CLS Novel Lipid-Lowering Therapies 2

Question 1

Inclisiran is a small interfering RNA (siRNA) therapy that targets PCSK9. What is its primary mechanism of action?

Accepted Answer

Degrades PCSK9 mRNA in hepatocytes to reduce PCSK9 synthesis

Answer

Inclisiran uses siRNA to degrade PCSK9 mRNA within hepatocytes, thereby reducing PCSK9 protein synthesis and increasing LDL receptor recycling.

Question 2

A patient on inclisiran 284 mg subcutaneous injection experiences LDL-C reduction of approximately 50% after the initial doses. What is the standard maintenance dosing interval?

Accepted Answer

Every 6 months

Answer

After the initial dose and a second dose at 3 months, inclisiran is administered every 6 months, offering a major adherence advantage over monoclonal antibodies.

Question 3

Which lipoprotein parameter is primarily reduced by bempedoic acid, and through what mechanism?

Accepted Answer

LDL-C, by inhibiting ATP citrate lyase upstream of HMG-CoA reductase in the liver

Answer

Bempedoic acid inhibits ATP citrate lyase (ACL), an enzyme upstream of HMG-CoA reductase in hepatic cholesterol synthesis, primarily lowering LDL-C.

Question 4

A statin-intolerant patient with heterozygous FH is prescribed bempedoic acid. Which adverse effect unique to this drug class requires monitoring?

Accepted Answer

Hyperuricemia and gout flares

Answer

Bempedoic acid inhibits urate transporter activity, leading to elevated serum uric acid levels and increased risk of gout flares.

Question 5

Evinacumab, an angiopoietin-like protein 3 (ANGPTL3) inhibitor, is approved for which patient population?

Accepted Answer

Homozygous familial hypercholesterolemia (HoFH) regardless of LDL receptor function

Answer

Evinacumab is FDA-approved for adults and pediatric patients ≥12 years with HoFH, notably effective even in those with non-functional LDL receptors.

(CLS) Clinical Lipid Specialist Certification Practice Test

(CLS) Clinical Lipid Specialist Certification Practice Test

CLS Novel Lipid-Lowering Therapies 2