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INCLISIRAN INJ,SOLN

Clinical Criteria Summary

Exclusion Criteria

  • End-stage renal disease on dialysis
  • Advanced heart failure with limited prognosis
  • Severe comorbid non-cardiovascular condition that is expected to limit life expectancy
  • Pregnancy or lactating
  • Primary Inclusion Criteria (One must be met)
  • History of ASCVD
  • Severe hypercholesterolemia (e.g., HeFH, LDL-C > 190 mg/dL) without ASCVD
  • Additional Inclusion Criteria (All must be met)
  • Contraindication, intolerance to or insufficient LDL-C reduction with maximally tolerated dose of statin and needs further LDL-C lowering to reduce ASCVD risk consistent with established guidelines
  • Contraindication, intolerance to or insufficient LDL-C reduction with ezetimibe and needs further LDL-C lowering to reduce ASCVD risk consistent with established guidelines
  • Contraindication, intolerance to or insufficient LDL-C reduction with a monoclonal antibody inhibitor of PCSK9 and needs further LDL-C lowering to reduce ASCVD risk consistent with established guidelines
  • Willing to return for subcutaneous administration of inclisiran by a healthcare provider at the initial visit, at 3 months and every 6 months thereafter
  • Pregnancy Considerations (Select if applicable)
  • Evaluate pregnancy status prior to initiating treatment since inclisiran may cause fetal harm
  • Counseling provided on potential risks vs benefits of treatment and the use of effective contraception during therapy is recommended

Source Documents