Fact file

Inclisiran: anti-cholesterol jab a ‘game-changer’ for heart attacks and strokes

The new drug could save tens of thousands of lives in England and Wales

A new anti-cholesterol jab could save 30,000 lives within a decade when it is made available on the NHS in England and Wales.

Inclisiran, which is set to be offered to hundreds of thousands of people, has been described as a “game changer” by health professionals. 

The pricey drug normally costs around £2,000 per dose, but manufacturer Novartis has “agreed an undisclosed discount” for the NHS, reported the BBC. Under the deal, the scheme will begin “within a month” says The Times.

NHS estimates say around 300,000 people will be offered the drug over the next three years, helping to prevent 55,000 heart attacks and strokes, and potentially saving 30,000 lives in the next decade.

More than two in five people in England have high cholesterol which puts them at significant risk of developing heart disease, while heart disease accounts for a quarter of deaths in England each year, says NHS England.

Nurses will be able to administer inclisiran as an injection in GP surgeries across England, meaning patients can avoid regular hospital visits.

After an initial dose, the drug will be given again after three months and then twice a year.

How does the drug work?

The drug has been named a “game changer” due to its “impressive trial results”, said Kat Lay in The Times. One global trial, led by Imperial College London, showed it could “safely cut cholesterol by 50%,” she reported. 

And a twice-yearly injection is also likely to be “less of a burden for the patient than remembering to take a daily pill”, said Lay. 

Inclisiran works in a different way to statins, which is a far cheaper drug treatment used to lower cholesterol in the blood. While statins “slow down” the production of cholesterol in the liver, inclisiran uses a “gene-silencing” effect to help the liver remove harmful cholesterol, according to the BBC.

In effect, it “turns off” – or silences – a gene called PCSK9, which results in the liver absorbing more “bad” cholesterol, called LDL cholesterol, from the blood and breaking it down.

The drug can be taken on its own, or alongside statins.

Who will be offered the drug?

The National Institute for Health and Care Excellence (NICE) has drafted recommendations that the drug be rolled out to hundreds of thousands of people with high cholesterol or mixed dyslipidemia – abnormally high levels of fats in their blood – who have already suffered a heart attack or stroke.

Under the “population health agreement” between Novartis and the NHS, nearly half a million people could eventually benefit from the treatment.

“Inclisiran represents a potential game-changer in preventing thousands of people from dying prematurely from heart attacks and strokes,” said Meindert Boysen, NICE deputy chief executive and director of the Centre for Health Technology Evaluation. 

"We’re therefore pleased to be able to recommend it as a cost-effective option on the NHS.”

And health professionals hope that in the future, the drug will be offered to “even more patients with heart problems”, reported The Guardian.

“More research is needed to confirm the full extent of its benefits, but I anticipate that in the future it will also be approved to lower cholesterol for a much wider group of people to prevent them from having a heart attack or stroke in the first place,” Professor Sir Nilesh Samani, the medical director of the British Heart Foundation, told the paper.

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