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NICE recently issued draft final guidance recommending inclisiran (Leqvio) as an option for people with primary hypercholesterolaemia or mixed dyslipidaemia who have had a cardiovascular event.

Inclisiran is the first of a new type of cholesterol-lowering treatment that interferes with RNA to change expression of a protein called convertase subtilisin/kexin type 9 (PCSK9). This increases hepatic clearance of low-density lipoprotein cholesterol.

The decision from NICE follows a commercial deal between the NHS and Novartis, which makes inclisiran available at discount.

The drug can be given in primary care as a twice-yearly injection either as monotherapy or with concurrent statins or other cholesterol lowering drugs. NICE notes, however, that there is no data directly comparing inclisiran with ezetimibe, alirocumab or evolocumab, and that there is no long-term evidence assessing inclisiran’s effect on cardiovascular outcomes.