Comment on “Homozygous familial hypercholesterolemia with severe involvement of the aortic valve: A sibling‐controlled case study on the efficacy of lipoprotein apheresis”

作者：F. Sbrana, B. Dal Pino, F. Bigazzi, T. Sampietro · 发表于：Journal of clinical apheresis · 年份：2020 · DOI：10.1002/jca.21834 · 被引用次数：1 · 研究领域：Medicine

Dear Editor, We read with interest the report of Galiano et al entitled “Homozygous familial hypercholesterolemia with severe involvement of the aortic valve-A sibling-controlled case study on the efficacy of lipoprotein apheresis” where is highlighted that in Homozygous familial hypercholesterolemia (HoFH) the lipid-lowering therapy, including Lipoprotein Apheresis (LA), should be initiated as early as possible following the diagnosis, because the HoFH prognosis is substantially treatment-dependent. Furthermore, a recent paper comparing HoFH different management approaches, highlights the importance in these patients of LA therapy for a correct treatment aiming to reduce cardiovascular events. However, the combination of LA with drug therapy, even though delays the development of atherosclerosis, it does not completely arrest its progression. For decades, LA had stood as sole, safe and lifesaving treatment. The new cholesterol-lowering drugs, recently introduced, even though very effective, do not have the right observation time to rule out their long-time safety. Therefore, it is not possible to anticipate the long-term consequences of Lomitapide, even if the Lomitapide Observational Worldwide Evaluation Registry (LOWER ClincalTrial.gov identifier NCT0213570) can give us some answers. This drug is available in Italy and it is refunded by the National Health System (€ 34.50986 for 28 days of therapy). Also, PCSK9 inhibitors are not effective in null receptor HoFH and the eff...