Lipoprotein-apheresis in familial hypercholesterolemia: Long-term patient compliance in a French cohort.

Autor: Beliard S; Cardiovascular Prevention Unit, Endocrinology and Metabolism Service, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France., Gallo A; Cardiovascular Prevention Unit, Endocrinology and Metabolism Service, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France; Sorbonne Universite, Inserm, Institute of Cardiometabolism and Nutrition (ICAN), UMR_S1166, Hôpital de la Pitié, Paris, France. Electronic address: antonio.gallo@aphp.fr., Duchêne E; Cardiovascular Prevention Unit, Endocrinology and Metabolism Service, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France; Sorbonne Universite, Inserm, Institute of Cardiometabolism and Nutrition (ICAN), UMR_S1166, Hôpital de la Pitié, Paris, France., Carrié A; Sorbonne Universite, Inserm, Institute of Cardiometabolism and Nutrition (ICAN), UMR_S1166, Hôpital de la Pitié, Paris, France; Assistance publique-Hôpitaux de Paris (APHP), Hôpitaux Universitaires Pitié-Salpêtrière/Charles-Foix, Department of Biochemistry for Endocrinology and Oncology, Obesity and Dyslipidemia Genetics Unit, France., Bittar R; Biochemistry functional Unit for Metabolic Disease Assistance Publique/Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France., Chapman MJ; Sorbonne Universite, Inserm, Institute of Cardiometabolism and Nutrition (ICAN), UMR_S1166, Hôpital de la Pitié, Paris, France., Bruckert E; Cardiovascular Prevention Unit, Endocrinology and Metabolism Service, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France; Sorbonne Universite, Inserm, Institute of Cardiometabolism and Nutrition (ICAN), UMR_S1166, Hôpital de la Pitié, Paris, France., Saheb S; Cardiovascular Prevention Unit, Endocrinology and Metabolism Service, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France; Sorbonne Universite, Inserm, Institute of Cardiometabolism and Nutrition (ICAN), UMR_S1166, Hôpital de la Pitié, Paris, France.
Jazyk: angličtina
Zdroj: Atherosclerosis [Atherosclerosis] 2018 Oct; Vol. 277, pp. 66-71. Date of Electronic Publication: 2018 Aug 18.
DOI: 10.1016/j.atherosclerosis.2018.08.007
Abstrakt: Background and Aims: Lipoprotein apheresis (LA) is a complex therapeutic option and poor compliance can adversely affect treatment outcome. The aim of this study was to describe long-term compliance to treatment in patients undergoing regular LA therapy and to investigate factors related to low compliance.
Methods: We analysed 11,391 prescribed procedures of LA performed between 1990 and 2007 in 51 patients with familial hypercholesterolemia. Regular LA treatment was initiated in patients presenting with either homozygous familial hypercholesterolemia (n = 21), or severe heterozygous familial hypercholesterolemia (n = 30) with elevated LDL-cholesterol levels and who did not respond adequately to diet and drug therapy; the majority of these patients (n = 30) had cardiovascular disease at initiation of therapy.
Results: The overall observed compliance rate based on the number of achieved/programmed procedures was 87.5%. Neither cardiovascular history nor subtypes of hypercholesterolemia was associated with compliance. In addition, there was no impact of patient demography on compliance. Treatment frequency alone significantly impacted non-compliance (i.e. patient with weekly procedures were less compliant). Interestingly, a non-significant decrease in compliance was observed among patients aged <20 years.
Conclusions: Despite the complexity of the LA procedure and its impact on the organisation of patients' daily lives, overall compliance was very high. The choice of an appropriate and adequate frequency of treatment significantly impacted patient compliance.
(Copyright © 2018 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE