論文

2021年11月

Switching from lipoprotein apheresis to evolocumab in FH siblings on hemodialysis: case reports and discussion.

CEN case reports
  • Takeo Ishii
  • ,
  • Masatsune Ogura
  • ,
  • Haruka Nakamori
  • ,
  • Mika Hori
  • ,
  • Mariko Harada-Shiba
  • ,
  • Kouichi Tamura
  • ,
  • Kunio Oyama

10
4
開始ページ
592
終了ページ
597
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s13730-021-00605-x

Familial hypercholesterolemia (FH) and chronic kidney disease, especially end-stage renal disease (ESRD), are common and put patients at a high risk of developing atherosclerotic cardiovascular disease (ASCVD). ESRD concomitant with FH may further increase the risk of ASCVD. Achieving target levels of low-density lipoprotein cholesterol (LDL-C) is difficult owing to the limitations of statin administration due to its side effects in ESRD. Therefore, some FH patients with ESRD require lipoprotein apheresis for the prevention of secondary ASCVD events. Although proprotein convertase subtilisin kexin 9 (PCSK9) inhibitors may offer a safe and effective option for lowering lipid levels in such patients, no guidelines are available for their use. Here, we report the case of two male siblings with FH in secondary prevention undergoing hemodialysis combined with PCSK9 inhibitor treatment. The siblings, who showed a heterozygous c.1846-1G>A mutation in the LDLR gene, underwent hemodialysis. In combination with the lipoprotein apheresis, siblings were administered evolocumab, a PCSK9 inhibitor. Both the siblings had coronary artery disease, diabetes, and ESRD, and received hemodialysis. Their LDL-C levels did not reach the target values despite administering statin, ezetimibe, and biweekly lipoprotein apheresis. On the introduction of evolocumab treatment, their LDL-C levels were significantly reduced without any adverse effects, resulting in successful withdrawal from lipoprotein apheresis therapy. Although the effects of switching from lipoprotein apheresis to PCSK9 inhibitors for cardiovascular protection remain unclear in FH patients with and without ESRD, our case report will be helpful in guiding future therapeutic decisions.

リンク情報
DOI
https://doi.org/10.1007/s13730-021-00605-x
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/34100221
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8494873
ID情報
  • DOI : 10.1007/s13730-021-00605-x
  • PubMed ID : 34100221
  • PubMed Central 記事ID : PMC8494873

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