{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:29:14Z","timestamp":1792290554665,"version":"4.4.0"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,10,30]],"date-time":"2019-10-30T00:00:00Z","timestamp":1572393600000},"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":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>Low\u2010density lipoprotein (LDL) apheresis has been considered the last option to treat refractory hyperlipidemia in patients with familiar hypercholesterolemia (FH). Evolocumab is a monoclonal antibody which has shown significant reduction of low\u2010density lipoprotein cholesterol (LDL\u2010C) serum levels and cardiovascular events.<\/jats:p><jats:p>The aim of the study was to examine the comparative impact of LDL\u2010apheresis vs Evolocumab vs the combination of both LDL\u2010apheresis and Evolocumab on lipid and lipoprotein parameters, and other metabolic\/inflammatory measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design of the study<\/jats:title><jats:p>Non\u2010randomized open case series study of 10 adult patients diagnosed with FH already on long\u2010term LDL\u2010apheresis therapy. The study was developed in three consecutive phases to compare LDL\u2010apheresis, Evolocumab treatment and the combination of both. Laboratory parameters were collected pre and post LDL\u2010apheresis and before Evolocumab administration. The primary endpoint was the reduction of LDL\u2010C during the three phases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Reduction of LDL\u2010C levels with Evolocumab were 31.4% vs LDL\u2010apheresis from 153\u2009\u00b1\u200935\u2009mg\/dL to 105\u2009\u00b1\u200956\u2009mg\/dL (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). Reduction of Lp(a) was also significantly higher with Evolocumab (45.5%) than LDL\u2010apheresis from 36 (6\u2010119) to 20 (3\u201041) mg\/dL, <jats:italic>P<\/jats:italic> = .027. In addition, HDL\u2010C and apo\u2010A increased after Evolocumab treatment, from 41\u2009\u00b1\u20096 to 46\u2009\u00b1\u20098 mg\/dL (<jats:italic>P<\/jats:italic> = .003) and from 124\u2009\u00b1\u200913 to 144\u2009\u00b1\u200925\u2009mg\/dL (<jats:italic>P<\/jats:italic> = .001), respectively. No changes in immunological or inflammatory parameters were observed and no serious adverse events were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Evolocumab reduces LDL\u2010C and Lp(a) more effectively than LDL\u2010apheresis and combination of Evolocumab plus LDL\u2010apheresis could be a therapeutic alternative to get lower LDL\u2010C and Lp(a) levels in patients with very high cardiovascular risk.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jca.21752","type":"journal-article","created":{"date-parts":[[2019,10,30]],"date-time":"2019-10-30T10:03:47Z","timestamp":1572429827000},"page":"9-17","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Efficacy of Evolocumab vs low\u2010density lipoprotein cholesterol apheresis in patients with familial hypercholesterolemia and high cardiovascular risk (EVOLAFER01)"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1524-3270","authenticated-orcid":false,"given":"Esther","family":"Torres","sequence":"first","affiliation":[{"name":"Servicio de Nefrolog\u00eda Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marian","family":"Goicoechea","sequence":"additional","affiliation":[{"name":"Servicio de Nefrolog\u00eda Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"},{"name":"Spanish Research Network (REDINREN)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Servicio de Nefrolog\u00eda Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda L.","family":"Rodr\u00edguez Ferrero","sequence":"additional","affiliation":[{"name":"Servicio de Nefrolog\u00eda Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Servicio de Nefrolog\u00eda Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicol\u00e1s","family":"Mac\u00edas","sequence":"additional","affiliation":[{"name":"Servicio de Nefrolog\u00eda Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Anaya","sequence":"additional","affiliation":[{"name":"Servicio de Nefrolog\u00eda Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,10,30]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)17018-9"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/hc4601.099487"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx144"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2015.01.036"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.676890"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.003294"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu274"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht273"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2013.19.2.139"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.4065\/76.10.1039"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOL.0b013e3283402f53"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2015.10.021"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1615664"},{"key":"e_1_2_6_15_1","volume-title":"Familial Hypercholesterolaemia (FH): Report of a Second WHO Consultation","author":"World Health Organization","year":"1999"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21470_c"},{"key":"e_1_2_6_17_1","first-page":"83","article-title":"Low\u2010density lipoprotein\u2010apheresis: an update. 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