Real-world study of inclisiran vs PCSK9 monoclonal antibodies in patients with acute coronary syndrome

LI Ting-ting; WANG Lin; LUO Wei; XU Jing-han; CONG Hong-liang

doi:10.20251/j.cnki.1003-3734.2025.18.009

Abstract：Objective:To observe the differences in efficacy between the two lipid-lowering therapies targeting proprotein convertase subtilisin/kexin type 9(PCSK9)-small interfering RNA(siRNA)inclisiran and PCSK9 monoclonal antibodies(mAbs)-in Chinese patients with acute coronary syndrome(ACS).Methods:A total of 87 ACS patients treated with inclisiran or PCSK9 mAbs were enrolled at the department of cardiology,Tianjin Chest Hospital between January 2023 and December 2024.Patients were divided into inclisiran group(n=34)and PCSK9 mAb group(n=34)based on their treatment regimen.The reduction of low-density lipoprotein cholesterol(LDL-C),target achievement rate,and lipid profiles were analyzed pre-treatment and at 30,90,and 180 days post-treatment to evaluate therapeutic benefits.Lipid variability was assessed using standard deviation(SD),average successive variability(ASV),coefficient of variation(CV),and corrected variance independent of the mean(VIM).Results:At 30 days post-treatment,no significant differences were observed in LDL-C reduction(P=0.126)or target achievement rate(P=0.300)between the two groups.However,at 90 and 180 days post-treatment,the inclisiran group demonstrated significantly greater LDL-C reduction(P=0.048 and P=0.038,respectively)and higher target achievement rate(P=0.006 and P=0.010,respectively)compared to PCSK9 mAb group.Additionally,the inclisiran group exhibited lower lipid variability than the PCSK9 mAb group,as evidenced by SD(0.16 vs 0.37,P=0.01),CV(19.15 vs 33.24,P=0.02),ASV(0.19 vs 0.48,P=0.01),and VIM(18.57 vs 33.98,P=0.05).Conclusion:Inclisiran provides sustained short-and long-term LDL-C reduction,improving target achievement rate,and demonstrating favorable safety in ACS patients.