LIPOSORBER
is an "extracorporeal" (blood taken outside the body) procedure
to remove LDL cholesterol ("bad" cholesterol) from the blood. Back
to Top
Using a
device known as the LIPOSORBER System, a portion of the patient's blood circulates outside the body.
During the procedure, the plasma (the liquid in which the cells are suspended)
is separated from the whole blood and the LDL cholesterol is then removed
from the plasma. Then, the plasma and blood are recombined and returned
back to the patient.The LIPOSORBER consists of disposable components (which are discarded after each treatment)
and an automated computerized machine that controls and monitors the LIPOSORBER treatment.The LIPOSORBER
treatment is described below:
- Access
to Blood.
Usually arm veins are used for the treatment, in which blood is taken
from one arm and pumped through the LIPOSORBER System. The blood is then returned to the patient via the other arm.
- Anticoagulation
(Blood Thinning)
Anticoagulation is necessary for all treatments in which blood is removed
from the body. Heparin is used to prevent the blood from clotting.
- Removal
of LDL
After the blood is thinned, it enters the LIPOSORBER System. All parts that come into contact with the patient's blood and
plasma are sterile, used for one treatment only, and then discarded.
The first step of the treatment is the separation of plasma from the
whole blood. The plasma then flows to one of two dextran sulfate - cellulose
adsorption columns, which removes the LDL cholesterol.
- Blood
Return
The LDL cholesterol is removed, the plasma is recombined with the other
blood components and returned to the patient.
The entire
procedure takes approximately two to three hours to perform. At any given
time, only about 400 ml (less than 1 pint) of the patient's blood (170ml)
and plasma (230ml) are circulating outside the patient's body. Back to Top
LIPOSORBER treatment can lower LDL cholesterol levels between 73 and 83 percent after a single
treatment. However, this significant lowering of the LDL cholesterol level
is not maintained. Because most patients being treated have a metabolic
defect that causes the overproduction of LDL cholesterol, treatment cannot
cure the underlying problem. Thus, the patient's LDL cholesterol level
begins to increase (or rebound) after treatment, eventually returning
to baseline (prior to LIPOSORBER treatment initiation) in
about two to four weeks. Back to Top
Although LIPOSORBER
treatment
is very selective in removing LDL cholesterol, there are other elements
in the patient's plasma that may be reduced. The mean reductions of the
most important of these plasma components are HDL cholesterol (4 - 13%), plasma
proteins (15%), fibrinogen
(29%), Vitamin E (55 - 63%) and platelets (17%). These reductions rarely
pose a risk to the patient's health. However, physicians do periodically
check the levels of these plasma components before and after treatment,
in the event there are any changes of clinical significance. Back to Top
There are
two groups of patients who are candidates for LIPOSORBER treatment. They are individuals who have not responded adequately to diet
and maximum tolerated drug therapy for at least six months:
- Patients
with an LDL cholesterol level above 300 mg/dl.
- Patients
with an LDL cholesterol level between 200 - 300 mg/dl with coronary
heart disease.
Please ask
your doctor to confirm if you are a candidate for LIPOSORBER treatment. Back to Top
In order
for LIPOSORBER treatment to maintain a lower level of LDL cholesterol in the blood, patients
should repeat the procedure regularly. In general, individuals with LDL
cholesterol levels starting above 300 mg/dl after diet and maximum tolerated
drug therapy should be treated once per week, and individuals with LDL
cholesterol levels starting at 200 mg/dl will usually be treated once
every two weeks. LIPOSORBER treatment is regarded as a lifelong therapy. Patients must continue their
diet and cholesterol-lowering medications after starting LIPOSORBER treatment. Back to Top
Approximately
300,000 treatments with the LIPOSORBER System have been performed worldwide on over 2,500 patients. Typically,
the adverse reactions associated with LIPOSORBER treatment are those observed in any procedure involving the circulation
of blood outside the body. These adverse reactions include hypotension
(low blood pressure), nausea/vomiting, flushing/blotching, angina/chest
pain, fainting, lightheadedness, anemia (not enough iron in the blood),
abdominal discomfort, numbness/tingling, tachycardia (fast pulse), headache,
shortness of breath, hemolysis (breaking of red blood cells), bradycardia
(slow pulse), itching/hives, blurred vision, arrhythmia (irregular heartbeat),
vasovagal reaction (nervous reaction often caused by emotional stress
from fear or pain), prolonged bleeding due to the blood thinning agent,
chills, diaphoresis (sweating) and blood loss.Hypotension
or low blood pressure is the most common adverse reaction. In US clinical
trials, hypotension occured in less than 1% of all treatments. Certain
blood pressure lowering medications can enhance the likelihood of hypotension.
If the patient is being treated with one of these drugs, his/her doctor
may advise to hold the medication at least 24 hours prior to LIPOSORBER
treatment. If an ACE (Angiotensin Converting Enzyme) -inhibitor is used to manage
the patient's blood pressure, it should be held at least 24 hours or more
prior to LIPOSORBER treatment. Also, if a patient does experience a hypotension reaction
during LIPOSORBER treatment, this can be corrected by temporarily stopping the treatment,
positioning the patient differently, and in some cases, giving IV fluids.Terminating
the treatment generally stops most of the adverse events that may occur
during LIPOSORBER treatment. (Healthcare professionals should refer to the Full Prescribing
Information section of this web site). Back to Top
For the indicated
patient population, LIPOSORBER treatment is considered medically necessary and is covered by many insurance and
managed care plans. Kaneka is working closely with major insurance companies
to ensure successful coverage. A Hot-line is available to assist all health
care professionals and patients in obtaining appropriate reimbursement. Back to Top
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