Beta2-microglobulin-selective adsorbent column (Lixelle) for the treatment of dialysis-related amyloidosis

Abstract

Lixelle is a direct hemoperfusion-type adsorbent column developed for selective elimination of beta2-microglobulin (beta2-m) from the circulating blood of patients with dialysis-related amyloidosis (DRA). Lixelle S-35, that has a column volume of 350 mL, efficiently eliminates beta2-m and improves symptoms of DRA such as joint pain and nocturnal awakening. The performance of Lixelle S-15, that has a column volume of 150 mL, is dependent on the dialysis membrane used in combination with the adsorbent column in a hemodialysis circuit. The combination of S-15 and a dialysis membrane with a high beta2-m clearance eliminates an amount of beta2-m that is nearly equal to the amount removed by using S-35. Treatment with S-15 for 6 months improved joint pain with an efficacy similar to that observed when using S-35. The major adverse effects were hypotension and decrease in hematocrit, and these incidences were much less in S-15 compared to S-35.