{"id":"doi:10.1186/s12933-023-01752-4","kind":"review","title":"Clinical potential of inclisiran for patients with a high risk of atherosclerotic cardiovascular disease","authors":["Nishikido T"],"author_count":1,"year":2023,"published":"2023-01-30","venue":"Cardiovascular diabetology","cited_by":38,"doi":"10.1186/s12933-023-01752-4","arxiv_id":null,"nct_id":null,"source_url":"https://doi.org/10.1186/s12933-023-01752-4","archive_url":"https://space-kitty.com/papers/doi:10.1186/s12933-023-01752-4","updated":null,"pmid":"36717882","pmcid":"PMC9887852","openalex_id":null,"pdf_url":"https://europepmc.org/articles/PMC9887852/pdf","abstract":"Elevated low-density lipoprotein cholesterol (LDL-C) level is associated with an increased risk of atherosclerotic cardiovascular disease. Although high-intensity lipid-lowering therapies with statins and ezetimibe are highly effective for reducing LDL-C levels, over half of high-risk patients do not achieve guideline-recommended LDL-C goals. Thus, there is a significant gap between treatment guidelines and their implementation in daily clinical practice. The major causes are individual variability in the response to lipid-lowering therapies and variation in treatment adherence. Proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibodies combined with statins provide marked and consistent reduction in LDL-C levels; however, poor adherence due to the need for subcutaneous injections every 2 or 4 weeks and high cost are major obstacles to their use in real-world clinical settings. Inclisiran, a recently approved novel small interfering ribonucleic acid (siRNA) molecule that inhibits PCSK9 synthesis, provides robust and long-term reduction in LDL-C levels with a low inter-individual variability in the LDL-C-lowering response. Moreover, its administration by biannual injection is expected to greatly improve treatment adherence. Clinical trials of this drug lasting for up to 4 years showed acceptable safety profiles, and ongoing studies accumulate evidence of its longer-term safety. This narrative review summarizes the available evidence on the efficacy and safety of inclisiran and analyzes its potential to overcome the gap between guideline recommendations and real-world clinical practice in current LDL-C-lowering therapies, with a focus on reduced LDL-C level variability and improved treatment adherence.","abstract_license":"CC-BY (article license as recorded by Europe PMC; abstract reproduced unmodified apart from markup removal)","license":"CC-BY","is_open_access":true,"retracted":false,"peer_reviewed":null,"categories":[],"details":null,"provenance":"europepmc","attribution":"Abstract of \"Clinical potential of inclisiran for patients with a high risk of atherosclerotic cardiovascular disease\" by Nishikido T, https://doi.org/10.1186/s12933-023-01752-4, used under its Creative Commons Attribution license (CC-BY); markup removed, otherwise unmodified.","topics":[{"slug":"cardiovascular-innovation","name":"Cardiovascular Therapeutics","domain_slug":"medicine"}],"cited_in_dossiers":[]}