From the Research
Inclisiran does not lower lipoprotein(a) levels. Inclisiran is a small interfering RNA (siRNA) medication that specifically targets PCSK9 production in the liver, which increases LDL receptor availability and enhances LDL cholesterol clearance from the bloodstream. While inclisiran effectively reduces LDL cholesterol by approximately 50-55%, clinical studies have not shown any significant effect on lipoprotein(a) levels, as noted in the most recent study from 2023 1. This differs from some other lipid-lowering therapies like PCSK9 inhibitor antibodies (evolocumab and alirocumab), which may modestly reduce lipoprotein(a) by 20-30%. For patients specifically needing to lower lipoprotein(a), other approaches would be more appropriate, such as niacin, PCSK9 inhibitor antibodies, or emerging therapies like antisense oligonucleotides targeting lipoprotein(a) production. The mechanism behind inclisiran's lack of effect on lipoprotein(a) relates to its specific action on hepatic PCSK9 synthesis rather than directly affecting lipoprotein(a) metabolism or production pathways.
Key Points
- Inclisiran is a siRNA medication that targets PCSK9 production in the liver
- It effectively reduces LDL cholesterol by approximately 50-55%
- Clinical studies have not shown any significant effect on lipoprotein(a) levels
- Other lipid-lowering therapies, such as PCSK9 inhibitor antibodies, may be more effective in reducing lipoprotein(a) levels
- Inclisiran's mechanism of action is specific to hepatic PCSK9 synthesis and does not directly affect lipoprotein(a) metabolism or production pathways
Clinical Implications
- Inclisiran may not be the best treatment option for patients with high lipoprotein(a) levels
- Other therapies, such as niacin or PCSK9 inhibitor antibodies, may be more effective in reducing lipoprotein(a) levels
- Clinicians should consider the individual patient's needs and lipid profile when selecting a treatment option
- Further research is needed to fully understand the effects of inclisiran on lipoprotein(a) levels and to develop more effective treatments for patients with high lipoprotein(a) levels, as suggested by recent studies 2, 3, 4, 5.