Prevention & lipidsRandomised controlled trial

Safety and Lipid-Lowering Efficacy of Inclisiran Monotherapy in Patients Without Atherosclerotic Cardiovascular Disease (ASCVD)

J Am Coll CardiolPublished

  • Randomised controlled trial
  • phase 3
  • double-blind
  • multicentre
  • placebo- and active-comparator controlled
  • 2:1:1 randomisation

Twice-yearly inclisiran dosing not evaluated beyond the first 180 days

Authors' conclusion

V-Mono demonstrates for the first time that in patients not receiving lipid-lowering therapy, inclisiran as monotherapy, is superior to both placebo and ezetimibe in reducing LDL-C levels over a 6-month follow-up period and was well tolerated.

Study context

Population
Adults aged 18–75 years without ASCVD, DM or familial hypercholesterolemia, low-density lipoprotein cholesterol (LDL-C) 100–190 mg/dL, 10-year ASCVD risk <7.5%, not on lipid-lowering therapy
Participants
350 adults
Comparison
Inclisiran monotherapy vs ezetimibe vs placebo
  • Inclisirann = 174
  • Ezetimiben = 89reference
  • Placebon = 87reference
Primary endpoint
Percentage change in LDL-C from baseline
Follow-up
Day 150

Primary result

As reported in the abstract

Placebo

1.4

mean · %

Ezetimibe

−11.2

mean · %

Inclisiran

−46.5

mean · %

Inclisiran vs Placebo
difference −47.9 %; P < 0.0001
Inclisiran vs Ezetimibe
difference −35.4 %; P < 0.0001

Secondary outcomes

Other lipid and lipoprotein(a) levels

Inclisiran showed favorable improvements in other lipid and lipoprotein(a) levels

Safety

Tolerability

Inclisiran well tolerated, no new safety concerns

Original publication

Safety and Lipid-Lowering Efficacy of Inclisiran Monotherapy in Patients Without ASCVD. J Am Coll Cardiol. Published 5 May 2025. doi:10.1016/j.jacc.2025.04.049

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