guidelines

inclisiran for hypercholesterolaemia (nice ta733)

ta733: secondary prevention eligibility (prior cv events), ldl-c threshold ≥2.6 mmol/l despite max tolerated therapy, and how it fits alongside statins/ezetimibe/pcsk9 pathways.

last reviewed: 2026-02-13
based on: NICE TA733 (published 06 Oct 2021; accessed Feb 2026)

TA733: who is eligible?

  • Adults with primary hypercholesterolaemia (heterozygous familial and non-familial) or mixed dyslipidaemia.
  • Requires established cardiovascular disease history (examples in TA733 include acute coronary syndrome/MI/unstable angina needing admission, revascularisation, coronary heart disease, ischaemic stroke, or peripheral arterial disease).
  • LDL-C threshold: persistently ≥2.6 mmol/L despite maximum tolerated lipid-lowering therapy:
    • max tolerated statin ± other agents, or
    • non-statin lipid-lowering therapies if statins are contraindicated/not tolerated.

How to frame it in primary care

  • Primary care role: identify eligible secondary prevention patients with persistently high LDL-C despite adherence/optimisation; refer/liaise with lipid services per local pathway.
  • Practical step before referral: confirm adherence, address secondary causes (e.g. hypothyroid, nephrotic syndrome), optimise statin intensity and add ezetimibe if indicated/allowed by local formulary.
  • Dosing schedule (conceptual): long-interval injection schedule (initiation, early follow-up dose, then 6-monthly maintenance) per SmPC/local service protocol.

Transparency

This page is an educational, clinician-written summary of publicly available NICE guidance intended for trained healthcare professionals. It uses original wording (not copied text) and should be used alongside the full NICE source, local pathways, and clinical judgement. Doses provided are for general reference; always check the BNF/SPC.