SELECTIVE REMOVAL OF PLASMA LOW-DENSITY-LIPOPROTEIN WITH THE HELP SYSTEM - BIWEEKLY VERSUS WEEKLY THERAPY

Purpose: Biweekly (once every 2 weeks) heparin-induced extracorporeal low-density lipoprotein (LDL) precipitation (HELP) therapy was evaluat ed for safety and efficacy in selectively reducing LDL cholesterol lev els compared with weekly HELP therapy. Patients and methods: Biweekly treatments were given to high-risk, diet/drug resistant hypercholester olemic patients (n = 23) after 6 months of weekly HELP therapy. Lipids , lipoprotein cholesterol, apolipoproteins A-I and B, and fibrinogen w ere measured on plasma samples before and after treatment. Results: Me an plasma volume treated was 2.81 and mean treatment duration 1.7 h. T herapy complications were minimal. In 98% of 268 biweekly HELP treatme nts, LDL cholesterol levels were reduced by > 30%. For patients comple ting 6 months of biweekly therapy following 6 months' weekly therapy ( n = 23), mean LDL cholesterol levels were reduced 138.5 mg/dl (111.2 m g/dl weekly) with a time-averaged decrease from mean pre-apheresis lev els of 33% for biweekly therapy (39% weekly). Mean total cholesterol ( 161.2 mg/dl biweekly versus 132.9 weekly) and apolipoprotein B (104.6 mg/dl versus 92.6) levels were also reduced with each treatment. Mean HDL cholesterol was reduced only 6.1 mg/dl (6.3 mg/dl weekly). Conclus ions: Biweekly HELP treatments can safely reduce LDL cholesterol level s as consistently as weekly HELP treatments. However, the higher pre-t reatment LDL cholesterol levels with biweekly treatments may produce l ess therapeutic benefit than with weekly therapy.