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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

Music by Good Talk

An Incli-ng of Benefit? Efficacy and Safety of Inclisiran for Elevated LDL

An Incli-ng of Benefit? Efficacy and Safety of Inclisiran for Elevated LDL

July 6, 2020

Lipid management continues to be an essential component in the prevention and treatment of atherosclerotic cardiovascular disease (ASCVD).  For the past decade, clinical practice guidelines have gone back and forth about optimal treatment goals but guidelines all agree that statins should be used as the preferred initial therapy. However, there is still a lack of clarity about the optimal add-on therapies. The newest LDL-lowering therapy is inclisiran, a small interfering RNA (siRNA) that targets the PCSK9 pathway.

Guest Authors:  Joshua O. Holmes, PharmD, MS and Amanda Schartel, PharmD, BCACP

Music by Good Talk

Age is Just a Number: Discontinue Statins with Care

Age is Just a Number: Discontinue Statins with Care

February 14, 2020

More than 14 million Americans age 75 years and older face a dilemma. They are at high risk for atherosclerotic cardiovascular disease (ASCVD). On the other hand, older adults are more susceptible to adverse effects associated with statins. Many adults, often in their 60s or early 70s, decide to initiate statin therapy for the primary prevention of ASCVD. However, at some point in a patient’s life, the potential benefits may no longer be so clear … or the risks and costs increase. Unfortunately, there is little information on the potential consequences of stopping statin in patients who are tolerating statins.

Guest Authors:  Maricar Conson, PharmD and W. Cheng Yuet, PharmD, BCACP

Music by Good Talk

Cardiovascular Risk with Elevated Triglycerides - Does Icosapent Ethyl REDUCE-IT?

Cardiovascular Risk with Elevated Triglycerides - Does Icosapent Ethyl REDUCE-IT?

February 22, 2019

Although hypertriglyceridemia has consistently been associated with increased CV events, medications that lower triglycerides have failed to reel in a significant reduction in major CV events when combined with statin therapy. Could purified fish oil derivatives be the answer? Or just another red herring? The Reduction of CV Events with Icosapent-Ethyl Intervention Trial (REDUCE-IT) sought to clarify the utility of icosapent ethyl, a highly purified EPA derivative.

Guest Authors: Melissa Norton, PharmD and Elizabeth A. Cook, PharmD, AE-C, BCACP, CDE

Music by Good Talk

Top Ten Things Every Clinician Should Know About the 2018 Cholesterol Guidelines

Top Ten Things Every Clinician Should Know About the 2018 Cholesterol Guidelines

January 9, 2019

The American Heart Association / American College of Cardiology (AHA/ACC) Task Force recently published the 2018 Guideline on the Management of Blood Cholesterol. The guidelines writing committee had representation from 12 organizations, including the National Lipid Association, American Diabetes Association, and the American Pharmacists Association — all of whom endorsed the guidelines. The previous guidelines (published in 2013) were intended to answer some specific clinical questions and significantly changed our approach to treatment. The 2018 guidelines provide a more comprehensive set of recommendations, akin to the (older) National Heart, Lung, and Blood Institute Adult Treatment Panel (ATP) III guidelines last published in 2002!

Guest Authors:  Dawn Fuke, Pharm.D., BCPS, and Zach Conroy, PharmD, BCACP

Music by Good Talk

LDL Limbo: How Low is Too Low?

LDL Limbo: How Low is Too Low?

October 26, 2018

There has been significant debate regarding the safety of achieving very low LDL-C levels, including a potential negative impact on cognitive function. The current ACC/AHA guidelines (circa 2013) suggest decreasing the statin dose in patients with two consecutive LDL-C levels below 40 mg/dL based on expert opinion. The lack of evidence has been a major challenge for clinicians and it is unclear whether medication doses should be reduced in high-risk patients who may benefit from very low LDL-C levels.  A recently published meta-analysis sought to address this clinical dilemma.

Podcast Case: Very Low LDL Case

Guest Authors:  Apryl Anderson, PharmD and Dave Dixon, PharmD, BCPS, BCACP, CLS, CDE

Music by Good Talk

 

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