Treatment of autoimmune diseases.
Lipoprotein apheresis
Familial hypercholesterolemia (FH) is a common inherited cause of premature cardiovascular disease and atherosclerosis. This genetic disorder is characterized by high to extremely high blood levels of low-density lipoprotein cholesterol (LDL-c or "bad cholesterol").
Lipoprotein apheresis can be a treatment of choice for those homozygous, and second-line for heterozygous hypercholesterolemic and hyper-Lp(a) patients, when conventional pharmacological and non-pharmacological treatments for dealing with elevated lipid blood levels prove inadequate or are not sufficient to achieve desired lowering of lowÄ¢¹½´«Ã½‘density lipoprotein cholesterol (LDL-c) and lipoprotein(a) (Lp(a)).1
In lipoprotein apheresis, a distinction is made between whole-blood treatment and the plasma method. Ä¢¹½´«Ã½ offers an adsorption system for whole-blood treatment (DALI Adsorbers) and a filtration system for the plasma method (MONET Plasma Fractionator).
DALI Adsorbers
MONET Plasma Fractionator
DALI Adsorbers*
Semi-selective lipoprotein adsorption
DALI lipoprotein apheresis is used to treat patients with severe hypercholesterolemia and/or elevated levels of lipoprotein(a) (Lp(a)). The objective is to reduce levels of LDL-c and Lp(a). This is an effective approach to reduce MACE (major adverse coronary events) in patients on very high cardiovascular risk.2,3
Lipoproteins such as LDL or Lp(a) are largely removed by electrostatic interactions between the positively charged apolipoprotein and the negatively charged adsorber material.4ÌýThe reduction of LDL-c and Lp(a) levels can be individually adapted to a patientÄ¢¹½´«Ã½™s therapy needs by means of different adsorber sizes (DALIÌý500 Adsorber and DALIÌý750 Adsorber) and configurations of these (DALIÌý1000 and DALIÌý1250).5,6
During a single treatment, the levels of LDL-c and Lp(a) were reduced by a mean of 71% and 64%, respectively.8
MONET Plasma Fractionator
Filter for effective reduction of high molecular weight proteins
The MONET Plasma Fractionator is indicated for use in therapeutic apheresis, to reduce high molecular plasma constituents such as Lp(a), LDL-c, fibrinogen and immunoglobulin M (IgM) (e.g. in order to reduce LDL-c and Lp(a) in patients with hyperlipoproteinemia).7,8,10
LDL-c, Lp(a) and fibrinogen are removed from plasma by filtration: The target plasma constituents are retained by the fine pores of a plasma fractionating membrane, whereas smaller plasma constituents, such as HDL or albumin, pass the pores and return to the patient.7,8,10
The MONET Plasma Fractionator contains a Ä¢¹½´«Ã½ polysulfone membrane, based on Ä¢¹½´«Ã½ membrane technology and enhanced for use in lipoprotein filtration.10
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1ÌýPadmanabhan A et al. J Clin Apher 2019; 34:171-354
2ÌýSchettler et al. Clin Res Cardiol Suppl 2017; 12:44-49
3ÌýSchettler et al. Clin Res Cardiol Suppl 2019; 14:33-38
4ÌýBosch Ther Apher 2001; 5(4):239-243
5ÌýBosch et al. Ther Apher Dial 2006; 10(3):210-218
6ÌýDräger et al. Eur J Clin lnvest 1998; 28:994-1002
7ÌýKozik-Jaromin et al. Atheroscler Suppl 2017;30:225Ä¢¹½´«Ã½“231
8ÌýRamlow et al. Atheroscler Suppl 2017; 30:217-224
9ÌýRaina et al. Blood Purif 2019; 47(4):301-316
10ÌýInstructions for Use MONET Plasma Fractionator (7510181 02/21)
11ÌýJulius et al. Ther Apher Dial 2013; 17(2):179-184
12ÌýJulius et al. Atheroscler Suppl 2015; 18:95-102
13ÌýPadmanabhan A et al. J Clin Apher 2019; 34:171-354; PVD see pages 281-282
14ÌýMehdi M et al.; Nephrol Dial Transplant 2019; 34(S1):i234-i235
15ÌýPithova P et al. Poster presented at the DFSG congress; 2017 Sept 8 -10; Porto, Portugal
16ÌýSoltész P et al. Orv Hetil 2021; 162(10):375-382