Background and Aims : Small interfering RNA molecules (siRNA) e.g.,
Inclisiran represent an attractive alternative to monoclonal antibodies for
Proprotein convertase subtilisin/kexin type 9 (PCSK9) lowering. These
molecules offer profound lowering of (intra- and extracellular) PCSK9 at a
lower-dose frequency and potentially at a lower cost. Inclisiran has undergone
phase 1, 2, and 3 evaluation all within the context of the ORION
trials, with good efficacy and safety. Considering that Egypt is a middleincome
country with a burdened economy, concerns are raised on which
patients would benefit from this expensive medication. Therefore, the
Egyptian Association for Vascular biology and Atherosclerosis (EAVA) took
the responsibility of providing the 1st Egyptian consensus on the use of
Inclisiran in clinical practice.
Methods: EAVA analyzed the data that would enable us to obtain clear
indications for the use of Inclisiran.
Results: Dyslipidemia represents a major atherosclerotic risk factor in
Egypt. Among Egyptian patients with acute coronary syndromes, it has
been estimated that the prevalence of dyslipidemia is 48%, and that of ‘atleast-
possible’ FH is 17%. Reaching low-density lipoprotein cholesterol
(LDL-C) goals is difficult as well.
Conclusions: We recommend the use of Inclisiran in addition to statins ±
ezetimibe in patients with either [1]. established ASCVD or [2]. FH with
one of the following: another major risk factor, eGFR < 30 ml/min,or veryhigh
risk DM, who didn’t reach LDL-C goals and/or with true statin intolerance. |
