CLS Novel Lipid-Lowering Therapies 3

Question 1

In the ORION-10 trial of inclisiran, what was the approximate mean LDL-C percent reduction from baseline at day 510?

Accepted Answer

50–55%

Answer

ORION-10 demonstrated a sustained time-averaged LDL-C reduction of approximately 52% from baseline with inclisiran in patients with ASCVD.

Question 2

A 58-year-old woman with ASCVD and statin myalgia is started on bempedoic acid/ezetimibe combination tablet. Which statement best describes the additive mechanism?

Accepted Answer

Bempedoic acid reduces hepatic synthesis while ezetimibe blocks intestinal cholesterol absorption via NPC1L1

Answer

The complementary mechanisms—hepatic synthesis inhibition by bempedoic acid and intestinal absorption inhibition by ezetimibe via NPC1L1—produce additive LDL-C lowering.

Question 3

ANGPTL3 inhibition by evinacumab lowers LDL-C through which primary pathway?

Accepted Answer

Enhancing lipoprotein lipase (LPL) and endothelial lipase (EL) activity to accelerate lipoprotein catabolism

Answer

ANGPTL3 normally inhibits both LPL and endothelial lipase; evinacumab removes this inhibition, accelerating catabolism of triglyceride-rich and LDL particles.

Question 4

Which of the following novel therapies specifically targets Lp(a) and is currently in advanced clinical development for cardiovascular risk reduction?

Accepted Answer

Pelacarsen / olpasiran (anti-Lp(a) ASO or siRNA)

Answer

Pelacarsen (an ASO) and olpasiran (a siRNA) both specifically target Lp(a) synthesis and are in Phase 3 cardiovascular outcomes trials.

Question 5

A patient with HoFH on lomitapide develops elevated transaminases (ALT 4× ULN) after 4 months. What is the recommended management?

Accepted Answer

Suspend lomitapide, recheck LFTs within 1 week, and resume at a lower dose if enzymes normalize

Answer

Per lomitapide prescribing information and REMS program guidance, dose modification and monitoring is indicated for ALT/AST ≥3× ULN; suspension with reassessment guides safe resumption.

(CLS) Clinical Lipid Specialist Certification Practice Test

(CLS) Clinical Lipid Specialist Certification Practice Test

CLS Novel Lipid-Lowering Therapies 3