Background
Elevation of low-density lipoprotein cholesterol (LDL-c) is still a hugely unmet need in the reduction of atherosclerotic cardiovascular disease. In the published CardioRisk project in Egypt, up to 71% of female participants had dyslipidemia. Control of LDL-c levels and thus improvement of hyperlipidemia is quite often very difficult. With the introduction of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, the decrease of significant cardiac adverse events, the patient control rate, and the death rate have all been improved. Inhibition of the formation of PCSK9 through inclisiran, which is a novel method of reducing LDL-c and is only given twice per year, seems alluring. After revision of published data, we analyzed the potential advantages of the use of inclisiran.
Conclusion
The Egyptian Association for Vascular Biology and Atherosclerosis (EAVA) analyzed the data necessary for obtaining clear indications for the usage of inclisiran. We propose the addition of inclisiran to statins with or without ezetimibe for patients with documented atherosclerotic cardiovascular disease (ASCVD) or similar risk, familial hypercholesterolemia (FH) with another major risk factor, and very high and high risk diabetes mellitus, who did not reach LDL-c goals and/or with true statin intolerance. Inclisiran is also recommended as upfront therapy, with triple combination, in extreme risk subjects such as those with post acute coronary syndromes (ACS). |
