Briani Francesco, Bagli Mauro, Venturi Gabriele, Bacchion Francesco, Mugnolo Antonio
Division of Cardiology, Mater Salutis Hospital, Verona, Legnago, Italy.
Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy.
Atheroscler Plus. 2025 Jan 28;59:54-58. doi: 10.1016/j.athplu.2025.01.001. eCollection 2025 Mar.
Elevated low-density lipoprotein cholesterol (LDL-C) levels are associated with atherosclerotic cardiovascular diseases. Inclisiran, a small interfering RNA, has been observed to effectively and sustainably reduce LDL-C in large randomized controlled trials (RCTs); however, real-world data on its short-term efficacy and use are limited. This study aims to assess the efficacy and safety of inclisiran in a real-life population within one month from the first administration.
This observational, single-center, retrospective cohort study included patients affected by dyslipidemia who could not achieve their LDL-C target despite a maximum tolerated oral lipid-lowering therapy (LLT). 284 mg Inclisiran was subcutaneously administered. Blood samples were collected before the inclisiran administration and at week and one month afterward with the aim toevaluate achievement of LDL-C targets at these time intervals (primary endpoint) and reduction in LDL-C levels (secondary endpoint).
From September 2022 to December 2023, inclisiran was administered to 33 patients at Mater Salutis Hospital. After exclusion of two patients due to statin therapy modification or discontinuation during follow-up, a final number of 31 patients were included. At a median follow-up of 32 (IQ 30-37) days, 21 (67.7 %) patients reached their LDL-C target (primary endpoint). At 7 days, LDL-C mean value decreased from 123.6 ± 42.1 mg/dl to 97.9 ± 53.6 mg/dl, (p < 0.001), with a 29.9 ± 20.6 % reduction. At 32 days, LDL-C mean value declined to 58.5 ± 42.8 mg/dl (p < 0.001), with a 56.9 ± 20.9 % reduction.
In a real-life single center population, inclisiran safely led to LDL-C target achievement within one month. Significantly reduction of LDL-C levels were already present in the early days after the first administration.
低密度脂蛋白胆固醇(LDL-C)水平升高与动脉粥样硬化性心血管疾病相关。Inclisiran是一种小干扰RNA,在大型随机对照试验(RCT)中已观察到其能有效且持续地降低LDL-C;然而,关于其短期疗效和使用的真实世界数据有限。本研究旨在评估Inclisiran在首次给药后1个月内对真实人群的疗效和安全性。
这项观察性、单中心、回顾性队列研究纳入了尽管接受了最大耐受剂量的口服降脂治疗(LLT)仍未达到LDL-C目标的血脂异常患者。皮下注射284mg Inclisiran。在注射Inclisiran前以及注射后1周和1个月采集血样,目的是评估这些时间点LDL-C目标的达成情况(主要终点)以及LDL-C水平的降低情况(次要终点)。
2022年9月至2023年12月,Mater Salutis医院对33例患者使用了Inclisiran。在排除2例因随访期间他汀类药物治疗调整或停药的患者后,最终纳入31例患者。中位随访32(四分位间距30 - 37)天,21例(67.7%)患者达到LDL-C目标(主要终点)。在7天时,LDL-C均值从123.6±42.1mg/dl降至97.9±53.6mg/dl,(p<0.001),降低了29.9±20.6%。在32天时,LDL-C均值降至58.5±42.8mg/dl(p<0.001),降低了56.9±20.9%。
在真实世界的单中心人群中,Inclisiran在1个月内安全地使患者达到了LDL-C目标。首次给药后的早期LDL-C水平就已显著降低。