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1 March 2022

Blog by Dr Phil Jennings

Dr Phil Jennings, Chief Executive

When the National Institute for Health and Care Excellence (NICE) approved the use of Inclisiran last autumn, it represented a new opportunity to make a real difference to those patients at high risk of having a heart attack or stroke.

As a GP, I see at first hand – and all too frequently in my area – people with harmful levels of cholesterol. The addition of this new, injectable therapy is, to my mind, something to be welcomed and I know across the Pennines it’s already making a difference to the lives of people there.

We know cardiovascular disease (CVD) has been identified in the Long Term Plan as the single biggest area where the NHS can save lives over the next decade. CVD has a huge impact on people’s lives yet early detection and treatment can make a real difference. I think Inclisiran bridges a gap in the lipid-management pathway, offering a further choice of additional agent when statins have already been used.

Inclisiran is a novel molecule and the first of its type in class, currently only manufactured by Novartis hence our relationship with a single company. There is evidence from trials already underway which show that when a patient already receiving statins as part of their treatment is prescribed Inclisiran there is a significant reduction in their low-density lipoprotein level – by around 50%. Compared to doubling a statin dose this is a much bigger clinical effect and is a very potent intervention.

300,000 people in England could be prescribed Inclisiran, many in the north of England where heart disease rates are around twice as great as those in the south-east. Patients in Manchester, Cheshire, Merseyside and Lancashire, where levels are especially high, stand to benefit.

As an Academic Health Science Network, our job now is to highlight this opportunity and we’re currently working in our local areas to see how different models of Inclisiran delivery fit with existing local services and PCNs. How we reach patients and offer the drug is up for debate – it could be via a GP practice, community pharmacist etc.

Identifying other clinical pathways to support patients with high cholesterol is vital if we want to reduce the risk of CVD particularly healthy eating and staying active with regular exercise. Inclisiran is just one part of the medical lipid-management pathway. It is used currently only in combination with statins (unless statins cannot be tolerated) for those patients who have already suffered from a heart attack or stroke. Research continues for other indications in the future.

If you would like to be involved we’re keen to talk. Contact either Dr Julia Reynolds, my lipids lead at the Innovation Agency or myself for more information.

https://www.ahsnnetwork.com/ahsn-network-leading-roll-out-of-innovative-treatment-for-cardiovascular-disease

Phil.jennings@innovationagencynwc.nhs.uk

Julia.reynolds@innovationagencynwc.nhs.uk

Dr Phil Jennings

Chief Executive

@DrPhilJennings

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