Real-World Low-Density Lipoprotein Cholesterol Control After Transitioning From Evolocumab to Inclisiran

Inclisiran is a siRNA therapy that provides sustained reduction in low-density lipoprotein cholesterol (LDL-C) with twice-yearly dosing, but real-world data after switching from PCSK9 monoclonal antibodies remain limited.

We retrospectively analyzed 32 patients with coronary artery disease who transitioned from evolocumab to inclisiran. Median LDL-C was 27.0 mg/dL at baseline and remained stable at 3, 6, and 9 months (29.0, 30.5, and 29.5 mg/dL). Eight patients (25%) exceeded the LDL-C target (<70 mg/dL) at least once, more frequently among those with heterozygous familial hypercholesterolemia. Discontinuation occurred in 12.5%.

Switching to inclisiran generally maintained LDL-C levels, although patients with familial hypercholesterolemia may require closer monitoring.