Home > Focus Areas > Lipid Management Connect > Post
  • Saved

39min

Did you know?

Poor adherence to daily lipid-lowering therapy is a major driver of residual cardiovascular risk. Inclisiran, a small interfering RNA (siRNA) that silences PCSK9 production in the liver, is administered by subcutaneous injection only twice per year after two initial doses. Phase 3 ORION trials (n=3,660 patients across ORION-10, -11, and -9) demonstrated that twice-yearly inclisiran reduced LDL cholesterol by 50–52% from baseline over 18 months, with effects persisting between doses and a safety profile comparable to placebo.

NCCN Guidelines
Discussion question

For patients with atherosclerotic cardiovascular disease or heterozygous familial hypercholesterolemia who struggle with adherence to daily oral therapy, how does a twice-yearly injectable PCSK9-silencing approach change your lipid management strategy?

Profile Image
  • Uploads
  • 39min
    This could be a game changer, if affordable. So many patients are statin non-adherent due to side effects or perceptions about the medication, so if we could get them to goal without having to fight for them to take a daily pill that they don't trust or don't like, this would be ideal. Again, having access to it without significant financial barriers or need for a specialist to prescribe would be necessary for widespread, successful use.
  • 3d
    I’ve been very enthusiastic about Leqvio. It is safe and effective and quite convenient, especially impatient who struggled with compliance.
  • 6d
    ABSOLUTELY A WONDERFUL IDEA BUT WHAT LEQVIO LACKS IS ADEQUATE INSURANCE COVERGE. EXCEPT FOR MEDICARE PART B WHERE THERE IS A 0 DOLLAR COPAY AND NO PA, IT IS ALMOST IMPOSSIBLE TO GET LEQVIO APPROVED. EVEN FOR MEDICARE PART B PATIENTS I HAVE TO SEND THESE PATIENTS OUT TO A LOCAL INFUSION CENTER TO GET THEIR MEDICATION AS BUY AND BILL OPTION FOR LEQVIO IS NOT FEASIBLE FOR MY PRACTICE.
  • 1w
    It is definitely appealing to many patients that desire simplification in their medications with the prospects of improved compliance and LDL as well as LpA lowering. Often, I try to find opportunities to prescribe PCSK9 inhibitor medication as long as it is insurance covered and reasonable / affordable out of pocket cost
  • 1w
    It’s great.
  • 2w
    This would be great for my patients that struggle with compliance. Hopefully it would provide improved outcomes like the other PCSK9 injectables.
  • 2w
    This drug works great. Lowers LDL, helps adherence and limited side effects.
  • 2w
    It will greatly improve compliance.
  • 3w
    It would help with patient compliance being only twice a year.
  • 3w
    For patients who struggle with compliance with medical therapy. Injectable with twice yearly dosing could improve patient compliance and hopefully improved outcomes, although outcomes data is forthcoming
  • 3w
    For patients who struggle with daily pills, twice-yearly inclisiran can be a useful option.
    It may improve adherence and provide consistent LDL lowering.
    I would consider it alongside lifestyle changes and other guideline-directed lipid therapy.
    The key is choosing the treatment that the patient can realistically maintain long term.

Show More Comments