Key result
Inclisiran linked to ~64% LDL-C reduction at 90 days in adults with ASCVD.
Why the study?
Does inclisiran reduce LDL-C in adults with established atherosclerotic cardiovascular disease in a real-world setting?
Observational (n=120)
No
Does inclisiran reduce LDL-C in adults with established atherosclerotic cardiovascular disease in a real-world setting?
In a real-world Spanish cohort of secondary prevention patients, inclisiran effectively reduced LDL-C by 63.8% at 90 days, with 64.5% achieving target levels <55 mg/dL.
BACKGROUND Inclisiran produces sustained LDL-C lowering in clinical trials. Real-world evidence in homogeneous secondary prevention populations is limited. OBJECTIVE To evaluate the early effect of inclisiran on LDL-C in a homogeneous secondary prevention cohort with coronary artery disease. METHODS We conducted a retrospective, observational study of 120 adults with established atherosclerotic cardiovascular disease treated with inclisiran between December 2023 and August 2025 at a tertiary care center in Spain. Baseline and 90-day lipid profiles were compared. Subgroup analyses examined LDL-C reduction by sex, type 2 diabetes, statin, ezetimibe, and bempedoic acid use, as well as Lp(a) and remnant cholesterol (RC) levels. RESULTS Mean baseline LDL-C was 126.1±34.7mg/dL (3.26±0.90mmol/L), decreasing to 45.3±28.3mg/dL (1.17±0.73mmol/L) at 90 days (absolute change -80.9mg/dL; -2.09mmol/L, -63.8%). The therapeutic target, <55mg/dL (<1.4mmol/L), was achieved by 64.5%. Statin users had significantly greater reductions (p<0.01). LDL-C lowering was similar across sexes despite higher baseline levels in women, and slightly greater in patients with diabetes (p=0.48). Elevated Lp(a) showed a weak inverse correlation with LDL-C change although a trend was shown (r=-0.18). RC fell by 16.6% (p=0.008). Bempedoic acid users (n=16) had numerically greater reductions, though not statistically significant probably due to the low n of patients. Inclisiran was well tolerated in this cohort, with no significant adverse events reported. CONCLUSIONS Inclisiran achieved marked LDL-C reductions at 90 days in real-world secondary prevention, especially with the concurrent use of statins. Its twice-yearly dosing and favorable safety profile, in the term observed, support integration into guideline-directed therapy. Larger, longer-term studies should assess durability of effect, long term adherence and the impact on cardiovascular outcomes.
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Piro et al. (2026) conducted an observational in Atherosclerotic cardiovascular disease (n=120). Inclisiran vs. Baseline was evaluated on LDL-C reduction at 90 days (MD -80.9 mg/dL). Inclisiran reduced mean LDL-C from 126.1 mg/dL at baseline to 45.3 mg/dL at 90 days (an absolute reduction of 80.9 mg/dL or 63.8%) in adults with atherosclerotic cardiovascular disease.
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