Treatment: Inclisiran

What is inclisiran?

Inclisiran is a relatively new medication used to treat people with high cholesterol that has not been successfully reduced with other treatments. It belongs to a class of drug called a PCSK9 inhibitor, which works by blocking a type of protein made in the liver that encourages bad cholesterol levels to build.

Inclisiran is administered by a health professional every six months via an injection under the skin, usually in the abdomen, upper arm or thigh. When starting the drug, after the first injection there is an extra second dose at three months, and thereafter injections are given every six months.

Why is inclisiran given?

Inclisiran is used to lower bad cholesterol levels in patients who cannot get their cholesterol to target, and have exhausted all other lipid management therapies - including statins - either because those medicines could not lower LDL levels enough, or they could not be taken due to side effects. Inclisiran can be used alone or in combination with other treatments, such as statins.

In the UK, the medication is usually used in people with existing cardiovascular disease (either heart disease, strokes or peripheral arterial disease) who have LDL cholesterol levels that are still too high after other treatment options have been exhausted. In this case, there is a risk that if LDL cholesterol remains uncontrolled, more heart disease or strokes can occur, due to worsening of “furring” or atherosclerosis.   

What does inclisiran treatment involve?

Before receiving Inclisiran, you will have a blood test to confirm the starting levels of cholesterol in your bloodstream. This baseline includes a full lipid profile (including LDL-C), as well as tests for your liver function, kidney function, thyroid and diabetes status (HbA1c).

At OneWelbeck an injection of Inclisiran is given into the abdomen by a cardiac nurse during a short appointment in our Heart Health outpatient clinic. 

You will then have a follow-up appointment three months after your first injection where you will again have a blood test to assess your full lipid profile (including LDL-C). If these are satisfactory, and show that the treatment is safe for you and is working, you will be able to continue your treatment with a second dose of Inclisiran. Thereafter you will have injections every 6 months.

What can I expect from Inclisiran?

Inclisiran is a relatively new drug, but it has been widely tested and is approved for use in the UK and recommended by NICE for certain patients. Clinical trial evidence shows that Inclisiran can halve bad cholesterol levels, with reductions in LDL cholesterol levels commonly seen after 90 days of treatment.

What are the risks associated with taking Inclisiran?

Inclisiran is considered to be a safe drug, with very few risks and only rare occurrences of side effects. With the correct administration of the drug by a OneWelbeck cardiac nurse, any potential risks from the injection are significantly lowered. 

There is a small risk that someone may be allergic to the components in the medication but none have been reported as of yet. In some cases, patients experience a mild to moderate reaction at the site of the injection, which can cause a rash, pain or redness. 

Please note that you are unable to take Inclisiran if you are pregnant or breastfeeding.