ÖGIM 2014

The lipoprotein-apheresis is a safe and effective therapy for the treatment of patients with homozygous or therapy refractory heterozygous familial hyperlipidaemia, elevated LP (a), intolerance of all lipid-lowering drug therapies and progressive atherosclerosis.

Various therapy systems achieve a comparable reduction of LDL cholesterol and LP (a) of 70-80%.

Intensive multi-disciplinary care of the patients, including regular monitoring of the course in specialized centres, is necessary and a prerequisite for successful treatment.

Antibodies have a direct and indirkt (via immune complex) pathogenic role in SLE.

IAS at SLE in

• In therapy refractory cases (Cyclophosphamidversager, MMF failure)

• If Cyc or MMF is contraindicated

Infections are dependent on disease activity and KO medication (cyc, steroids), IAS makes no difference. Ref. Stummvoll GH, Vienna. Klin. Wochenschr., 2004

E. G:: IAS successfully in patients with lupus-GN IV and Gleichzeitiber tuberculosis. Ref. S. Narrow service, Am J Kid dis2002

• Fast effect “short-term”: reduction of global disease activity, anti-dsDNA mirror and within 3 months also proteinuria. Ref. GH Stummvoll, annrheumdis2005

• High rate of remissions

• Prolonged IAS (> 1yr) feasible, stabilizes activity parameters, reduces proteinuria further. Ref. G.H. Stummvoll, NDephrologyDialysis and Transplantation 2011

Wiener apheresis Einheit, inner med. 3/Nephrology, Meduniwien

3 high-affinity adsorber are in use with different ligands are in use:

– Sheep IG (Therasorb ®), Protein A (Immunosorba ®), Synthetic peptide GAM (Globaffin ®)

• IAS currently as a Ultima ratio

– Used earlier?

• Prospective study?

• Which Adsober type is better?

Based on the data and the pathogenetically implied meaning