Prevention & lipidsRandomised controlled trial

An “Inclisiran First” Strategy vs Usual Care in Patients With Atherosclerotic Cardiovascular Disease

J Am Coll CardiolPublished

  • Randomised controlled trial
  • pragmatic
  • open-label
  • multicentre
  • 1:1 randomisation

Authors' conclusion

An "inclisiran first" implementation strategy led to greater LDL-C lowering compared with usual care without discouraging statin use or raising new safety concerns.

Study context

Population
US patients with atherosclerotic CVD and low-density lipoprotein cholesterol (LDL-C) ≥70 mg/dL despite maximally tolerated statins30.9% women
Participants
450 patients
Comparison
"Inclisiran first" strategy plus usual care vs usual care alone
Primary endpoint
Percentage change in LDL-C from baseline; statin discontinuation rates
Follow-up
Day 330

Primary result

As reported in the abstract

LDL-C reduction from baseline to day 330

P < 0.001

Statin discontinuation

Further findings

LDL-C goal achievement

P < 0.001

<70 mg/dL

<55 mg/dL

Safety

TEAEs and serious TEAEs

TEAE

Serious TEAE

Injection-site TEAEs and TEAEs causing treatment withdrawal

Injection-site TEAE

TEAE causing withdrawal

Treatment-emergent adverse event (TEAEs) and serious TEAEs

Rates compared similarly between strategies

Injection-site TEAEs and TEAEs causing treatment withdrawal

More common with inclisiran first

Original publication

An “Inclisiran First” Strategy vs Usual Care in Patients With Atherosclerotic Cardiovascular Disease. J Am Coll Cardiol. Published 7 April 2024. doi:10.1016/j.jacc.2024.03.382

Summarised from the published abstract; every number is checked against it