PMC10326624_01
Erythematous and painful injection site reaction (ISR) developed 48 h after the second subcutaneous injection of alirocumab in the left arm.
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F1
Forty-eight hours after the second SC injection of alirocumab in the left arm, the patient developed a painful and palpable ISR with an erythematous nodule of about 5 cm in major diameter (Figure 1), that resolved after 5 days of topical application of betamethasone.
Timeline of LDL-C levels variations according to lipid-lowering therapy. T1: February 2021 (no lipid-lowering therapy); T2: August 2021 (6-month therapy with high-intensity statin plus ezetimibe); T3: September 2021 (1-month therapy with the addition of PCSK9-inhibitor mAb); T4: February 2022 (3-month PCSK9-inhibitor mAb withdrawal); T5: January 2023 (3-month therapy with the addition of inclisiran).
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F2
Indeed, PCSK9i mAbs therapy had lowered LDL-C to 96 mg/dl, while 3 months after withdrawal the LDL-C raised back to 191 mg/dl (Table 1 and Figure 2). Furthermore, three months after the first injection of inclisiran, the patient's lipid panel was the following: TC 184 mg/dl, HDL-C 59 mg/dl, TG 73 mg/dl, LDL-C 103 mg/dl, Lp(a) 113 mg/dl (Table 1 and Figure 2).