Transition from LDL apheresis to evolocumab in heterozygous FH is equally effective in lowering LDL, without lowering HDL cholesterol

Abstract Background and aims LDL apheresis is effective in reducing low-density lipoprotein (LDL) cholesterol (LDL-C) and clinical endpoints, however, the treatment is invasive and time consuming. In the present study, we explored lipid profiles and quality of life in patients with heterozygous familial hypercholesterolemia (FH) when altering the treatment regimen from weekly LDL apheresis to bi-weekly evolocumab treatment. Methods Three patients with FH and coronary artery disease, established in LDL apheresis for 135 ± 13(SD) months, participated. The patients were examined with blood sampling before and after LDL apheresis (week 0), and before evolocumab administration (week 1–7), quality of life was assessed (week 1, 3, 7). Results The historically highest, untreated LDL-C was 10.3 ± 0.8 mmol/L, during weekly LDL apheresis, 5.5 ± 0.9 mmol/L pre-apheresis and 1.2 ± 0.2 mmol/L post-apheresis ( p = 0.02). One week after apheresis, LDL-C was 6.1 ± 0.7 mmol/L, after three (bi-weekly) injections of evolocumab, LDL-C was 5.0 ± 0.7 ( p