Inclisiran and siRNA-Based Lipid Lowering: A New Frontier Including ANGPTL3 Inhibitors and Apo C III Inhibitors

Cardiovascular (CV) disease remains the leading cause of death worldwide. Dyslipidemia is a well-known risk factor for CV disease. The persistent rise in heart disease despite widespread use of statins highlights the limitations of current cholesterol management strategies. While statins are effective, underutilization and intolerance leave significant treatment gaps, especially in women. Women tend to develop greater side effects to statins and are also prone to genetic polymorphisms which make them statin under-responsive. Beyond low-density lipoprotein, other lipoprotein targets have been investigated such as triglycerides and lipoprotein(a) that may contribute to the patient’s residual CV risk. Fortunately, new drug classes targeting these varied lipid pathways have shown promise in lowering cholesterol levels and reducing the CV event rates. This review will discuss the mode of action, effectiveness, and recommendations of three new classes of drugs – inclisiran, anti-angiopoietin-like 3 drugs, and apolipoprotein C-III inhibitors. Their effectiveness in women will be discussed in a separate section.