Why the study?
Small interfering RNAs targeting hepatic PCSK9 synthesis represent a novel approach to lower LDL-C, prompting a review of clinical trial data and the potential impact of inclisiran.
Does inclisiran reduce LDL cholesterol in patients with established cardiovascular disease, high-risk primary prevention, or familial hypercholesterolemia?
Does inclisiran reduce LDL cholesterol in patients with established cardiovascular disease, high-risk primary prevention, or familial hypercholesterolemia?
Effect estimate: 50% reduction
Inclisiran provides a sustained 50% reduction in LDL-C with a convenient twice-yearly dosing regimen, offering a promising strategy for high-risk patients on background statin therapy.
PURPOSE OF REVIEW: Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition is a new strategy to reduce LDL cholesterol (LDL-C), that is currently pursued by mAbs. A promising novel approach to target PCSK9 is using small interfering RNAs to inhibit hepatic PCSK9 synthesis. The first small interfering RNA developed for this purpose is inclisiran. Here, we review its clinical trial data and potential impact on patient management. RECENT FINDINGS: Inclisiran achieves sustained, additional 50% LDL-C reduction in patients receiving background statin therapy. Resulting LDL-C changes can be maintained by an infrequent dosing regimen with twice per year injections, that appear safe and well tolerated. Thus far, inclisiran has been studied in patients with established cardiovascular disease, high-risk primary prevention and in patients with familial hypercholesterolemia. SUMMARY: High and very high-risk individuals may benefit from the additional LDL-C-lowering effect of inclisiran when added to current lipid-lowering therapies. Furthermore, the simple dosing regimen may improve the convenience for users and facilitate patient adherence to therapy. The safety and convenience of inclisiran may offer new opportunities for population health.
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Brandts et al. (2020) conducted a review in Hypercholesterolemia / High cardiovascular risk. Inclisiran vs. Background statin therapy was evaluated on LDL-C reduction (50% reduction).
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