Authors

• Senka Pejković — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0002-7557-9358
• Nikolina Jurković Dubravčić — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0002-9754-8712
• Renee Mixich — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0002-0991-7515

Keywords

inclisiran, statins, management, nurse

DOI

Full Text

Atherosclerotic cardiovascular disease is considered the leading cause of cardiovascular morbidity and mortality in the Western world. The treatment of hypercholesterolemia for primary and secondary prevention is primarily with statins, according to current European guidelines. Statins are effective in lowering high-blood cholesterol levels at the highest tolerated dose as first-line therapy. (1) In the event that statins alone are not sufficient to adequately regulate blood lipids, ezetimibe is added as a second drug at a dose of 10 mg. In addition to statins, and ezetimibe, newer drugs are also used to lower LDL, namely alirocumab. (2) When high-dose statins in combination with ezetimibe are not enough or statin treatment causes side effects, there is a new drug: inclisiran, a drug with a unique effect in lowering LDL cholesterol, administered twice a year. (3) In Croatia, inclisiran was first used in May 2022 at Dubrava University Hospital. To date, twenty-two patients are receiving inclisiran therapy for the treatment of hypercholesterolemia. Patients eligible for inclisiran therapy are those with established cardiovascular disease who are already taking statin therapy or who are eligible for monotherapy because the statin was contraindicated. Inclisiran is an effective drug administered subcutaneously twice a year by a nurse. The nurse plays a very important role, both in the introduction of the drug, the application of the drug and in the further monitoring of the patient.

Literature

1. Skorić B. What is New in the Most Recent Guidelines for the Management of Dyslipidemias of the European Society of Cardiology and the European Atherosclerosis Society? Cardiol Croat. 2021;16(1-2):87–95. https://doi.org/10.15836/ccar2021.87
2. Wright RS, Ray KK, Raal FJ, Kallend DG, Jaros M, et al. Pooled Patient-Level Analysis of Inclisiran Trials in Patients With Familial Hypercholesterolemia or Atherosclerosis. J Am Coll Cardiol. 2021 March 9;77(9):1182–93. https://doi.org/10.1016/j.jacc.2020.12.058
3. Ray KK, Landmesser U, Leiter LA, Kallend D, Dufour R, et al. Inclisiran in Patients at High Cardiovascular Risk with Elevated LDL Cholesterol. N Engl J Med. 2017;376(15):1430–40. https://doi.org/10.1056/NEJMoa1615758