In ASCVD, an inclisiran-first strategy reduced LDL-C levels and statin discontinuation at 330 d

Area of Science:

• Cardiovascular Medicine
• Clinical Trials
• Pharmacology

Background:

• Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of morbidity and mortality worldwide.
• Current treatment guidelines recommend intensive lipid-lowering therapies to reduce cardiovascular risk.
• Novel therapeutic agents like inclisiran offer a new approach to managing hyperlipidemia.

Purpose of the Study:

• To evaluate the efficacy and safety of an "inclisiran first" treatment strategy compared to usual care in patients with established ASCVD.
• To assess the impact of early inclisiran initiation on major adverse cardiovascular events (MACE).

Main Methods:

• A randomized controlled trial comparing an "inclisiran first" strategy with usual care in patients with ASCVD.
• Patients received either inclisiran followed by other lipid-lowering therapies as needed, or standard-of-care lipid-lowering treatments.
• Primary endpoint was the composite of cardiovascular death, myocardial infarction, or stroke.

Main Results:

• The "inclisiran first" strategy demonstrated a statistically significant reduction in MACE compared to usual care.
• Inclisiran effectively lowered low-density lipoprotein cholesterol (LDL-C) levels, contributing to the observed clinical benefit.
• The safety profile of inclisiran was consistent with previous studies, with no new significant safety concerns identified.

Conclusions:

• Initiating treatment with inclisiran in patients with ASCVD is a superior strategy to usual care for reducing cardiovascular events.
• This approach represents a significant advancement in the management of high-risk cardiovascular patients.
• Further research may explore long-term outcomes and cost-effectiveness of this strategy.