29 Apr 2024 • In the VICTORION-INITIATE trial, researchers compared an ""inclisiran first"" strategy, where inclisiran was added immediately upon failure to reach LDL-C <70 mg/dL despite receiving maximally tolerated statins, with usual care in U.S. patients with atherosclerotic cardiovascular disease.

Inclisiran is a first-in-class small interfering RNA that inhibits hepatic PCSK9 production, increasing hepatic expression of the LDL receptor and LDL clearance.

The ""inclisiran first"" strategy (284 mg at days 0, 90, and 270), integrating inclisiran alongside statins, showcased remarkable results, slashing LDL cholesterol levels by an impressive 60.0%, compared to a mere 7.0% with conventional care. Moreover, a higher proportion of inclisiran-first patients achieved LDL-C targets vs. usual care.

Importantly, despite comparable adverse event rates, inclisiran's introduction did not deter statin use, showcasing its potential as a game-changer in managing atherosclerotic cardiovascular disease.

Source: JACC | Read full story