Inclisiran — EECC MCQ

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ModerateHypertension & Preventive CardiologyInclisiranEECC

A 65-year-old woman with very high cardiovascular risk (prior stroke, LDL-C target <1.4 mmol/L) has achieved an LDL-C of 1.8 mmol/L on rosuvastatin 20 mg and ezetimibe 10 mg. She declines regular PCSK9 inhibitor injections due to injection phobia. Which alternative injectable lipid-lowering therapy requires only twice-yearly administration?

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Correct answer: E — Inclisiran

Inclisiran is a small interfering RNA (siRNA) that targets PCSK9 mRNA in hepatocytes, reducing PCSK9 production and thereby upregulating LDL receptors. Its key advantage is a dosing schedule of only twice yearly (after initial and 3-month doses), which addresses adherence and injection burden concerns. The ORION trials demonstrated ~50% LDL-C reduction sustained with twice-yearly subcutaneous injections. The ESC/EAS Dyslipidaemia Guidelines now include inclisiran as an option for LDL-C lowering (Class IIa). Alirocumab requires fortnightly or monthly injections. Pelacarsen targets Lp(a), not LDL-C.

Reference: ESC/EAS (2019/2025): Guidelines for the Management of Dyslipidaemias