Novartis’ Leqvio Hits Key Targets in Phase IV V-DIFFERENCE Study
Novartis announced positive results from V-DIFFERENCE, a phase IV trial evaluating Leqvio (inclisiran) plus lipid-lowering therapy (LLT) versus placebo plus LLT in patients with high cholesterol who had not achieved guideline-recommended LDL-C goals. Findings were presented in a Hot Line session at the 2025 European Society of Cardiology (ESC) Congress in Madrid.
Key Findings
Primary Endpoint Achieved:
- After 90 days, 85% of patients on Leqvio + LLT reached LDL-C targets vs 31% on placebo + LLT (p<0.0001).
- Benefits seen as early as 30 days (81% achieved LDL-C goals).
LDL-C Reduction:
- At 360 days, Leqvio reduced LDL-C by an average of 59%, outperforming placebo by 35% (p<0.0001).
- Clinically significant results observed by day 60.
Muscle-Related Safety Outcomes:
- Leqvio patients were 43% less likely to experience muscle-related adverse events (MRAE) (p<0.0001).
- Numerical improvements reported in pain-related quality-of-life scores.
Consistency Across Groups:
Results held across age, sex, and cardiovascular risk subgroups.
Expert Perspectives
Prof. Ulf Landmesser, M.D. (Charité, Berlin):
“V-DIFFERENCE is the largest LDL-C lowering study with Leqvio to date. These findings highlight effective options for patients still above recommended LDL-C levels.”
Dr. Ruchira Glaser, Novartis:
“The results show Leqvio can help patients reach LDL-C goals faster without additional therapies or maximized statin dosing, transforming cardiovascular care.”
Global Reach: Approved in 100+ countries, licensed from Alnylam Pharmaceuticals.
The Bigger Picture – VictORION Program
Encompasses 60,000+ patients across 50 countries.
Includes trials such as ORION-4 (secondary prevention), V-2-PREVENT, V-1-PREVENT, V-INTERVENTION, V-PLAQUE, andV-RIDES.
Focuses on randomized clinical trials, real-world data, prevention studies, and patient-centered outcomes.
The Unmet Need in Cardiovascular Health
Cardiovascular disease (CVD): Leading global killer, responsible for more deaths than cancer, diabetes, or lung disease combined.
Atherosclerotic cardiovascular disease (ASCVD): Causes 85% of CV deaths; primary cause of mortality in the EU and U.S.
LDL-C exposure: Key driver of atherosclerotic plaque build-up, heart attack, and stroke risk.
Prevention Opportunity: Lowering LDL-C by 10 mg/dL can cut major CV event risk by ~20%.
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