Exercise no. 322 Inclisiran (LEQVIO°) in certain types of hypercholesterolaemia

When a cholesterol-lowering drug is considered useful for preventing cardiovascular events in an adult with hypercholesterolaemia, a statin such as pravastatin or simvastatin is the first-choice drug. Alirocumab and evolocumab are monoclonal antibodies directed against an enzyme called PCSK9, which degrades hepatic LDL cholesterol receptors. These antibodies lead to an increase in the number of these receptors, thus increasing LDL cholesterol uptake by the liver and reducing the level of LDL cholesterol in the blood. They are authorised in the European Union for use in certain types of hypercholesterolaemia, when statins and ezetimibe (an inhibitor of intestinal cholesterol absorption) are considered insufficiently effective, or when statins cannot be used, for example because of their adverse effects. Alirocumab and evolocumab have not been shown to prevent cardiovascular events in patients who have never experienced such an event (i.e. in "primary" cardiovascular prevention), and they appear to have weak preventive efficacy in patients who have already experienced such an event (i.e. in "secondary" cardiovascular prevention). They have not been shown to extend survival nor to reduce cardiovascular mortality.