The Impact of Lipoprotein Apheresis on Inflammatory Factors: A Systematic Review and Meta-Analysis

Lipoprotein apheresis is a well-established therapy for patients with dyslipidemia unresponsive to conventional lipid-lowering strategies. However, its impact on systemic inflammation remains uncertain. This systematic review and meta-analysis evaluated the effect of apheresis on circulating inflammatory markers, including C-reactive protein (CRP), high-sensitivity CRP (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha). Following PRISMA guidelines, a systematic search of PubMed, Scopus, and ISI Web of Science was conducted up to June 2025. Studies reporting pre- and post-apheresis values for inflammatory markers were included. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated. Thirteen publications met inclusion criteria. Meta-analysis demonstrated that apheresis significantly reduced CRP levels (SMD = -0.31; 95% CI: -0.44 to -0.18; p < 0.001), particularly in long-term interventions. No significant changes were observed for IL-6, TNF-alpha, or hs-CRP. In conclusion, apheresis significantly reduces CRP levels, especially with long-term treatment, suggesting a modest anti-inflammatory benefit. However, its effects on other markers remain unclear. Larger and high-quality trials are warranted.