Turning the Tide: Early PCSK9 Intervention Post-ACS - Episode 9
Panelists discuss how inclisiran’s biannual dosing and early use after ACS events, as demonstrated in the VICTORION-INCEPTION study, offer a practical and effective strategy for sustained LDL reduction, improved adherence, and enhanced cardiovascular outcomes when combined with statin therapy.
The conversation highlights the critical importance of early low-density lipoprotein (LDL) reduction following acute coronary syndrome (ACS), emphasizing inclisiran’s unique role in achieving and maintaining low LDL levels. Unlike daily or biweekly treatments, inclisiran offers sustained LDL reduction with biannual dosing, improving patient adherence and clinical outcomes. The VICTORION-INCEPTION study demonstrates how upstream use of inclisiran, in conjunction with standard lipid-lowering therapies, can effectively target high-risk patients shortly after ACS, helping prevent recurrent cardiovascular events through long-term LDL control.
Key results from the study showed that patients treated with inclisiran achieved an approximately 50% reduction in LDL levels, with nearly two-thirds reaching guideline-recommended targets of less than 70 mg/dL, and many achieving even lower thresholds under the 2025 post–ACS event guidelines. The study also confirmed that inclisiran use did not lead to a decrease in statin adherence, alleviating concerns that the injectable might replace rather than complement statins. Clinically, this dual-therapy approach significantly increased the percentage of patients achieving optimal LDL levels compared with usual care alone, which showed minimal LDL reduction.
From a health systems perspective, inclisiran addresses long-standing adherence challenges by being administered in the clinic, ensuring patients receive their dose when they show up for appointments. This real-world practicality offers a transformative model for lipid management in value-based care environments, especially where health care systems are accountable for outcomes. The study underscores the importance of combining statins with PCSK9 inhibitors like inclisiran for maximal benefit, correcting misconceptions that injectable therapies alone are sufficient. Overall, the VICTORION-INCEPTION study provides compelling, actionable evidence supporting earlier and more aggressive LDL management to reduce cardiovascular risk.