Abstract
OBJECTIVE: To find out the efficacy of Inclisiran sodium in heterozygous familial hypercholesterolemia (HeFH) and homozygous familial hypercholesterolemia (HoFH) patient groups. METHODS: PubMed, Embase, and Clinicaltrials.gov databases were searched for the relevant studies. Atherosclerotic parameters considered included LDL-C, total cholesterol, PCSK9, apolipoprotein-B, and non-HDL-C. Primary outcomes were the percentage difference in atherosclerotic parameters at follow-up relative to baseline values. Our study examined these primary outcomes to determine whether there is a statistically significant difference between the HeFH and HoFH groups. The risk of bias was assessed by the Cochrane risk of bias tool. RESULTS: Analysis of four ORION clinical trials unveiled the significant difference in pooled mean differences in LDL-C (HeFH: -48.62%, HoFH: -9.12%; P < 0.05) total cholesterol (HeFH: -30.31%, HoFH: -11.50%; P < 0.05), apolipoprotein-B (HeFH: -39.97%, HoFH: -14.68%, P < 0.05), and non-HDL-C (HeFH: -44.51%, HoFH: -12.22%; P <0.05) between HeFH and HoFH groups. However, the difference in the pooled mean difference in PCSK9 values (HeFH: -68.41%, HoFH: -56.25%; P = 0.2) between the HeFH and HoFH groups was statistically insignificant. Studies were of high quality. CONCLUSION: There was a significant difference in the reductions in atherosclerotic lipid parameters in heterozygous and homozygous populations after the administration of inclisiran except for the PCSK9 parameter. Further studies are needed to support this conclusion.