Review Date: 01/02/2026

Primary hypercholesterolaemia or mixed dyslipidaemia

NICE TA733 Inclisiran for treating primary hypercholesterolaemia or mixed dyslipidaemia

Inclisiran is licensed for Adults with primary hypercholesterolaemia (heterozygous familial and non-familial) or mixed dyslipidaemia as an adjunct to diet. It is recommended only if:
• There is a history of any of the following cardiovascular events (secondary prevention):
o acute coronary syndrome (such as myocardial infarction or unstable angina needing hospitalisation)
o coronary or other arterial revascularisation procedures
o coronary heart disease
o ischaemic stroke or
o peripheral arterial disease, AND
• Low-density lipoprotein cholesterol (LDL-C) concentrations are persistently 2.6 mmol/l or more, despite maximum tolerated lipid-lowering therapy, that is:
o maximum tolerated statins with or without other lipid-lowering therapies or,
o other lipid-lowering therapies when statins are not tolerated or are contraindicated.
• The recommended dose is 284 mg inclisiran administered as a single subcutaneous injection: initially, again at 3 months, followed by every 6 months.

Summary of National Guidance for Lipid Management for Primary and Secondary Prevention of CVD, see guidance here

Adults with primary hypercholesterolaemia (heterozygous familial and non-familial) or mixed dyslipidaemia

Brand : Nustendi

See guidance : Lipid optimisation for the Secondary Prevention of Cardiovascular Disease in Adults

NICE TA694 Bempedoic acid with ezetimibe for treating primary hypercholesterolaemia or mixed dyslipidaemia

Bempedoic acid with ezetimibe is recommended for primary hypercholesterolaemia (heterozygous familial and non-familial) or mixed dyslipidaemia as an adjunct to diet in adults, only if statins are contraindicated or not tolerated and ezetimibe alone is insufficient.

Bempedoic acid is licenced for primary hypercholesterolaemia or mixed dyslipidaemia in patients who have not responded adequately to other appropriate measures [in combination with a statin, or with a statin and other lipid-lowering therapies, or with other lipid-lowering therapies or alone if a statin contra-indicated or not tolerated]

Review Date: 01/06/2023

Reduce the risk of cardiovascular events in adult statin-treated patients at high cardiovascular risk with elevated triglycerides (≥150 mg/dL [≥ 1.7 mmol/l]) and • established cardiovascular disease, or • diabetes, and at least one other cardiovascular risk factor.

Brand: Vazkepa

NICE TA805 Icosapent ethyl with statin therapy for reducing the risk of cardiovascular events in people with raised triglycerides

Review Date: 01/01/2027

Adults with primary hypercholesterolaemia (heterozygous familial and non-familial) or mixed dyslipidaemia

Brand - Nilemdo

See guidance: Pathway for Bempedoic acid (Nilemdo®) use for the management of primary hypercholesterolaemia or mixed dyslipidaemia at DBTH trust.

Bempedoic acid is licenced for primary hypercholesterolaemia or mixed dyslipidaemia in patients who have not responded adequately to other appropriate measures [in combination with a statin, or with a statin and other lipid-lowering therapies, or with other lipid-lowering therapies or alone if a statin contra-indicated or not tolerated]