apheresis is a technology used to remove LDL from hypercholesterolemic patients. The technique includes both specific and non-specific removal of LDL such as exchange of the whole plasma and selective adorption of LDL. The therapy is mainly used for homozygotes and in severe cases of heterozygotes of familial hypercholesterolemia (FH) (LDL receptor deficiency). Since HMG-CoA reductase inhibitors, statins, were introduced in late 1980s, the number of patients who required LDL apheresis decreased, in particular for the heterozygous FH patients with more recent powerful statins. Modern LDL apheresis technology is very sophisticated and perhaps expensive, while the number of the patients is very limited. Several companies developed the instruments for this procedure, but found the market is limited. Nevertheless, these companies are expected to remain in the market for an ethical reasons, as the patients using their LDL apheresis machines are entirely dependent on them for their life.