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Raised From The Grave: A Second Life for Sotagliflozin?

Raised From The Grave: A Second Life for Sotagliflozin?

June 24, 2021

The prevalence of heart failure in patients with diabetes is four times higher than in the general population.  Likewise, chronic kidney disease (CKD) and diabetes are common morbidities. As new drug classes emerge in the management of diabetes and heart failure and CKD, it is important to thoroughly evaluate available literature and identify opportunities to reduce complications and costs. Sotagliflozin is a first-in-class dual SGLT-1 and 2 inhibitor approved in Europe.  Does it improve outcomes in patients with heart failure or CKD?

Guest Authors:  Maren Richards Brinton, PharmD and Jonathan C. Hughes, PharmD, BCPS, BCACP

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Tiny (n-of-1) Trials to Overcome Statin-Associated Muscle Pain

Tiny (n-of-1) Trials to Overcome Statin-Associated Muscle Pain

June 11, 2021

In blinded clinical trials the percentage of patients who experience muscle symptoms while taking a statin is typically in the 3-5% range.  In practice, the percentage of patients who report muscle symptoms is 10-25%.  This disparity between what has been observed in blinded trials and what patients experience when treated with a statin is due, in part, to the nocebo effect — a belief that a medication may cause harm.  How many lives could be saved if we routinely used tiny randomized, controlled, blinded trials to determine when statin therapy can be safely continued?

Guest Panelists: Elizabeth Hearn, PharmD; Stuart T Haines PharmD, BCPS, BCACP; and Kathryn (Katie) Kiser, PharmD, BCACP

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Is Home Blood Pressure Monitoring a “Home Run” for Blood Pressure Management?

Is Home Blood Pressure Monitoring a “Home Run” for Blood Pressure Management?

April 29, 2021

Nearly 67 million people, which equates to 3 out of every 4 people, living with high blood pressure in the US remain uncontrolled, despite the clear and compelling benefits of achieving good control. Remote monitoring and self-management of BP may enable us to broadly achieve optimal BP control in most patients. Increased use of telehealth technology improves access to care, but the effects on the cost and quality of care, particularly in the context of hypertension management, have not been clearly established.

Guest Authors: Mary Taylor, PharmD and Megan Supple, PharmD, BCACP, CPP

Guest Panelist:  Joseph Saseen, PharmD, BCPS, BCACP, CLS

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FAST Take: Update on Febuxostat Cardiovascular Safety

FAST Take: Update on Febuxostat Cardiovascular Safety

April 2, 2021

We know gout is among the many comorbidities that increase the risk of cardiovascular disease (CVD). In 2018, the cardiovascular safety of febuxostat and allopurinol in patients with gout and cardiovascular morbidities (CARES) trial concluded that febuxostat was non-inferior to allopurinol. BUT, two of the secondary endpoints were very concerning. Febuxostat was inferior to allopurinol in terms of cardiovascular death and all-cause mortality. Many clinicians were left wondering whether febuxostat was cardiotoxic …. or conversely, perhaps allopurinol was cardioprotective. Will another cardiovascular outcome trial provide greater clarity to guide clinical practice?

Guest Authors: Sophia Dietrich, PharmD and Michael W. Nagy, PharmD, BCACP

Guest Panelist: Dawn Fuke, PharmD, BCPS

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Can a Polypill ‘TIP’ the Scale to a One-Size-Fits All Approach?

Can a Polypill ‘TIP’ the Scale to a One-Size-Fits All Approach?

February 26, 2021

Creating an ideal therapeutic regimen is often like putting a puzzle together, with adherence being a critical piece of that puzzle. Studies, and clinical experience, show that patients are more likely to adhere to once-daily medication administration when compared to regimens that require more frequent dosing.  Given that pill burden and medication cost are an increasing problem, would our patients benefit from a simple, low-cost, one-size-fits-all approach to addressing cardiovascular risk?

Guests:  Ebony Isis Evans, PharmD, Katy Pincus, PharmD, BCPS, BCACP, and Sara Wettergreen, PharmD, BCACP

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Is it Time to Add Colchicine to the CVD Cocktail?

Is it Time to Add Colchicine to the CVD Cocktail?

January 4, 2021

Systemic inflammation appears to be an important contributor to atherosclerotic cardiovascular disease but, to date, no medications have been approved that specifically target systemic inflammation. Could colchicine, an anti-inflammatory drug that has been used for decades, move from “perhaps-do” to a “must-do” standard of care for patients with coronary artery disease (CAD)? Data from two previous trials have demonstrated colchicine’s positive impact on cardiovascular outcomes. The LoDoCo2 study asks us, again, to consider colchicine for patients with CAD.

Guest Authors:  Augustus (Rob) Hough, PharmD, BCCP and Taylor Huff, PharmD

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Less Might Be Better: Deprescribing Antihypertensive Medications in Older Adults

Less Might Be Better: Deprescribing Antihypertensive Medications in Older Adults

October 30, 2020

Health care professionals often don’t think twice about adding a new medication when a patient is not at goal. But we’re reluctant to stop a medication for a chronic condition when the patient appears to be stable and doing well.  Polypharmacy in older adults is a significant problem.  It’s costly and increases the likelihood of adverse effects. Several observational studies have suggested that lower blood pressure and multiple antihypertensive medications may be harmful in the elderly. Is it possible to discontinue medications without causing serious harm?

Guest Authors: Keturah Weaver Pharm D, BCPS and Daniel Longyhore Pharm D, M.S., BCACP

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Can VOYAGER Put PAD Patients Back on Their Feet?

Can VOYAGER Put PAD Patients Back on Their Feet?

August 28, 2020

Peripheral artery disease (PAD) impacts 8.5 million Americans age 40 years or older, often leading to acute limb ischemia, amputation, hospitalization, revascularization, major adverse cardiac events (MACE), and death. In addition to being at very high risk of MACE, more than 10% of PAD patients who had revascularization surgery are hospitalized for major adverse limb events, including acute limb ischemia leading to amputation. Could combination therapy, an antithrombotic regimen comprised of a direct oral anticoagulant and an antiplatelet agent, help prevent limb ischemia and cardiovascular (CV) events in these high-risk patients?

Guest Authors:  Navya Varshney, PharmD, BCPS and Rachel Lowe, PharmD, BCPS

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Will Bempedoic Acid provide SERENITY for Patients with Statin Intolerance?

Will Bempedoic Acid provide SERENITY for Patients with Statin Intolerance?

August 14, 2020

Current guidelines recommend statins for primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD) due to their well-established therapeutics benefits.  Unfortunately, many patients are unable to tolerate statins due to statin-associated muscle symptoms (SAMS), most commonly manifested as myalgias. Patients who are unable to tolerate a statin can be challenging to treat. Even if the patient is willing to try a lower dose or a different statin, the patient’s low-density lipoprotein cholesterol (LDL-C) may still be above the recommended threshold.  This puts patients unable to tolerate statins at increased risk of ASCVD or of a recurrent cardiovascular event. Is bempedoic acid a useful therapeutic option in patients with SAMS?

Guest Authors:  Kara Gurries, PharmD, BCACP and Janeen Ibarreta, PharmD

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No Provider Status, No Problem: CCM as a Revenue Source in Community Pharmacy

No Provider Status, No Problem: CCM as a Revenue Source in Community Pharmacy

July 31, 2020

Hypertension is poorly managed in the United States with only 25% of patients achieving optimal blood pressure (BP) control (BP less than 130/80 mmHg).  To achieve optimal control, patients require close follow-up and BP-lowering medication regimens need to be titrated and periodically adjusted. Community pharmacists are in a unique position to manage patients who have poorly controlled hypertension. However, significant barriers exist to implementing hypertension management services by community pharmacists including a lack of reimbursement. Is chronic care management (CCM) a viable payment model to support these services?

Guest Authors:  Kimberly Zitko, PharmD, BCACP, BCGP and Brittany Schmidt, PharmD, BCACP

Music by Good Talk

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