Inclisiran, a Potent Lipid Lowering Treatment for Reaching LDL Goals on Top of Statins and Ezetimibe: A Single User Experiences

BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality, and reducing LDL cholesterol is a key strategy in lowering cardiovascular risk. Inclisiran, a small interfering RNA that targets PCSK9, is an effective lipid-lowering treatment. AIM: This study evaluates the long-term efficacy of inclisiran in patients with high cardiovascular risk who fail to reach LDL goals despite statin and ezetimibe therapy. METHODS: A total of 33 patients with high-risk atherosclerotic disease and elevated LDL cholesterol levels, despite maximal statin/ezetimibe therapy or patients who couldn't tolerate statins, were administered inclisiran at baseline with 21 patients receiving a second dose at 3 months. Lipid profiles were measured at baseline, 3 months after first dose, and 3 months after second dose. The primary outcome was the change in LDL-C levels from baseline to post-treatment. RESULTS: Inclisiran significantly reduced LDL-C levels from a baseline mean of 2.66 mmol/L to 1.49 mmol/L after the first dose (p < 0.001). A total of 73.0% of patients achieved LDL-C levels below 1.8 mmol/L, 57.7% below 1.4 mmol/L, and 34.6% below 1.0 mmol/L, with 42.3% experiencing a reduction of more than 50% after the first dose. These reductions were maintained after the second dose, with LDL-C levels remaining significantly lower than baseline. CONCLUSION: Inclisiran provides significant and sustained LDL-C reductions in patients with high cardiovascular risk and represents an effective long-term treatment option for reducing cardiovascular risk.