Inclisiran no tratamento da hipercolesterolemia
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Resumo
Objetivo: Analisar o mecanismo de ação, eficácia, segurança e principais estudos sobre o inclisiran no tratamento da hipercolesterolemia. Revisão bibliográfica: Hipercolesterolemia é um dos distúrbios metabólicos mais prevalentes no mundo. Embora as estatinas sejam os fármacos de escolha para o tratamento visando a redução do LDL Colesterol (LDL-C), podem não ser toleradas ou mesmo insuficientes em até 20% dos pacientes. Medicamentos direcionados à pró-proteína convertase subtilisina/kexina tipo 9 (PCSK9) surgiram como promissoras opções terapêuticas. Inclisiran liga-se aos receptores de asialoglicoproteína (ASGPR), expressos apenas em hepatócitos, fato que explica seu perfil de segurança; participa de um complexo ribonucleoprotêico (RISC); induz ao silenciamento de RNA mensageiro (mRNA); reduz a síntese de PCSK9 em ribossomos; aumenta o número de receptores de LDL na superfície dos hepatócitos; e reduz a concentração sérica de LDL-C. Considerações finais: Inclisiran é uma molécula de interferência gênica que inibe a síntese de PCSK9, promove a degradação de mRNA ou inibe sua tradução, fornecendo uma redução robusta, sustentada e com baixa variabilidade interindividual do LDL-C. Pode desempenhar um papel importante na terapia da dislipidemia no futuro. É necessário que seja considerado o custo para tornar a proposta terapêutica viável para ampla gama de pacientes.
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