Apheresis
An isoform-insensitive Lp(a) assay correlates well with traditional polyclonal methods in apheresis patients, pilot study argues for standardisation (J Clin Apher 2025)
Original title: Lipoprotein(a) Measurement in Lipoprotein Apheresis: Time to Change?
This pilot study compared Lp(a) measurements using routine polyclonal antibody methods against a newer assay that recognises a single copy of apo(a) per molecule, insensitive to apo(a) size polymorphism, in 31 subjects (mean age 62 ± 11 years, 7 women) undergoing regular lipoprotein apheresis. Pre-apheresis and post-apheresis measurements using the two methods correlated well, with R2 values of 0.89 and 0.76 respectively. Despite the interpretive challenge posed by the different units of measurement between methods, the authors argue that adopting an apo(a)-size-insensitive assay is a necessary step to standardise, improve and extend the accuracy and diagnostic power of Lp(a) measurement, a long-discussed but repeatedly delayed transition due to the lack of automated, isoform-insensitive methods.
Original abstract
The question of standardizing the measurement of lipoprotein(a) [Lp(a)] has been discussed for many years, but the unavailability of automated methods insensitive to the structural heterogeneity of Lp(a) and the transition to a new unit of measurement have delayed this process. The aim of this study is to compare, in subjects undergoing regular lipoprotein apheresis (LA) treatment (31 subjects, mean age 62 ± 11 years, female 7/31), Lp(a) measurements performed using routine polyclonal antibodies with a method that recognizes a single copy of apo(a) per molecule. This pilot study for adopting an assay insensitive to apo(a) size polymorphism showed a good match with the traditional method: correlations between pre-LA and post-LA measures show an R2 of 0.89 and 0.76, respectively. Despite the interpretative problem caused by adopting different units of measurement, we believe that moving to an assay insensitive to the dimensional variation of apo(a) represents a necessary change to standardize, improve, and extend the accuracy and diagnostic power of Lp(a).
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.