Development of Novel siRNA Therapeutics: A Review with a Focus on Inclisiran for the Treatment of Hypercholesterolemia
Open accessAbstract
Over the past two decades, it was discovered that introducing synthetic small interfering RNAs (siRNAs) into the cytoplasm facilitates effective gene-targeted silencing. This compromises gene expression and regulation by repressing transcription or stimulating sequence-specific RNA degradation. Substantial investments in developing RNA therapeutics for disease prevention and treatment have been made. We discuss the application to proprotein convertase subtilisin/kexin type 9 (PCSK9), which binds to and degrades the low-density lipoprotein cholesterol (LDL-C) receptor, interrupting the process of LDL-C uptake into hepatocytes. PCSK9 loss-of-function modifications show significant clinical importance by causing dominant hypocholesterolemia and lessening the risk of cardiovascular disease (CVD). Monoclonal antibodies and small interfering RNA (siRNA) drugs targeting PCSK9 are a significant new option for managing lipid disorders and improving CVD outcomes. In general, monoclonal antibodies are restricted to binding with cell surface receptors or circulating proteins. Similarly, overcoming the intracellular and extracellular defenses that prevent exogenous RNA from entering cells must be achieved for the clinical application of siRNAs. N-acetylgalactosamine (GalNAc) conjugates are a simple solution to the siRNA delivery problem that is especially suitable for treating a broad spectrum of diseases involving liver-expressed genes. Inclisiran is a GalNAc-conjugated siRNA molecule that inhibits the translation of PCSK9. The administration is only required every 3 to 6 months, which is a significant improvement over monoclonal antibodies for PCSK9. This review provides an overview of siRNA therapeutics with a focus on detailed profiles of inclisiran, mainly its delivery strategies. We discuss the mechanisms of action, its status in clinical trials, and its prospects.
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The intracellular RNAi mechanism allows inclisiran to deliver prolonged LDL-C reductions because of its three-month and then six-month administration schedule.
“The intracellular RNAi mechanism allows Inclisiran to deliver prolonged LDL-C reductions because of its three-month and then six-month administration schedule [68, 69].”
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An update on inclisiran for the treatment of elevated LDL cholesterol
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Graphene oxide and silicene as 2D platforms for complexation and intracellular delivery of siRNA
Razavi, L., Raissi, ., & Farzad, F. (2024) · Journal of Drug Delivery Science and Technology · doi:10.1016/j.jddst.2024.105514 · Cited by 8 · see citing works
Cutting-edge lipid-lowering pharmacological therapies: Improving lipid control beyond statins
Capuozzo, M., Ottaiano, A., Cinque, C., Farace, S., & Ferrara, F. (2025) · Hipertensión y Riesgo Vascular · doi:10.1016/j.hipert.2024.12.002 · Cited by 8 · see citing works
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“The intracellular RNAi mechanism allows Inclisiran to deliver prolonged LDL-C reductions because of its three-month and then six-month administration schedule [68, 69].”
Update: Enzymatische Synthese für industrielle Anwendungen
Bayer, T., Wu, S., Šnajdrová, R., Baldenius, K., & Bornscheuer, U. T. (2025) · Angewandte Chemie · doi:10.1002/ange.202505976 · Cited by 4 · see citing works
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Blocking Translation of Oncogenic mRNA
Christie, K. N. (2023) · Journal of Cancer Therapy · doi:10.4236/jct.2023.146021 · Cited by 4 · see citing works
2024 KSoLA Update on New Lipid-Lowering Agents: Inclisiran and Bempedoic Acid
Kim, H., Cha, J., & Lee, S. (2025) · Journal of Lipid and Atherosclerosis · doi:10.12997/jla.2025.14.2.135 · Cited by 6 · see citing works
A Facile and Promising Delivery Platform for siRNA to Solid Tumors
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Ebenezer, O., Oyebamiji, A. K., Olanrewaju, A. A., Akinola, O. T., Afolabi, S. O., Olaseinde, A. A., & Tuszyński, J. A. (2024) · Pharmacological Research - Reports · doi:10.1016/j.prerep.2024.100021 · Cited by 2 · see citing works
Self-citationA Novel Pot-Economy Approach to the Synthesis of Triantennary GalNAc-Oligonucleotide
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Гиполипидемическая терапия в особых ситуациях
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"Potential Application of Oligonucleotide Therapeutics in SARS-CoV-2 Genomic RNA Knockdown"
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RNA-Based Therapies for Hypercholesterolemia and Coronary Artery Disease
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- Authors
- Ebenezer, O., Comoglio, P., Wong, G. K.-S., & Tuszynski, J. A.
- Affiliations
- Mangosuthu University of Technology (ZA)
- Politecnico di Torino (IT)
- University of Alberta (CA)
- Department of Mechanical and Aerospace Engineering (DIMEAS), Politecnico di Torino, 10129 Turin, Italy
- Corresponding author
- Wong, Gane Ka-Shu
- Venue
- International Journal of Molecular Sciences
- Publisher
- MDPI AG
- Published
- 2023-02-16
- Volume
- 24
- Issue
- 4
- Pages
- 4019
- ISSN
- 1422-0067 (ISSN-L)
- PMC
- PMC9966809
- OpenAlex
- W4321235730
- Cited by
- 39
- References
- 176
- Citations by year
- 2026: 9 · 2025: 10 · 2024: 12 · 2023: 8
- FWCI
- 1.03
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Molecular Sciences (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Figshare (submittedVersion, cc-by)
- MUT (cc-by)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › RNA Interference and Gene Delivery
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
- Keywords
- inclisiran, siRNA therapeutics, PCSK9 inhibition, hypercholesterolemia, GalNAc-conjugated siRNA, siRNA delivery, LDL cholesterol, monoclonal antibodies, cardiovascular disease, RNA interference
- MeSH terms
- Proprotein Convertase 9, Antibodies, Monoclonal, Anticholesteremic Agents, Cardiovascular Diseases, Humans, Hypercholesterolemia, Cholesterol, LDL, RNA, Small Interfering
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