First clinical results after HELP apheresis in Long COVID Syndrome

Treeman

Senior Member
Messages
847
Location
York, England
First clinical results after HELP apheresis in Long COVID Syndrome
(#59)

Dr. Gunnar J. Bücker1, Dr. Marcella Bürkner1, Dr. Lutz Fricke2, Prof. Christel Weiß31
Nephrology group practice, Osnabrück, Germany; 2
Nephrology group practice, Bochum, Germany; 3
University of Heidelberg, Department of Medical Statistics, Mannheim, Germany

Long COVID Syndrome (LC) is a new and complex disease lacking an established treatment so far. First reports portray HELP apheresis (HELP) as a promising therapy in LC. Since 2021, we have offered HELP in two practices and treated 120 patients so far. Our objective was to evaluate patients` response to HELP in LC.

Method: The patients‘ response to the HELP has been evaluated by means of a questionnaire checking for
symptoms before and after apheresis, as well as the current state of symptoms. The intensity of symptoms was depicted in a five-tier Likert scale ranging from 1 (bad, very pronounced) – 5 (very good, asymptomatic). Inclusion criteria: LC, at least 2 sessions of apheresis in 2022. Exclusion criteria: pre-existing ME/CFS, Post Vac-Syndrome. The questionnaires were issued to 64 patients (Osnabrück 48, Bochum 16). In total 31 responses (OS 26, BO 5) have been analysed so far. Statistical significance was assessed by Friedman test and Wilcoxon test for paired samples. A test result was considered as statistically significant for p less than 0.05. Subsequently, the median of results is presented.

Results: The patients were aged between 18 and 78 years, with an average of 41 years. 18 of 31 participants are female. The overall rating increased from a score of 2 (range 1 – 3) before apheresis to 3 (1-5) after apheresis and to 4 (1.2-5) currently. Comparison of symptoms before and after HELP shows a significant and sustained alleviation of symptoms (p < 0,0001). Further improvement after HELP compared to the patient’s current situation was not statistically significant. The evaluation of specific symptoms resulted in similar observations: patients’ general condition, walking restriction, dyspnoe, chest pain, POTS, PEM, brain fog, insomnia, fatigue and depression improved significantly. The median number of treatments per patient was 5 (2-7). The median duration of symptoms before treatment was 10 months (2-23), follow-up after apheresis was 6.5 months (1-10). Side effects were limited to 1 out of 144 treatment sessions, which resulted in a patient suffering from low blood pressure. 83 percent of the patients would recommend the treatment. Two relapses were noted after a new COVID infection. No worsening of symptoms has been reported after the procedure.

The given findings show a high response rate with significant clinical improvements and long-lasting results. Thus, HELP seems to be a promising and safe treatment option for patients suffering from LC.
 

Treeman

Senior Member
Messages
847
Location
York, England
Looks pretty interesting @Treeman ,particularly as there is a large number of patients. The chance of all of them having a placebo response seems unlikely.

I think the thing to understand is that is not an unproven practice.

The NHS have been using apheresis for some time. All be it on cancers, auto immune diseases etc, but accepted, not ME/CFS or LC. (https://www.nhsbt.nhs.uk/what-we-do/diagnostic-and-therapeutic-services/therapeutic-apheresis/)

The risks involved are minimal, it's the cost that is prohibited for many.
 

Wishful

Senior Member
Messages
6,116
Location
Alberta
I'm wondering if a good analogy is getting the interior of your car cleaned: it doesn't fix the engine problem or the transmission problem, but it does feel nicer.
 

Osaca

Senior Member
Messages
344
These are quite different procedures which all have different techniques and goals. The different types of apheresis we commonly see in our community are:

- Plasmapheresis
- Immunadsorption (Immunapheresis)
- H.E.L.P. Apheresis® (Lipidapheresis)
- Inuspheresis®

In a plasmapheresis the plasma is seperated from blood and then replaced by Donor plasma or a human albumin solution. In an immunadsorption the separated plasma is not thrown away but one instead tries to filter out autoantibodies using specific filters after which the plasma is reintroduced. These two procedures ultimately try to address different forms of autoimmunity by the removal of autoantibodies and can for instance be used in SLE. Immunadsorption is currently being researched quite heavily in LC and ME/CFS and autoimmune conditions.

The heparin induced H.E.L.P. Apheresis has the aim of eliminating Lipoproteins and is more commonly used to address Lipometabolic disorders. This became popular due to Beate Jäger and her "treatment" of "microclots" in the hope that this improve microcirculation.

Inuspheresis® is somewhat of a more advanced H.E.L.P. apheresis but doesn't use heparin and instead filters out some additional things. But being a registered trademark instead of being research oriented I'm even less conviced of this.

Further depending on the different filters and different techniques used there can be added differences amongst these procedures. More details can be found on this forum by using the search function for any of the procedures as these things have been quite heavily discussed on here.
 
Last edited:

Wishful

Senior Member
Messages
6,116
Location
Alberta
Possibly, however it could also give the system a rest and allow it to reset.
Yes, but it's possible that this treatment--or any other--could instead sustain or even worsen the dysfunction. With ME, there's no way to be sure. To me it seems like any treatment is basically a coin flip as to whether it helps or harms. Until we know what is involved in ME, we're just pretending that the theories suggests that treatment x will be more likely to help than harm, unless there's actual statistical evidence for it working.
 

Treeman

Senior Member
Messages
847
Location
York, England
Yes, but it's possible that this treatment--or any other--could instead sustain or even worsen the dysfu

Possibly, but on a case by case situation that might not be the case. I've never had a situation where I've done something that made me permanently worse. So I'd assume that this won't either. But I'm not severe and I would think if anyone was, it could be a more significant effect.
unless there's actual statistical evidence for it working.

There is above, for long COVID patients that went to the clinics. Also there is a severe ME/CFS patient who had the treatment in Cyprus and she talks about how it helped her.

Edit, add the video

 
Back