Inclisiran is a small interfering RNA (siRNA) that inhibits PCSK9, approved for high cholesterol and homozygous familial hypercholesterolemia. This page compares Inclisiran to other PCSK9 inhibitors such as Alirocumab (Praluent), Evolocumab (Repatha), and Lerodalcibep (Lerochol). A notable difference among these therapies is their administration schedule.
Inclisiran Alternatives: How It Compares to Other PCSK9 Inhibitors
Hipa.ai Research · Source: ClinicalTrials.gov / AACT · Last updated: AI-augmented data · 0/6 curated
Source: ClinicalTrials.gov via AACT · Hipa.ai, 2026-05-07Download chart as PNG
Approved comparators include Alirocumab (Praluent) and Evolocumab (Repatha) from 2015, with Inclisiran approved in 2021, while Lerodalcibep (anticipated 2025), Enlicitide Decanoate, and Tafolecimab remain in Phase 3 development.
Quick comparison table
| Drug | Class | Approved indications | Dosing | Year approved | Lead pivotal endpoint | Annual cost (rough) |
|---|---|---|---|---|---|---|
| Inclisiran (Leqvio) | PCSK9 inhibitor (siRNA) | high cholesterol, homozygous familial hypercholesterolemia | 284 mg subcutaneously initially, at 3 months, and then every 6 months | 2026 | 52.3% @ 17 months | $7k |
| Alirocumab (Praluent) | PCSK9 inhibitor | Heterozygous familial hypercholesterolemia, Clinical atherosclerotic cardiovascular disease, Prevention of cardiovascular events, +2 more | 75 mg or 150 mg subcutaneously once every 2 weeks, or 300 mg subcutaneously once every 4 weeks | 2015 | — | $6k |
| Evolocumab (Repatha) | PCSK9 inhibitor | Primary hyperlipidemia, Homozygous familial hypercholesterolemia, Cardiovascular risk reduction | 140 mg every 2 weeks or 420 mg once monthly | 2015 | — | $6k |
| Lerodalcibep (Lerochol) | PCSK9 inhibitor | High cholesterol | 300 mg subcutaneously once monthly | Pipeline | 60.27% @ 52 weeks | — |
| Enlicitide Decanoate | PCSK9 inhibitor | — | 20 mg orally once daily | Pipeline | 55.8% @ 24 weeks | — |
| Tafolecimab (Sintbilo) | PCSK9 inhibitor | — | 150 mg every 2 weeks, 450 mg every 4 weeks, or 600 mg every 6 weeks subcutaneously | Pipeline | 63% @ 12 weeks | — |
Cost estimates are list-price approximations and do not reflect rebates, formulary tier, or out-of-pocket costs after benefits. The class-typical lead-pivotal endpoint here is LDL-C reduction; cells render each drug's actual pivotal endpoint, which may differ. The "Year approved" column shows the FDA approval year for hypercholesterolemia specifically — drugs approved for other indications first appear with their this-indication date, or as Pipeline if not yet approved for this indication. Cross-trial comparisons can mislead — head-to-head Phase-3 data (when present) is below.
Inclisiran vs Alirocumab (Praluent)
No head-to-head Phase-3 trial directly compares Inclisiran with Alirocumab.
Cross-trial caveat: the two drugs were tested in different patient populations at different time points. Cross-trial comparisons of response rates can mislead — the only rigorous comparison is a head-to-head randomized trial.
Inclisiran vs Evolocumab (Repatha)
No head-to-head Phase-3 trial directly compares Inclisiran with Evolocumab.
Cross-trial caveat: the two drugs were tested in different patient populations at different time points. Cross-trial comparisons of response rates can mislead — the only rigorous comparison is a head-to-head randomized trial.
Inclisiran vs Lerodalcibep (Lerochol)
The pivotal head-to-head evidence comes from a head-to-head Phase-3 trial (NCT05004675) enrolling 166 participants, primary completion 2024-05.
Primary-endpoint values for NCT05004675 are not yet posted in the AACT results database.
Source: ClinicalTrials.gov via AACT — pulled directly from the trial's posted results. View the full trial record.
Pipeline alternatives
Several investigational IL-17 / IL-17-related drugs are currently in active Phase 3 development, representing alternatives with a different mechanism of action compared to Inclisiran. Among these is Lerodalcibep from LIB Therapeutics LLC, with its lead Phase 3 trial registered as NCT04790513. Another candidate is Enlicitide Decanoate, developed by Merck Sharp & Dohme LLC, which is being investigated in its lead Phase 3 study, NCT06450366.
Also in advanced development is Tafolecimab from Innovent Biologics (Suzhou) Co. Ltd., with its primary Phase 3 trial identified as NCT04709536. These agents target IL-17 pathways, offering distinct therapeutic approaches.
Choosing between Inclisiran and its alternatives
Inclisiran, an siRNA PCSK9 inhibitor, offers a distinct mechanism of action compared to monoclonal antibodies like Alirocumab (Praluent) and Evolocumab (Repatha). Its less frequent dosing schedule may be a significant factor for patient adherence and convenience, potentially preferred over regimens requiring administration every 2 weeks or monthly.
Conversely, Alirocumab (Praluent) and Evolocumab (Repatha) have a longer clinical track record. These agents also provide dosing flexibility, with Alirocumab available at 75 mg or 150 mg subcutaneously once every 2 weeks, or 300 mg subcutaneously once every 4 weeks, and Evolocumab at 140 mg every 2 weeks or 420 mg once monthly. Lerodalcibep (Lerochol) demonstrated a placebo-adjusted LDL-C reduction of 60.27% at 52 weeks with once-monthly 300 mg dosing.
Ultimately, the choice among PCSK9 inhibitors should be made by the prescribing clinician in consultation with the patient, considering individual patient factors, treatment goals, and clinical context.
Sources and methodology
Trial data was pulled from the ClinicalTrials.gov registry via the AACT relational mirror maintained by the Clinical Trials Transformation Initiative. AACT data freshness: .
Head-to-head trials cited on this page:
- NCT05004675: Inclisiran vs Lerodalcibep · Trial to Evaluate Efficacy and Safety of LIB003 and Inclisiran in High-risk CVD Patients
Cross-trial comparison limitations:drugs without a direct head-to-head trial are compared using each drug's own pivotal trial. These trials enrolled different patient populations at different time points and used different statistical analysis sets. Cross-trial response-rate differences should not be interpreted as proof that one drug is more effective than another.
Related drug pages on Hipa.ai
Not medical advice. This page summarizes publicly-reported clinical trial data for informational purposes. Treatment decisions belong with a qualified prescribing clinician who knows your medical history. Drug approvals, dosing, and safety profiles change over time — always confirm with the current FDA prescribing information.
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