Apheresis
A single apheresis session cuts Lp(a) by 60-75%, a review of lipoprotein apheresis for elevated Lp(a) (J Lipid Res 2016)
Original title: Lipoprotein apheresis to treat elevated lipoprotein (a)
This review by Waldmann and Parhofer covers lipoprotein apheresis for treating elevated Lp(a), given that lifestyle changes and available drugs either fail to effectively lower Lp(a) or show no clinical benefit. A single apheresis session acutely decreases Lp(a) by approximately 60-75%, and weekly or biweekly apheresis maintains mean interval concentrations reduced by about 25-40%. Most apheresis systems lower both LDL and Lp(a), while Lipopac specifically lowers only Lp(a); apheresis is expensive and time-consuming but has very few side effects. Two randomised controlled trials gave conflicting results on angiographic changes, and while retrospective analyses suggest regular apheresis provides clinical benefit for patients with elevated Lp(a), adequate randomised controlled trials are still lacking.
Original abstract
An elevated plasma concentration of lipoprotein (a) [Lp(a)] is an independent risk factor for cardiovascular disease. Life style modification and currently available drugs either fail to effectively lower plasma Lp(a) levels or do not result in clinical benefit. However, lipoprotein apheresis is very efficient in decreasing Lp(a) concentrations. A single apheresis session can acutely decrease Lp(a) by approximately 60-75%, and apheresis performed weekly or biweekly results in considerably decreased mean interval concentrations (approximately 25-40% reduction). While most apheresis systems (heparin-induced extracorporeal LDL precipitation, direct adsorption of lipoproteins, lipoprotein apheresis with dextran-sulfate, lipid filtration, immunoadsorption) decrease LDL and Lp(a), Lipopac is specific and only decreases Lp(a). Lp(a) apheresis is expensive and time consuming, but associated with very few side effects. Two randomized controlled trials give conflicting consults with respect to the effect on angiographic changes. Retrospective analyses indicate that regular apheresis translates into clinical benefit in patients with elevated Lp(a), but adequate randomized controlled trials are lacking.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.