{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T15:50:46Z","timestamp":1781193046137,"version":"3.54.1"},"reference-count":16,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,4,11]],"date-time":"2018-04-11T00:00:00Z","timestamp":1523404800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:p>A 49 years old woman (weight 68 kg, BMI 27.3 kg\/m<jats:sup>2<\/jats:sup>) with heterozygous familial hypercholesterolemia (HeFH) and multiple statin intolerance with muscle aches and creatine kinase elevation, presented at the Outpatient Lipid Clinic of Verona University Hospital in May 2015. Hypercholesterolemia was firstly diagnosed during adolescence, followed in adulthood by a diagnosis of Cogan's syndrome, a rheumatologic disorder characterized by corneal and inner ear inflammation. No xanthomas, corneal arcus, or vascular bruits were detectable at physical examination. Screening for macrovascular complications did not reveal relevant damages. Ongoing medical therapy included salicylic acid, methylprednisolone, methotrexate, and protonic\u2010pump inhibitor. In the absence of specific lipid\u2010lowering therapy, plasma lipid levels at first visit were: total\u2010cholesterol\u2009=\u2009522 mg\/dL, LDL\u2010cholesterol\u2009=\u2009434 mg\/dL, HDL\u2010cholesterol\u2009=\u200984 mg\/dL, triglycerides\u2009=\u2009120 mg\/dL, Lp(a)\u2009=\u200913 mg\/dL. On December 2015, evolocumab 140 mg sc every 2 weeks was initiated. After a 24\u2010week treatment, the LDL\u2010cholesterol levels decreased by an average of 21.2% to 342\u2009\u00b1\u200922 mg\/dL (mean\u2009\u00b1\u2009SD). On May 2016, LDL\u2010apheresis (H.E.L.P.system) was started as add\u2010on therapy. Compared to the average levels obtained during the evolocumab monotherapy period, the LDL\u2010cholesterol was reduced by 49.4%, thus reaching an inter\u2010apheresis level (mean\u2009\u00b1\u2009SD) of 173\u2009\u00b1\u200937 mg\/dL. This report suggests that a combination therapy with evolocumab and lipoprotein\u2010apheresis may have synergic effects on circulating lipid levels. Its relevance as a highly effective treatment option for hyperlipidemia in HeFH patients warrants further investigation in larger datasets.<\/jats:p>","DOI":"10.1002\/jca.21632","type":"journal-article","created":{"date-parts":[[2018,4,11]],"date-time":"2018-04-11T11:33:30Z","timestamp":1523446410000},"page":"546-550","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Evolocumab and lipoprotein apheresis combination therapy may have synergic effects to reduce low\u2010density lipoprotein cholesterol levels in heterozygous familial hypercholesterolemia: A case report"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2963-3990","authenticated-orcid":false,"given":"M. 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