Last updated on February 2018

Post Approval Study of Lixelle for the Treament of Dialysis-Related Amyloidosis

Brief description of study

Dialysis-related amyloidosis (DRA) is a serious complication of long-term hemodialysis (HD). Its pathogenic mechanism involves accumulation of 2-microglobulin (2M) in the blood. 2M is produced by most cells in the body and is metabolized in the kidney in healthy individuals. However, in HD patients with renal dysfunction, 2M which is not removed entirely by HD accumulates excessively in the blood. Then it forms amyloid fibrils that are deposited in bones, joints, and soft tissues. The fibrils are further modified by advanced glycation end products (AGE), inducing local macrophage infiltration and production of cytokines leading to chronic inflammation and activation of osteoclasts. Consequently, severe complications with various symptoms are developed, which are collectively referred to as DRA.

Lixelle is a whole-blood 2M apheresis column developed to adsorb and eliminate 2M selectively from the blood of DRA patients. The treatment is performed with Lixelle connected upstream of the dialyzer in series on a HD circuit in every session. The Lixelle column contains porous cellulose beads with covalently linked hexadecyl alkyl chain ligands, which selectively adsorb 2M, via a molecular sieving effect because of its porous structure and hydrophobic interaction with ligands. Lixelle has been used to relieve symptoms and prevent the progression of DRA in Japan since 1996, when health insurance coverage and reimbursement for the treatment were approved by Japanese Ministry of Health, Labor, and Welfare. Improvement of the activities of daily living (ADL) and remission of arthralgia by Lixelle treatment has been shown in several clinical studies.

Clinical Study Identifier: NCT02952144

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Jeffrey Silberzweig, MD

The Rogosin Institute
New York, NY United States
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Recruitment Status: Open

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