A twice-yearly jab that combats cholesterol could revolutionise heart care, according to its creator. The drug, Leqvio, also known as inclisiran, has been shown in recent trials to help patients reach their cholesterol targets faster than other treatments.
Patients also reported less muscle pain, a common side effect of the cholesterol-reducing medication statins. Cholesterol is a fatty substance made by the liver and present in specific foods.
Understanding cholesterol is essential, as it consists of two types: high-density lipoproteins (HDL), known as the ‘good cholesterol,’ and low-density lipoproteins (LDL), often called the ‘bad cholesterol.’
The latter, affected by unhealthy lifestyle factors, is believed to lead to life-threatening conditions such as heart disease and strokes when its levels become too high. Meanwhile, HDL cholesterol is linked to a lower risk of these cardiovascular problems. It is present in many common foods such as salmon, nuts, avocado, and legumes.
Statins, the most frequently prescribed drug on the NHS for high cholesterol, reduce the amount of cholesterol the body produces. Patients typically need to take one tablet daily for life.
On the flipside, Leqvio, produced by Novartis, operates by interfering with genetic material to restrict the production of a protein that can raise levels of bad cholesterol. It’s administered via an injection, with an initial dose, another at three months, and then every six months thereafter.
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The Novartis trial, dubbed V-DIFFERENCE, involved 898 people who were given a Leqvio injection and a specific high-intensity statin, in addition to other medicines known as lipid-lowering therapies (LLTs) tailored to their personal needs.
Meanwhile, the other group of 872 patients received a placebo injection and the same high-intensity statin, along with other lipid-lowering therapies (LLTs) tailored to their needs. After 90 days, 85% of patients in the Leqvio group reached their cholesterol goal, whereas only 31% in the placebo group did so.
Ruchira Glaser, global head of the cardiovascular, renal and metabolic development unit at Novartis, said: “Novartis is dedicated to tackling the most challenging problems in cardiovascular disease. These results highlight the potential of Leqvio to transform cardiovascular care by improving meaningful patient outcomes.
“V-DIFFERENCE has provided evidence that early use of Leqvio is an effective way to help patients reach their LDL-C goals faster without the need to add other therapies or maximise statin doses.”
The study was also the first to examine Leqvio’s ability to reduce muscle pain, a common side effect of statins. It was discovered that patients on Leqvio were 43% less likely to experience muscle-related issues compared to the placebo group.
Ulf Landmesser, chairman of the department of cardiology, angiology and intensive care medicine at German Heart Centre of Charite and Charite University Medicine Berlin, said the trial is the first to focus on patient outcomes.
He added: “These findings are significant as they demonstrate effective options for lipid management improvement in patients at risk, a majority of whom continue to remain above recommended LDL-C levels.”
The latest NHS Health Survey for England estimates the proportion of adults with raised cholesterol was 53% in 2022, up from 43% in 2019. This was greater among women (56%), compared to men (49%).
The V-Difference trial’s findings are set to be presented at the European Society of Cardiology (ESC) Congress in Madrid.
What do ‘healthy’ cholesterol levels look like?
The NHS explains that ‘ideal’ cholesterol levels depend on individual factors such as age and health conditions. Nonetheless, a general guideline for healthy adults is to maintain the following levels:
- Total cholesterol: Below 5mmol/L
- HDL (good cholesterol): Above 1.0mmol/L for men or above 1.2mmol/L for women
- Non-HDL (bad cholesterol): Below 4mmol/L