# Lipoprotein apheresis: still needed in many patients, or soon a historical practice?

Review · Schettler VJJ, Akgun Y, Floege J, Zoccali C

- Archive id: doi:10.1093/ckj/sfag240
- Published: 2026-08-04
- Venue: Clinical kidney journal
- DOI: https://doi.org/10.1093/ckj/sfag240
- PMID: 42626375
- PMCID: PMC13492341
- Citations: 1
- Source URL: https://doi.org/10.1093/ckj/sfag240
- PDF: https://europepmc.org/articles/PMC13492341/pdf
- Provenance: europepmc

## Abstract

Lipoprotein apheresis (LA) has long been used as an ultima ratio therapy for patients with extreme lipid-driven cardiovascular risk. One perspective maintains that, despite major advances in lipid-lowering pharmacology and the emergence of gene-silencing therapies, LA remains indispensable for selected patients with homozygous familial hypercholesterolaemia, severe hypercholesterolaemia refractory to maximal therapy, and isolated lipoprotein(a) \[Lp(a)\]-mediated progressive cardiovascular disease. An opposing view argues that modern and emerging pharmacological agents-PCSK9 inhibitors, inclisiran, bempedoic acid, evinacumab, and targeted Lp(a)-lowering antisense and small interfering RNA agents-have already rendered LA obsolete in almost all patients, with its remaining niche closing rapidly as outcome data accumulate. This combined manuscript juxtaposes the two positions in a streamlined form and concludes with a balanced conclusion of the future role of LA.

_Abstract reproduced under CC-BY (article license as recorded by Europe PMC; abstract reproduced unmodified apart from markup removal)._

Topics: [Cardiovascular Therapeutics](https://space-kitty.com/topics/cardiovascular-innovation)

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