Abstract 4364741: Real-World Assessment of the Efficacy of Inclisiran in Lowering Low-Density Lipoprotein Cholesterol: Outcomes From AAH Tertiary Cardiovascular Clinics

Abstract

Background: Inclisiran is a novel innovative therapy for the reduction of low-density lipoprotein cholesterol (LDL-C). However, real-world data about its efficacy are limited. Hypothesis: We hypothesized that inclisiran would significantly reduce LDL-C in patients unable to achieve their target LDL-C goals with conventional therapies. Aims: To investigate the impact of inclisiran on LDL-C levels in a real-world clinical setting at a tertiary cardiovascular center. Methods: We retrospectively analyzed all adult patients at our healthcare network’s cardiovascular clinics who were initiated on inclisiran between December 2021 and May 2024. Baseline patient characteristics, medications, and comorbidities were extracted. Each patient’s lipid profile, including total cholesterol, LDL-C, high-density lipoprotein cholesterol (HDL-C), and triglycerides, was collected prior to the initiation of inclisiran, at 6 months, and at 12 months. Results: A total of 380 patients (78% White, 62% female) were included in this study. The mean age was 70 years. The most common comorbidities were coronary artery disease (82%), hypertension (81%), diabetes mellitus (31%), and congestive heart failure (22%). Two hundred nine patients (55%) were on any intensity statin, 174 patients (46%) were on ezetimibe, and 62 patients (16%) were on bempedoic acid during the initiation of inclisiran. Ninety-two patients (24%) were on an alternative PCSK9 inhibitor before switching to inclisiran. At 6 months, there was a 40% reduction in LDL-C, a 35% reduction in HDL-C, a 22% reduction in total cholesterol, and no significant reduction in triglycerides. The reduction was maintained at 12 months. Figure 1 shows the lipid profile at baseline, 6 months, and 12 months. Conclusions: Inclisiran was effective in reducing LDL-C, HDL-C, and total cholesterol by 6 months. This improvement in cholesterol was maintained at 12 months.