LDL-C Optimization Using Inclisiran in Patients in Which Drug-Drug Interactions Limit LDL Lowering

Trial statusRecruiting
Trial phasePhase 4
Trial typeInterventional
Biological sexAll
Age18-85
SponsorUniversity of California, San Diego

About this trial

Drug-drug interactions often limit statin optimization in a population of patients prescribed cytochrome P3A4 inhibitors, which include immunosuppressive agents, protease inhibitors, and antifungals. These patients frequently have autoimmune conditions or rheumatologic disorders that require complex drug regimens and are often on low-dose statin therapy or no statin at all, resulting in suboptimal LDL levels despite increased cardiovascular (CV) risk.

There is an unmet clinical need to improve LDL levels in this vulnerable patient population, which faces increased CV risk due to underlying conditions that also contribute to polypharmacy and multiple drug-drug interactions. This study is a randomized, open-label trial evaluating subcutaneous inclisiran plus standard of care for LDL-C lowering in high-risk primary prevention patients with multiple comorbidities (e.g., Type II diabetes, liver disease, chronic kidney disease, autoimmune disease, solid-organ transplant) who are taking five or more medications in which drug-drug interactions prevent optimization of statin therapy.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Provision of signed and dated informed consent form.

Stated willingness to comply with all study procedures and availability for the duration of the study, including potential randomization to injections.

Age >18 and <85 years and able to provide self-consent.

Taking five or more prescription drugs at the time of enrollment, of any type.

Disqualifiers

Prior or current use of inclisiran.

Known hypersensitivity or allergy to inclisiran or its components.

Active liver disease or unexplained persistent elevations in liver enzymes (ALT or AST >3x upper limit of normal).

History of rhabdomyolysis or severe muscle-related statin intolerance.

Trial design

Design model

Parallel

Treatments tested in this trial

  • Inclisiran sodium 300 mg (equivalent to 284 mg inclisiran) in 1.5 mL

    Drug

    The intervention arm will receive subcutaneous injection of inclisiran 284mg at the baseline visit, 3 months and 9 month visit.

Treatment groups

100 Participants
are divided into 2 treatment groups
Group A: Standard of Care, no interventionNo intervention 0 interventions
Group B: Inclisiran ArmActive comparator 1 intervention

Trial outcomes

Primary outcomes

1

Change of LDL-Cholesterol

Percent Change in LDL-C from baseline to month 12 of treatment with inclisiran as add on to background lipid-lowering therapy that includes maximally tolerated statin.

Time frame
12 months

Secondary outcomes

1

Change in Atherogenic Lipid Burden

Absolute and percent change in LDL particle number, apo B, non-HDL, and small dense LDL, lipoprotein(a), from baseline (Visit 1) to month 12 of treatment with inclisiran

Time frame
12 months

Other outcomes

1

Patient-Reported Experience

Patient-reported outcomes and experiences determined by surveys at each visit (the Standardized Treatment Satisfaction Questionnaire with Medication Relationship of the total number of medications on adherence to lipid lowering therapy).

Time frame
12 months
2

Incidence of Adverse Events

Incidence of adverse events occurring during treatment with inclisiran.

Time frame
12 months

Sponsors and contacts

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