Successful experience with inclisiran in renal transplant patients

Background. Kidney transplant (KT) recipients are a high-risk group for atherosclerotic cardiovascular disease (CVD), closely linked to dyslipidemia. Objective. To demonstrate the efficacy and safety of a novel proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, inclisiran, for hyperlipidemia correction in and reduction of the risk of developing CVD in KT recipients. Material and methods. A series of clinical cases included five patients (two men, three women, mean age 56±10 years) with high cardiovascular risk, dyslipidemia, and persistently elevated low-density lipoprotein (LDL) levels, despite ongoing statin and ezetimibe therapy. Inclisiran targeted therapy was prescribed for secondary (4 patients) and primary (1 patient) CVD prevention. Subcutaneous inclisiran injection (284 mg in 1.5 mL solution) was administered in KT department, repeat injection was made after three months, the next injections were performed after 6 months. Dynamic studies of blood LDL, creatinine, tacrolimus levels were performed using standard methods. Results. Adjunctive inclisiran therapy led to a reduction in blood LDL levels by an average of 32% at two weeks, 40% at one month, and 55% at three months. Continued treatment maintained target LDL values. Inclisiran treatment caused no adverse effects and had no negative impact on transplanted kidney function. Conclusion. KT recipients with high risk of atherosclerotic CVD represent a promising group for lipid-lowering therapy including inclisiran.