Abstract Number: Esoc2026a1785 Effectiveness and Persistence of Inclisiran in Belgian Patients With Cerebrovascular Atherosclerotic Disease: A Subgroup Analysis From the BE.REAL Study

Abstract Background and aims Patients with cerebrovascular disease (CeVD) benefit from lipid-lowering therapy, yet LDL-C targets are often unmet. Post-hoc analyses of ORION-9, -10, and -11 showed a 45.7% LDL-C reduction with inclisiran in CeVD patients, but real-world evidence remains limited. BE.REAL is a non-interventional BElgian Registry to Evaluate the reAl life treatment with incLisiran on top of standard of care lipid-lowering therapy in patients with atherosclerotic cardiovascular disease (ASCVD) across 16 hospitals. Methods Patients with ASCVD treated with reimbursed inclisiran between May 2022 and August 2025 were enrolled. Data were collected during routine clinical practice. This analysis focuses on a subgroup of 47 patients with established CeVD included in the interim analysis, each with varying follow-up durations of up to 33 months (maximum 7 injections). Results Mean baseline LDL-C was 138.6mg/dL 95%CI 127.1-150mg/dL). 70% of the patients did not receive a statin as background therapy mainly due to reported statin intolerance (60%). 68% of the population was female and 72% had hypertension or took hypertensive medication. Of the 47 patients included, 18 patients already received their 5th injection (Table). Persistence rate was high, with 95.2% receiving their second injection within the recommended 3-month window, remaining consistent across subsequent injections. LDL-C decreased by 39% (-52.8 SD: 26.3mg/dL, n=20) after the second injection, with consistent reductions until injection 6. Conclusions In this real-world Belgian cohort of CeVD patients with high unmet medical need, inclisiran achieved LDL-C reductions consistent with clinical trial data. Persistence was high, supporting its feasibility in routine practice. Conflict of interest Noémie Ligot: Nothing to disclose. Peter Vanacker: Nothing to disclose. Sven de Mey, Charlotte van den Broek, Silke Vermaerke, Cécile Godfroid, Mieke Jansen, Eléonore Maury, Caroline Guinée: Employees of Novartis Pharma. Table 1 - belongs to Conclusions