Beasley, Allen, Crow, Methvin, Portis & Miles, P.C.

Cholesterol-fighting medicine may fail some people, as the controversial and embattled drug Vytorin illustrates, but now medical technology provides a solution for those who just can’t lower their cholesterol any other way: a low-density lipoprotein (LDL) apheresis machine.

Think of it as a device that scrubs the blood clean, much like kidney dialysis, except that the machine targets and removes bad LDL cholesterol instead of the impurities removed by dialysis.

The cholesterol machine draws the patient’s blood from one arm. It then breaks the blood down into red blood cells and plasma, sending the red cells back into the patient’s bloodstream. Meanwhile, the machine infuses the blood plasma with the blood thinning drug heparin, which binds to the LDL cholesterol, thereby drawing it out of the plasma. The device then sends the clean plasma back into the patient’s other arm.

The machine removes and cleans 2.5 liters of blood, about half of the body’s blood supply.

This two-hour process is short lived, so it must be repeated every two weeks for effective treatment of high cholesterol. The therapy is also extremely expensive, costing about $3,000 for each session ($6,000 per month), and as such is currently used only as a last resort for patients who have been unable to lower their cholesterol after six months of diet, exercise, and pharmaceutical medicines.

Some people rack up their cholesterol score from the foods they eat. For others, too much bad LDL cholesterol is produced by the liver, thanks to the family genes. For many, elevated cholesterol comes from both sources.

To combat the cholesterol problem on both fronts, Merck teamed up with Schering-Plough to create Vytorin, a drug that combines Merck’s Zocor with Schering-Plough’s Zetia. However, clinical trials revealed that the drug was at best a flop and at most a toxic cancer-promoting drug. In either case, it failed to treat cholesterol any more effectively than cheaper generic statins.

There’s a good chance that most patients who qualify for treatment on the LDL apheresis machine have tried Vytorin first but found it to be ineffective in controlling their levels of LDL cholesterol. Familial hypercholesterolemia, a genetic predisposition for high cholesterol, occurs in approximately 1 in 500 people.

Sources include: http://www.liposorber.com/ldl/index.htm, and http://www.stltoday.com

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