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Observational study of inclisiran effectiveness in Moscow healthcare

https://doi.org/10.15829/1560-4071-2023-5687

EDN: QVNYVO

Abstract

Aim. To evaluate the effectiveness of PCSK9 inhibitors (alirocumab, inclisiran and evolocumab) in patients with atherosclerotic cardiovascular disease (ASCVD) and failure to achieve the target low-density lipoprotein cholesterol (LDL-C) level for the period from November 21, 2022 to December 31, 2023.

Material and methods. For the observational study, 50 patients were included in the inclisiran therapy group and 30 patients in the control group (patients with ASCVD receiving PCSK9 inhibitors (alirocumab, n=1; evolocumab, n=29)). All study participants had their anamnestic data analyzed, and initially underwent electrocardiography, echocardiography, extracranial and lower limb Doppler ultrasound, and laboratory tests (complete blood count, biochemical blood tests, lipid profile). Three medical organizations of the Moscow State Healthcare System participate in the study.

Results. Interim data are presented to evaluate the effectiveness of PCSK9 targeted therapy in patients with ASCVD, obtained 3 months from the study start. The comparison groups were comparable in main clinical characteristics. When analyzing the lipid-lowering effect of inclisiran in the examined patients with ASCVD, LDL-C level significantly decreased from 2,53±0,10 mmol/l to 110±0,08 mmol/l (by 56,5%), p<0,0001, while the target LDL-C level <1,4 mmol/l was achieved by 77,5% of the subjects. Analysis of the lipid-lowering effect of alirocumab/evolocumab showed a significant LDL-C decrease from 2,48±0,16 mmol/l to 1,07±0,11 mmol/l (by 56,8%), p<0,0001.

Conclusion. The use of PCSK9 targeted therapy (alirocumab or inclisiran or evolocumab) in patients with ASCVD in Moscow make it possible to achieve target LDL-C levels, which are indicated in clinical guidelines, by 3 months.

About the Authors

A. I. Sapina
I.V. Davydovsky City Clinical Hospital; Research Institute for Healthcare and Medical Management of Moscow Healthcare Department
Russian Federation

Moscow


Competing Interests:

None



Yu. Yu. Varlamova
Diagnostic and Clinical Center № 1
Russian Federation

Moscow


Competing Interests:

None



M. G. Papyrina
City Clinic № 46
Russian Federation

Moscow


Competing Interests:

None



A. S. Bezymyannyy
Directorate for coordination of activities of medical organizations of the Department of Health of the city of Moscow
Russian Federation

Moscow


Competing Interests:

None



E. Yu. Vasilyeva
I.V. Davydovsky City Clinical Hospital; A.I. Evdokimov Moscow State Medical and Dental University of the Ministry of Health of the Russian Federation
Russian Federation

Moscow


Competing Interests:

None



References

1. Baigent C, Blackwell L, Emberson J, et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010;376:1670-81.

2. Meshkov AN, Ershova AI Deev AD, et al. Distribution of lipid profile values in economically active men and women in Russian Federation: results of the ESSE-RF study for the years 2012-2014. Cardiovascular Therapy and Prevention. 2017;16(4):62-7. (In Russ.) doi:10.15829/1728-8800-2017-4-62-67.

3. Ezhov MV, Kukharchuk VV, Sergienko IV, et al. Disorders of lipid metabolism. Clinical Guidelines 2023. Russian Journal of Cardiology. 2023;28(5):5471. (In Russ.) doi:10.15829/1560-4071-2023-5471.

4. Mach F, Baigent C, Catapano AL, et al., Group ESD. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS). Atherosclerosis. 2019;290:140-205. doi:10.1016/j.atherosclerosis.2019.08.014.

5. Waters DD, Brotons C, Chiang CW, et al. Lipid treatment assessment project 2: a multinational survey to evaluate the proportion of patients achieving low-density lipoprotein cholesterol goals. Circulation. 2009;120:28-34.

6. Gitt AK, Lautsch D, Ferrieres J, et al. Low-density lipoprotein cholesterol in a global cohort of 57,885 statin-treated patients. Atherosclerosis. 2016;255:200-9.

7. Zhang H, Plutzky J, Skentzos S, et al. Discontinuation of statins in routine care settings: a cohort study. Ann Intern Med. 2013;158:526-34.

8. Yezhov MV, Bliznyuk SA, Tmoyan NA, et al. Register of patients with familial hypercholesterolemia and patients of very high cardiovascular risk with lipid-lowering therapy underperformance (RENESSANS). Russian Journal of Cardiology. 2019;(5):7-13. (In Russ.) doi:10.15829/1560-4071-2019-5-7-13.

9. Mach F, Baigent C, Catapano AL, et al. ESC Scientific Document Group. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020;41(1):111-88. doi:10.1093/eurheartj/ehz455.

10. Byrne RA, Rossello X, Coughlan JJ, et al. ESC Scientific Document Group. 2023 ESC Guidelines for the management of acute coronary syndromes: Developed by the task force on the management of acute coronary syndromes of the European Society of Cardiology (ESC). European Heart Journal. 2023;44(38):3720-826. doi:10.1093/eurheartj/ehad191.

11. Leng G. Radical or not, NICE makes evidence-based recommendations BMJ. 2021;375: n2831. doi:10.1136/bmj.n2831.

12. Huang X, Leroux JC, Castagner B. Well-defined multivalent ligands for hepatocytes targeting via asialoglycoprotein receptor. Bioconjug Chem. 2017;28(2):283-95.

13. Wang N, Tall AR, New A Approach to PCSK9 Therapeutics. Circ Res. 120(7):1063-1065. doi:10.1161/CIRCRESAHA.117.310610.

14. KK Ray, Wright RS, Kallend D, et al. ORION-10 and ORION-11 Investigators. Two phase 3 trials of inclisiran in patients with elevated LDL cholesterol. N Engl J Med. 2020;382(16):1507-19. doi:10.1056/NEJMoa1912387.


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For citations:


Sapina A.I., Varlamova Yu.Yu., Papyrina M.G., Bezymyannyy A.S., Vasilyeva E.Yu. Observational study of inclisiran effectiveness in Moscow healthcare. Russian Journal of Cardiology. 2023;28(12):5687. (In Russ.) https://doi.org/10.15829/1560-4071-2023-5687. EDN: QVNYVO

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ISSN 1560-4071 (Print)
ISSN 2618-7620 (Online)