Episodes
Friday Jun 09, 2023
Is There a CLEAR Role for Bempedoic Acid in Cardiovascular Risk Reduction?
Friday Jun 09, 2023
Friday Jun 09, 2023
There are a variety of non-statin lipid-lowering medications with proven cardiovascular benefits; however, most of the evidence supporting their use has been as an adjunct with a statin. Bempedoic acid offers a novel mechanism of action to treat hypercholesterolemia. But is there a CLEAR role for bempedoic acid in the treatment and prevention of ASCVD in statin-intolerant patients?
Guest Authors: Sarah B. Edwards, PharmD and Briana Williams, PharmD, BCPS, BCACP
Special Guest: Joseph Saseen, PharmD, BCPS, BCACP
Music by Good Talk
Friday Apr 14, 2023
Friday Apr 14, 2023
You’ve probably encountered many patients who have experienced muscle symptoms after starting a statin. Statin-associated muscle symptoms (SAMS) contribute to treatment discontinuation and significantly increase cardiovascular (CV) adverse events and mortality. What strategies do you recommend to increase statin tolerance?
Guest Author: Rick Hess, PharmD, CDCES, BCACP
Music by Good Talk
Friday Jun 11, 2021
Tiny (n-of-1) Trials to Overcome Statin-Associated Muscle Pain
Friday Jun 11, 2021
Friday Jun 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
Music by Good Talk
Friday Feb 26, 2021
Can a Polypill ‘TIP’ the Scale to a One-Size-Fits All Approach?
Friday Feb 26, 2021
Friday Feb 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
Music by Good Talk
Friday Jul 17, 2020
Powerful Placebos and Notorious Nocebos: Implications for Ambulatory Care
Friday Jul 17, 2020
Friday Jul 17, 2020
Imagine you have recommended statin therapy to a patient with diabetes. A few weeks later, the patient experiences leg pain and stops it. Was this patient’s leg pain caused by the statin? Or was it a nocebo effect? Muscle symptoms in placebo-controlled trials of statin therapy range from 3-5%, while rates in real-world observational studies are between 15-20%. Ambulatory care pharmacists have an important role in recognizing and managing placebo and nocebo effects. Understanding the placebo effect allows clinicians to harness the power of placebos. Reframing risks during patient education may decrease nocebo effects.
Guest Authors: Sara Wettergreen, PharmD, BCACP and Joseph Nardolillo, PharmD
Music by Good Talk
Monday Jul 06, 2020
An Incli-ng of Benefit? Efficacy and Safety of Inclisiran for Elevated LDL
Monday Jul 06, 2020
Monday Jul 06, 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
Friday Feb 22, 2019
Friday Feb 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
Wednesday Jan 09, 2019
Top Ten Things Every Clinician Should Know About the 2018 Cholesterol Guidelines
Wednesday Jan 09, 2019
Wednesday Jan 09, 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
Friday Oct 26, 2018
LDL Limbo: How Low is Too Low?
Friday Oct 26, 2018
Friday Oct 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
Friday Aug 25, 2017
Friday Aug 25, 2017
Statins reduce atherosclerotic cardiovascular disease (ASCVD) risk. However, the utility of statin therapy in older adults — particularly in those age 75 years and older — remains controversial. The need for additional evidence to guide clinical practice is underscored by the fact that one-in-three older Americans report taking a statin. Given the paucity of prospective data, a post-hoc analysis of the ALLHAT-LLT (Antihypertensive and Lipid Lowering treatment to prevent Heart Attack Trial - Lipid Lowering Trial) was recently published. Does this new analysis really help inform the decision?
Guest Author: Leo Buckley, Pharm.D.
Music by Good Talk