"Vaccination" against heart attack?
New drug lowers cholesterol levels by up to 50 percent
Created: 11/23/2022, 8:30 p.m
By: Juliane Gutmann
mRNA technology is not only used in corona vaccines.
The drug Inclisiran against high cholesterol also works according to the principle.
Twice a year an injection with the active ingredient Inclisiran should lower cholesterol levels by up to 50 percent, according to the
medical journal
.
This study result is a breakthrough mainly because high cholesterol levels increase the risk of cardiovascular diseases such as heart attacks and strokes.
The most common cause of death in Germany is cardiovascular disease, which is why the need for therapy is particularly great here.
A relatively new therapeutic approach is treatment with the cholesterol-lowering drug inclisiran.
According to the German Society for Combating Lipid Metabolism Disorders and Their Sequelae DGFF (Lipid-Liga), Inclisiran was launched in Germany on February 1, 2021 and is the first and only small interfering RNA (ribonucleic acid)-based therapy for patients with hypercholesterolemia ( dyslipidemia leading to high blood cholesterol levels which can increase the risk of cardiovascular disease) or mixed dyslipidaemia (dyslipidaemia in which the composition of the blood fats is abnormal).
Too much saturated fatty acids and trans fatty acids, too few polyunsaturated fatty acids and too little dietary fiber: the wrong diet that is too high in fat is a major risk factor for elevated cholesterol levels.
© Michael Bihlmayer/Imago
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Inclisiran lowers LDL cholesterol – long-term
Inclisiran only has to be administered intravenously using a syringe twice a year in order to lower cholesterol levels and thus the risk of a heart attack.
According to the medical journal
, large-scale studies had
shown that inclisiran can keep the harmful LDL cholesterol in the body low for over six months.
LDL is the abbreviation for "low density lipoprotein", which transports the cholesterol produced by the liver to the body's cells.
Excessively high LDL cholesterol levels can indicate an increased risk of arteriosclerosis, bile stasis or urinary poisoning, as the
internists
inform on the Internet.
Therapy with steroid hormones or luteal hormones can also increase the LDL value, it is said.
Cholesterol survey
A long-term reduction in the LDL level by 50 to 55 percent is possible with inclisiran, according to the
medical journal
Professor Wolfgang Koenig, senior physician at the German Heart Center in Munich, who has analyzed the study situation on inclisiran in more detail.
The
picture
even describes the active ingredient as the "penicillin of the 21st century".
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But this has its price: a dose of Inclisiran costs almost 3,000 euros, as the cardiologist Professor Oliver Weingärtner explains in an interview with the Mitteldeutscher Rundfunk.
And there is another catch: So far, the preparation has only been approved for hardship cases.
For example, the Association of Statutory Health Insurance Physicians in Baden-Württemberg informs that the lipid-lowering drug Inclisiran can only be prescribed in exceptional cases.
With a few exceptions, the reserve drug cannot be prescribed at the expense of statutory health insurance.
Doctors should not prescribe Inclisiran if this results in additional costs compared to therapy with other lipid-lowering drugs such as statins.
However, there are exceptions: for patients with hypercholesterolemia or mixed dyslipidemia.
Injection against heart attack: mRNA therapy against high cholesterol levels
The therapy with Inclisiran works via the so-called RNA interference.
Like
Cardiologie.org
as a joint offer from the German Society of Cardiology - Heart and Circulatory Research eV (DGK), the Federal Association of Cardiologists in Practice (BNK) eV and Springer Medizin Verlag GmbH, Inclisiran is a chemically modified ribonucleic acid (RNA) molecule.
The substance has a lipid-lowering effect because, as so-called small interfering RNA (siRNA), it inhibits the intracellular synthesis of PCSK9, according to the heart expert portal.
The activity of the protein PCSK9 promotes an increased level of LDL in the blood.
Injecting inclisiran affects the mRNA (messenger ribonucleic acid) for PCSK9 in such a way that "the gene for PCSK9 synthesis is effectively switched off," according to
Kardiologie.org
.
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The mRNA therapy with the "lipid-lowering drug inclisiran does not resemble a vaccine in terms of its mechanism of action, but it does resemble a vaccine in terms of its form of application: the substance only has to be injected subcutaneously every six months to achieve a sustained strong reduction in LDL cholesterol in the blood," This is the conclusion of the editor-in-chief of
kardiologie.org
, Peter Overbeck.