Podcasts about pcsk9

Welcome to the latest Midlife Minute. This episode unpacks ongoing research on Lp(a), explores how women's lipids change during the perimenopause-to-menopause transition, and clarifies what we can do about it. Stay tuned for more! IN THIS EPISODE, YOU WILL LEARN: How total cholesterol, LDL, and ApoB tend to rise most steeply around the final menstrual period, rather than increasing gradually with chronological aging Why women should have their Lp(a) checked both before and after menopause How oral and transdermal estradiol can affect LDL, HDL, triglycerides, and Lp(a) differently Why I recommend including ApoB when checking your lipids during the perimenopause window How your lifestyle can reduce your cardiovascular risk, even when your Lp(a) is elevated Why omega-3 fatty acids and commonly used lipid medications do not lower Lp(a) Why supplements are not replacements for statins in genuinely high-risk patients  I review the various PCSK9 inhibitors currently available, how they are administered, and their effects  How a CAC, a CT angiogram, and an AI-assisted CT angiogram can help women and their providers determine how aggressive their approach should be when Lp(a) is elevated Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia's website. Submit your questions to support@cynthiathurlow.com  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia's book, The Menopause Gut. Cynthia's Intermittent Fasting Transformation Book The Midlife Pause Supplement Line References: 1. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association.Circulation. 2020. El Khoudary SR, Aggarwal B, Beckie TM, et al.Guideline 2. Menopause: A Cardiometabolic Transition. The Lancet. Diabetes & Endocrinology. 2022. Nappi RE, Chedraui P, Lambrinoudaki I, Simoncini T.Review 3. Dyslipidemia Across the Menopause Transition: Mechanisms, Trajectories, and Opportunities for Cardiovascular Prevention. Maturitas. 2026. Castaneda R, Tatit CP, Hurtado Andrade MD, Faubion SS, Shufelt CL.RecentReview 4. Lipoprotein(a) and Women's Cardiovascular Health: A Review. JACC. Advances. 2026. Michos ED, Saucier S, Mehran R, Koschinsky ML. 5. Lipid Metabolism in Women: A Review. Atherosclerosis. 2025. van Oortmerssen JAE, Mulder JWCM, Kavousi M, Roeters van Lennep JE.Review 6. Are Changes in Cardiovascular Disease Risk Factors in Midlife Women Due to Chronological Aging or to the Menopausal Transition?. Journal of the American College of Cardiology. 2009. Matthews KA, Crawford SL, Chae CU, et al.Observational 7. Trajectories of Lipids Around the Menopause Transition in Chinese Women: Results of the Kailuan Cohort Study. Fertility and Sterility. 2023. Dai Q, Wu S, Cao Z, et al. 8. Lipid Management in Patients With Endocrine Disorders: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology and Metabolism. 2020. Newman CB, Blaha MJ, Boord JB, et al.Guideline 9. The Effects of Menopause Hormone Therapy on Lipid Profile in Postmenopausal Women: A Systematic Review and Meta-Analysis. Frontiers in Pharmacology. 2022. Nie G, Yang X, Wang Y, et al.SR 10. Perspectives on Dyslipidemia and Coronary Heart Disease in Women. Journal of the American College of Cardiology. 2005. Bittner V.Review 11. Dyslipidemia in Midlife Women: Approach and Considerations During the Menopausal Transition. Maturitas. 2022. Torosyan N, Visrodia P, Torbati T, Minissian MB, Shufelt CL.Review 12. Effects of gender, age and menopausal status on serum apolipoprotein concentrations.13.Lipoprotein(a).The Journal of the American Medical Association. 2025. Mora S, Kronenberg     14. Why, how and in whom should we measure levels of lipoprotein(a): A review of the latest evidence and clinical implications. Diabetes, Obesity & Metabolism. 2025. Razavi AC, Bhatia HS, Blumenthal RS, Shapiro MD, Mehta A.RecentReview 15. Red Yeast Rice for Hypercholesterolemia: JACC Focus Seminar. Journal of the American College of Cardiology. 2021. Cicero AFG, Fogacci F, Zambon A.Review 16. Overall and Sex-Specific Effect of Berberine for the Treatment of Dyslipidemia in Adults: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials. Drugs. 2023. Blais JE, Huang X, Zhao JV.SR 17. Non-Genetic Influences on Lipoprotein(a) Concentrations. Atherosclerosis. 2022. Enkhmaa B, Berglund L.Review 18. NHLBI Working Group Recommendations to Reduce Lipoprotein(a)-Mediated Risk of Cardiovascular Disease and Aortic Stenosis. Journal of the American College of Cardiology. 2018. Tsimikas S, Fazio S, Ferdinand KC, et al.Review 19. Consumption of a defined, plant‐based diet reduces lipoprotein(a), inflammation, and other atherogenic lipoproteins and particles within 4 weeks. Clinical Cardiology. 2018. Najjar RS, Moore CE, Montgomery BD. 20. Lipoprotein(a): Current Evidence for a Physiologic Role and the Effects of Nutraceutical Strategies. Clinical Therapeutics. 2019. Santos HO, Kones R, Rumana U, et al.Review 21. Effect of Lipid-Lowering Therapies on Lipoprotein(a) Levels: A Comprehensive Meta-Analysis of Randomized Controlled Trials. Atherosclerosis. 2025. Xie S, Galimberti F, Olmastroni E, et al.Recent 22. Effect of Omega-3 Fatty Acid Supplementation on the Postprandial Metabolism of Apolipoprotein(a) in Familial Hypercholesterolemia. Journal of Atherosclerosis and Thrombosis. 2023. Ying Q, Croyal M, Chan DC, et al.RCT 23.Lipoprotein(a) and Cardiovascular Disease. Lancet. 2024. Nordestgaard BG, Langsted A.Review 24. Lipoprotein(a): A Genetically Determined, Causal, and Prevalent Risk Factor for Atherosclerotic Cardiovascular Disease: A Scientific Statement From the American Heart Association. Arteriosclerosis, Thrombosis, and Vascular Biology. 2022. Reyes-Soffer G, Ginsberg HN, Berglund L, et al.Guideline 25.Clinical Trial Design for Lipoprotein(a)-Lowering Therapies: JACC Focus Seminar 2/3.Journal of the American College of Cardiology. 2023. Malick WA, Goonewardena SN, Koenig W, Rosenson RS.Review 26.2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American Collegeof Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2026. Writing Committee Members, Blumenthal RS, Morris PB, et al.Guideline 27. Noninvasive Coronary Atherosclerotic Plaque Imaging. JACC. Cardiovascular Imaging. 2023. Kwiecinski J, Tzolos E, Williams MC, et al.Review 28. Computed Tomography Angiography Versus Agatston Score for Diagnosis of Coronary Artery Disease in Patients With Stable Chest Pain: Individual Patient Data Meta-Analysis of the International COME-CCT Consortium. European Radiology. 2022. Wieske V, Walther M, Dubourg B, et al.SR 29. Association of Coronary Artery Calcium Score With Qualitatively and Quantitatively Assessed Adverse Plaque on Coronary CT Angiography in the SCOT-HEART Trial. European Heart Journal. Cardiovascular Imaging. 2022. Osborne-Grinter M, Kwiecinski J, Doris M, et al.Clinical Trial 30. AI-Guided Quantitative Plaque Staging Predicts Long-Term Cardiovascular Outcomes in Patients at Risk for Atherosclerotic CVD. JACC. Cardiovascular Imaging. 2024. Nurmohamed NS, Bom MJ, Jukema RA, et al.Observational 31. The Lancet Commission on Rethinking Coronary Artery Disease: Moving From Ischemia to Atheroma. Lancet. 2025. Zaman S, Wasfy JH, Kapil V, et al.Review 32. Efficacy and safety of novel lipoprotein(a)‐targeted therapies: A systematic review and meta‐analysis of randomized controlled trials. Diabetes, Obesity & Metabolism. 2026. Santana AUL, Yusufzai MO, Freitas APS, et al. Recent Opinion

Should LDL be treated? In this episode of Metabolic Mind, Dr. Bret Scher explains why the better question is who may benefit from LDL lowering, how aggressively it should be treated, and what outcomes matter most to the individual patient.Dr. Scher reviews two major trials that studied aggressive LDL lowering in very different populations. VESALIUS-CV looked at high-risk patients with serious vascular disease and found that adding a PCSK9 inhibitor reduced both cardiovascular events and all-cause mortality. STAREE studied older adults without known cardiovascular disease and found fewer cardiac events with statin therapy, while overall survival and hospitalizations did not change. Disability-free survival also showed no differenceHe covers:Why LDL treatment depends on the person, not just the numberWhat VESALIUS-CV found in high-risk patients with vascular diseaseWhy STAREE tells a different story in older adults without known heart diseaseThe difference between reducing cardiac events and extending lifeWhy vascular disease should shape how aggressively LDL is treatedHow age, frailty, cognition, cancer risk, and independence affect the risk-benefit conversationWhy LDL may need a different discussion for someone using ketogenic therapyHow metabolic health, insulin resistance, and direct evidence of vascular disease fit into the decisionThese trials illustrate why LDL treatment should be individualized with a healthcare provider. For some patients, aggressive lowering may save lives. For others, the benefits may be smaller or less connected to the outcomes they care about most.

Healthcare companies are rethinking their business models as patients gain more control over how they access care and purchase medicine. Our analysts Erin Wright and Terence Flynn unpack this shift and the emerging opportunities.Read more insights from Morgan Stanley.----- Transcript -----Erin Wright: Welcome to Thoughts on the Market. I'm Erin Wright, US Healthcare Services Analyst at Morgan Stanley.Terence Flynn: And I'm Terence Flynn, Morgan Stanley's US BioPharma Analyst.Erin Wright: Today, how the consumer is moving into the driver's seat across healthcare.It's Monday, September 14th at 7:00 AMWe're recording in New York City, where Morgan Stanley's twenty-fourth Annual Healthcare Conference is happening this week. One of the biggest shifts we're seeing across the industry is patients gaining more choice, transparency, and control over how they access care and medicine. You can already see it in everyday behavior. In our AlphaWise survey earlier this year, thirty-four percent of US consumers said that they'd chosen to take a voluntary wellness lab test in the past three years, and roughly two-thirds already own a wearable or plan to buy one.And now we're seeing the same trend reshaping how people buy medicine and choose care. So Terence, let's start with biopharma. For years, direct-to-consumer pharma meant advertising and nudging people to ask your doctor about what particular treatment is best for them. What's different this time around? And what's different in this next wave of direct access?Terence Flynn: Yeah, absolutely. Thanks, Erin. So for most of the industry's history, the patient sat at the end of the value chain and had really limited control over the product, the price, or the route through which the drug was obtained.Manufacturers marketed to doctors and consumers, but the transaction was itself intermediated. So we think that's starting to change here. It's no longer simply about more consumer advertising or another cash pay discount. There's a parallel access infrastructure that's building here where the patient can increasingly start the initiation of the treatment journey themselves, obtain a prescription, often digitally through a telehealth provider, and then fill this prescription through other non-traditional channels.And so there really is a shift in the model that we're starting to see here. But again, we're not talking about replacing insurance here; we're talking about areas where friction is high and where a cash pay price is viable.Erin Wright: So Obesity has been the clearest proof point, as we are seeing patients asking providers about GLP-1s. Where else are we seeing this?Terence Flynn: Yeah. So manufacturers are actually already selling over twenty-five branded drugs directly to patients at cash prices. Now, the common features of these drug classes are that they're self-administered, so essentially the patient can start and stay on treatment, and where there's limited in-person infrastructure that's needed, and where, as I mentioned, you have a lower price point or a coverage gap, meaning traditional insurance coverage doesn't exist.Now, we're seeing this in large chronic categories. You mentioned obesity. Another one is, migraine headaches. There are also other areas that are amenable to telehealth, so think oral PCSK9 therapies, topical dermatology, non-opioid pain. So again, we think as more self-administered products launch, you're gonna see the addressable DTC pool expand.Erin Wright: And ultimately what does this reveal about patient demand and gaps in reimbursement?Terence Flynn: Yeah, I think GLP-1s, as you mentioned, Erin, provided the first proof point here that this new DTC model could actually be viable. And really the reason for that is that, the US employer coverage base right now, only about fifty percent cover these obesity medications.And so for the other fifty percent, you have a gap in coverage. And that's really why people are seeking other channels for coverage. And so again, that really created this opening here for this new model. And so again, that's another consideration when you think about other medicines that could go through these channels is you have to think about the insurance coverage situation. And so for some areas like oncology, for example, insurance coverage is gonna be very high, and so those wouldn't be amenable to a DTC approach.Erin Wright: So Terence, your analysis points to roughly twenty-six billion peak US opportunity. What makes a certain therapeutic well-suited for direct-to-consumer, and where is the opportunity most concentrated?Terence Flynn: Yeah. So there are really four variables that we considered. The first is self-administration. So as I mentioned, you have to be able to administer the medicine yourself, meaning you don't have to go into the physician or hospital for an injection, for example. The second is that the diagnosis doesn't need an in-person confirmation. So think of something like a biopsy or something. So you'd have to be able to diagnose, as I said, over a remote telehealth channel. The third would be something that is a lower price point. Obviously, there are, like we mentioned, the GLP-1 medicines are at a different price point versus oncology medicines.And then the last one would be any kind of legal restrictions. So sometimes FDA has a lot of restrictions around who can prescribe a medicine. These are called REMS. And so any medicine that had restrictions like that obviously would not be amenable to DTC. So again, we think through those different variables, and then we ultimately built up this twenty-six billion dollar TAM that represents about three percent of total branded pharmaceutical spend. Of that, about half is driven by the obesity or GLP-1 medications.So Erin, that's a good bridge to healthcare services because consumerism isn't just about paying cash. What does greater consumer control actually look like?Erin Wright: You're right. It's not just about paying out of pocket for healthcare. With now consumers becoming more proactive with their healthcare and preventative care, we are seeing a whole healthcare ecosystem shift, from health insurers now offering lifestyle savings accounts empowering patients with more choice on that front, health systems and hospitals are creating a digital front door and delivery of care twenty-four/seven on that front. And also, we're seeing more direct-to-consumer pharmacies and transparent pharmacies that are gaining traction.Terence Flynn: And what does the Alpha Wise survey data tell us about consumers' willingness to pay out of pocket for care?Erin Wright: So based on our AlphaWise consumer survey, twenty-five percent of consumers report paying entirely out of pocket for at least one healthcare service over the past year. That was actually higher than what we were expecting. Most commonly, this was attributable to behavioral and mental health services, about eight percent of the cohort.Annual spend was about nine hundred and eight dollars, but maximum willingness to spend was about double that. So this suggests consumers are using out-of-pocket services and medications and are willing to spend to do so.Terence Flynn: That's very interesting. How important are digital tools, wearables, and testing in actually accelerating this shift?Erin Wright: So wearables are certainly a piece of the puzzle. What is new though here is that we're seeing wearable data align with actual biological data, where, for example, clinical laboratories are now partnering with these wearable companies and other direct-to-consumer healthcare platforms to offer subscription-based biomarker panels and other testing services. This is where this type of technology becomes more actionable from a healthcare perspective and really, frankly, empowers patients to take matters into their own hands.Terence Flynn: So as consumers take more control, as you discussed, what types of healthcare service models are best positioned to benefit?Erin Wright: There are certainly a host of companies across healthcare that are attacking this from several different angles.But if we think about who in the industry has the most touch points into the consumer, into the patient, it would be your diversified managed care companies and vertically integrated managed care companies where we view that many of these larger insurers are best able to adapt to consumerism in healthcare. We're already starting to see that happen with stepped-up technology investments helping to facilitate greater transparency and access, whether it's across insurance, provider arms, technology, or, um, or pharmacy assets as well.To sum it up, in biopharma, we're seeing a parallel access channel emerge alongside traditional reimbursement. And in healthcare services, consumers are gaining more control over how they choose access and pay for their care. Consumers aren't stepping outside of the healthcare system. They're taking a more proactive and more active role in how they navigate it.Terrence, thank you for taking the time to talk.Terence Flynn: Great speaking with you Erin.Erin Wright: And thanks for listening. If you enjoy Thoughts on the Market, please leave us a review wherever you listen and share the podcast with a friend or a colleague today.

In this HealthspanMD AMA episode, Dr. Robert Todd Hurst, MD, FACC, FASE, answers practical questions about preventive cardiology and personalized health. The conversation covers how different cardiovascular imaging tests are used, when statins and alternative cholesterol medications may make sense, plant sterol absorption, hormone replacement therapy, the role of ChatGPT and artificial intelligence in healthcare, and how GLP 1 medications may affect cardiovascular and metabolic health. Throughout the discussion, Dr. Hurst explains why the right strategy depends on understanding an individual's specific risks rather than relying on a one-size-fits-all approach. Dr. Robert Todd Hurst, MD, FACC, FASE, is a cardiologist focused on preventive care and personalized cardiovascular risk reduction. Drawing on his clinical experience, including his previous work at Mayo Clinic, he approaches medications, diagnostics, nutrition, and lifestyle interventions as tools that should be selected according to the individual patient's risks, goals, preferences, and desired outcomes. At HealthspanMD, that philosophy extends beyond cardiovascular disease to a collaborative approach focused on improving long-term healthspan. KEY TIMESTAMPS 00:00 Preventive care questions covered in this AMA 02:18 What a coronary calcium score can and cannot tell you 04:38 Stress tests, CT angiograms, and identifying heart disease 06:56 Statins, cholesterol treatment, and personalized prevention 09:12 Combining statins with PCSK9 medications 11:32 Plant sterol absorption and unexpected artery disease 13:52 Hormone replacement therapy and cardiovascular health 16:07 Using ChatGPT and AI for preventive healthcare 18:29 GLP-1 medications for heart and metabolic health 20:52 Who may benefit from GLP-1 medications and closing thoughts   This information is for educational purposes only and is not medical advice. Don't make any decisions about your medical treatment without first talking to your doctor.   *Connect* *with* *HealthspanMD* :

Broadcast from KSQD, Santa Cruz on 9-03-2026: With CDC vaccine guidance politically contested, major medical societies (AAFP, AAP, ACOG, IDSA) issued their own recommendations through the Vaccine Integrity Project. Dr. Dawn recommends flu shots in October for peak Thanksgiving antibodies, high-dose flu vaccine (not adjuvanted) for frail seniors, and COVID/flu/RSV given at the same visit—except delay COVID vaccination four to six months after recent infection. Pregnant women should receive RSV vaccine at 32-36 weeks, and infants under eight months entering their first RSV season need vaccination if the mother wasn't vaccinated. RSV is one-time only for adults 75+, or for high-risk 50-74-year-olds. Measles is the most contagious human disease, transmissible through brief incidental contact (buses, taxis, carnival rides). Beyond acute mortality (one in 5,000 pre-vaccine), survivors face rare but catastrophic subacute sclerosing panencephalitis 10-40 years later—immune-mediated brain destruction comparable to Huntington's. Thirty percent of current outbreak cases are in adults reflecting decades of under-vaccination in certain communities, and pregnant unvaccinated mothers create a dangerous one-year window since the live vaccine cannot be given during pregnancy. Inlicitide (brand name Lipithandra) is the first oral PCSK9 inhibitor for LDL reduction, priced at $315/month versus $600 for the injectable version. Dr. Dawn positions it strictly as a treatment—not preventive—drug for patients who've had a heart attack or equivalent event and cannot achieve target LDL on statins alone, with prior authorization typically successful given documented disease. Updated cancer screening guidance from major societies: cervical cancer screening at 25 for HPV-vaccinated women (earlier if unvaccinated), annual mammograms from 45-54 then biennial, PSA screening starting at 50, and low-dose CT lung cancer screening at 50-80 for heavy smokers. Dr. Dawn pushes back on the 2018 Task Force downplaying of PSA screening, noting MRI-targeted transperineal biopsies have dramatically reduced false-positive complications. She also warns about rising male cancer diagnoses at later stages for stomach, lung, tongue, and throat cancers, and recommends the vinegar test for suspicious oral white spots. Parkinson's disease develops through a decades-long prodromal phase before motor symptoms appear—by tremor onset, at least half the substantia nigra neurons are dead. Four early warning signs: persistent loss of smell (90% of Parkinson's patients experience this up to 20 years before diagnosis; free scratch-and-sniff cards available from The Michael J. Fox Foundation), REM sleep behavior disorder (acting out dreams; 50-70% develop Parkinson's or Lewy body dementia within 5-10 years, 130-fold higher risk if over 50), chronic constipation (possibly linked to gut microbiome production of misfolded alpha-synuclein), and orthostatic hypotension. Available diagnostics include alpha-synuclein seed amplifier assay (CSF), skin biopsy, and DaTscan SPECT imaging (typically covered with "clinical uncertainty" documentation). A caller with insomnia asks about using vinegar to clean his new CPAP machine. Dr. Dawn recommends one part white vinegar to three parts warm water, then rinsing—or unscented Dr. Bronner's castile soap. She emphasizes avoiding bleach, alcohol, ammonia, scented soaps, and moisturizers, since mold prevention is the primary cleaning goal. Columbia University's STAR (Sperm Track and Recovery) AI system, inspired by astronomical star-detection algorithms, hunts vanishingly rare sperm in men with azoospermia by streaming semen through a hair-thin channel imaged 300 times per second. A robotic arm extracts flagged cells within milliseconds. Of 175 patients tested, 30% had recoverable sperm, and the system produced its first baby late last year for a couple with 20 years of infertility.

In this episode of Lab Rats to Unicorns, John Flavin sits down with Dr. Kiran Musunuru, a cardiologist, geneticist, professor at the University of Pennsylvania, and leading expert in gene editing. Kiran's research spans cardiovascular, metabolic, and rare genetic diseases, with a focus on turning advances in human genetics and CRISPR into therapies that address the underlying causes of disease. He is also a co-founder of Verve Therapeutics and helped lead the development of a personalized gene-editing treatment for infant KJ Muldoon. Kiran traces the path that brought him to gene editing, from growing up with a cardiologist father and pursuing combined medical and scientific training to recognizing the potential of human genetics, stem cells, and eventually CRISPR. He explains how his willingness to adopt new technologies led his lab from early tools like zinc finger nucleases and TALENs to CRISPR, base editing, and prime editing. That progression ultimately opened the possibility of not simply treating symptoms, but making precise changes to DNA that could turn off disease-causing genes or repair genetic mutations at their source. Throughout the conversation, Kiran shares how experiments targeting the cholesterol gene PCSK9 led to the idea of a one-time treatment for cardiovascular disease and ultimately to the creation of Verve Therapeutics. He discusses his unexpected journey into entrepreneurship, Verve's progression into human trials and acquisition by Eli Lilly, and his return to academia to apply the same gene-editing platform to rare diseases. The episode culminates with the remarkable story of KJ, whose personalized base-editing therapy was designed and produced in roughly six months, as well as Kiran's larger vision for transforming one-off treatments into a scalable platform capable of reaching patients around the world.

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we dive into the dynamic landscape of the industry, highlighting significant scientific breakthroughs, strategic partnerships, and regulatory updates that are reshaping healthcare as we know it. Novartis recently announced a major milestone with its BTK inhibitor, Rhapsido, which met its Phase 3 clinical trial goals for treating relapsing multiple sclerosis. This success is particularly noteworthy as it comes without any liver safety concerns, a common challenge for this class of drugs. The development of Rhapsido marks a promising advancement in managing neurological disorders, offering new hope for patients dealing with the debilitating effects of multiple sclerosis. However, not all developments are without challenges. Novartis and Bristol Myers Squibb have halted their CAR-T trials due to safety concerns linked to autoimmune conditions like lupus and multiple sclerosis. These pauses highlight the complexities involved in developing CAR-T therapies for non-oncological applications. At the same time, Roche and Simcere Zaiming have joined forces to develop SIM0660, a T-cell engager targeting B-cell diseases. This partnership, involving an initial payment of $75 million and potential milestones up to $1.53 billion, underscores the increasing interest in antibody-based therapies. These treatments leverage the body's immune system, moving towards more targeted modalities for oncology and autoimmune diseases. Meanwhile, drug pricing reforms continue to take center stage as the White House negotiates Most Favored Nation pricing agreements with pharmaceutical giants like Alcon and Astellas Pharma. These agreements aim to make medications more affordable by aligning US drug prices with those in other developed countries. Such policy initiatives reflect growing governmental efforts to address rising healthcare costs and improve access to essential medications. Shifting focus to vaccines, GSK has embarked on a Phase 3 trial for its mRNA-based flu vaccine. This initiative highlights the broader trend of extending mRNA technology beyond COVID-19 vaccines to tackle other infectious diseases. The adaptability and rapid production capabilities of mRNA platforms could revolutionize vaccine development and enhance our response to seasonal influenza. In cardiovascular health, Amgen's Repatha has shown a 20% reduction in mortality risk during a Phase 3 trial focused on primary cardiovascular prevention. This finding reinforces the critical role of PCSK9 inhibitors in lowering cholesterol levels and preventing cardiovascular events for high-risk patients. Similarly, Alumis faced setbacks when its TYK2 inhibitor failed to meet primary endpoints in a Phase 2 study for systemic lupus erythematosus. Despite this, promising subgroup signals suggest potential paths forward. On the regulatory front, the FDA has issued warnings to Alar Pharmaceuticals regarding unapproved promotional claims for its ketamine-based product ALA-3000. Additionally, Boston Scientific has suspended sales of its Imager II angiographic catheters due to manufacturing defects causing serious injuries. Medtronic is recalling its esophageal reflux monitoring capsule over safety issues tied to numerous injuries. These regulatory actions emphasize the critical importance of compliance with safety standards in protecting patient well-being. Industry innovation is further propelled by ongoing fundraising activities supporting cutting-edge research. Companies such as PMV Pharmaceuticals are advancing precision oncology therapies targeting p53 mutations, while Rakovina Therapeutics utilizes AI-powered platforms for cancer drug discovery. These efforts underscore the sector's commitment to addressing complex diseases through technological innovation. The exploration of novel therapeutic modalities continues with Eli Lilly's acquisition of Merida Biosciences for $2.88 billion to target autoimmune diseases by selectively degrading pathogenic autoantibodies. This acquisition aligns with broader trends toward precision medicine solutions aimed at modulating immune responses. In oncology news, Akeso's success with ivonescimab in biliary tract cancer exemplifies the potential of bispecific antibodies beyond initial indications. Meanwhile, Genentech's collaboration with DualityBio aims at overcoming resistance mechanisms in antibody-drug conjugates, promising expanded treatment options for patients resistant to existing therapies. Lastly, Labcorp's introduction of a new hepatitis D test represents a proactive step toward addressing diagnostic gaps in viral infections. Early detection remains crucial for effective disease management and improved patient outcomes. These developments collectively illustrate an industry at the forefront of innovation and strategic adaptation. As companies navigate these evolving landscapes, their focus remains steadfast on improving patient care through groundbreaking therapies while overcoming regulatory hurdles—a testament to their resilience and dedication in pursuing new healthcare frontiers.Support the show

Listen in as our expert panel breaks down what clinicians need to know about the 2026 dyslipidemia guidelines, such as the role of lipoprotein a, apolipoprotein B, and coronary artery calcium scoring. Plus, you'll walk away with practical takeaways to optimize lipid management including when to add non-statin therapies like PCSK9 inhibitors and ezetimibe for your patients.Special guests:Mary Katherine Cheeley, PharmD, BCPS, CLS, FNLAExecutive Director, Ambulatory Pharmacy ServicesGrady Health SystemJoel C. Marrs, PharmD, MPH, BCACP, BCCP, BCPS, CLS, FAHA, FASHP, FCCP, FNLACardiology Ambulatory Clinical PharmacistCheyenne Regional Medical Group Heart & Vascular InstituteAdjoint Associate ProfessorUniversity of Colorado School of MedicineYou'll also hear practical advice from panelists on TRC's Editorial Advisory Board:Stephen Carek, MD, CAQSM, DipABLMClinical Associate Professor of Family MedicinePrisma Health/USC-SOMG Family Medicine Residency ProgramUSC School of Medicine GreenvilleAndrea Darby-Stewart, MDAssociate Director, Honor Health Family Medicine Residency ProgramClinical Professor of Family, Community & Occupational MedicineThe University of Arizona College of Medicine - PhoenixCraig D. Williams, PharmD, FNLA, BCPSClinical Professor of Pharmacy PracticeOregon Health and Science UniversityFor the purposes of disclosure, Dr. Cheeley reports relevant financial relationships with [lipids] Novartis, Regeneron (honorarium). The other speakers have nothing to disclose.  All relevant financial relationships have been mitigated.This podcast is an excerpt from one of TRC's monthly live CE webinars, the full webinar originally aired in July 2026.

PCSK9 inhibitors (1:50), treatment of opiate use disorder (4:20), healthy dietary advice (6:20), the top 20 research studies of 2025 (11:40), atopic dermatitis prevention (15:10), and ambient temperature increase impact on pregnancy outcomes (17:10).  Please fill out our listener survey!

Welcome to this week's Midlife Minute episode! Statistically, one in three women will die of heart disease. So, today, we're answering some of the many questions I received about lipids and heart health. Although I've done other lipid-focused Midlife Minutes before, this episode is yet another dedicated to Dr. Tom Dayspring, as I've received such a vast number of questions on this particular topic.    IN THIS EPISODE, YOU WILL LEARN: Why understanding your ApoB and Lp(a) is an essential part of assessing your cardiovascular risk Why treatments for lipid abnormalities should be individualized to fit each specific abnormality  Essential lifestyle measures for supporting overall cardiovascular health How CAC scoring, CT coronary angiography, and Clearly AI-assisted imaging differ, what each test measures, and their limitations  How cardiovascular disease can sometimes present differently in women  Why are premature atrial contractions and premature ventricular contractions often benign when the heart is structurally normal? How the roles of statins, ezetimibe, PCSK9 inhibitors, GLP-1 medications, and emerging RNA therapies differ, and why they should not be considered interchangeable How declining estrogen impacts cardiovascular health Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia's website. Submit your questions to support@cynthiathurlow.com  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia's book, The Menopause Gut. Cynthia's Intermittent Fasting Transformation Book The Midlife Pause Supplement Line

Primary care physicians Kate, Mark, Henry and Gary discuss 4 new studies that could change your practice: treatments for hyperemesis gravidarum, calcium and vitamin D to prevent falls and fractures in older adults, the first oral PCSK9 inhibitor, and oral semaglutide to treat dementia .The John Hickner Memorial fund at MSU: https://give.msu.edu/?sid=17374 Hyperemesis gravidarum treatments: https://pubmed.ncbi.nlm.nih.gov/41478546/ Supplementing with calcium or vitamin D: https://pubmed.ncbi.nlm.nih.gov/42161415/ Oral PCSK-9 enlicitide:  https://pubmed.ncbi.nlm.nih.gov/41879224/ Cochrane review of PCSK-9s: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011748.pub3/full Semaglutide for dementia: https://pubmed.ncbi.nlm.nih.gov/41865758/

Cardiovascular disease remains a leading cause of death, while evolving guidelines and increasingly aggressive LDL cholesterol targets are changing how clinicians approach lipid management. Jodi Martinez, Pharmacist Clinical Specialist in Cardiology at the University of Colorado Hospital, part of UCHealth, joins Kerry Schwarz, Senior Clinical Manager for Evidence Based Medicine and Outcomes with the Vizient Center for Pharmacy Practice Excellence, to explore the emerging role of enlicitide in lipid management. They discuss the evidence behind its approval, its potential to expand patient access and where this first oral PCSK9 inhibitor may fit alongside existing therapies.   Guest Speaker: Dr. Jodi Martinez, Pharm.D., BCPS, BCCP, HF-CERT Pharmacist Clinical Specialist in Cardiology University of Colorado Hospital, UCHealth   Host:  Dr. Kerry Schwarz, Pharm.D., MPH Senior Clinical Manager, Evidence-Based Medicine and Outcomes Vizient Center for Pharmacy Practice Excellence    Show Notes:  [01:26] The limitations of current lipid management and why many high-risk patients still struggle to reach increasingly aggressive LDL cholesterol targets. How cost, prior authorization requirements and step therapy can create barriers to accessing injectable PCSK9 therapies. [03:27] The evidence behind enlicitide and findings from the CORALreef clinical trial supporting its FDA approval. How enlicitide performed across LDL cholesterol, non-HDL cholesterol, ApoB and lipoprotein(a) endpoints, and why cardiovascular outcomes remain an important unanswered question. [06:37] An oral PCSK9 inhibitor could expand access by offering an alternative to specialty injectable therapies. Why retail pharmacy availability, cost and greater prescribing flexibility could help more patients receive intensive lipid lowering therapy. [08:11] The potential barriers to enlicitide adoption, including delays in formulary review, insurance coverage and the administrative burden placed on clinicians. The lack of published cardiovascular outcomes could influence payer coverage, formulary placement and early uptake. [10:15] Station remains the cornerstone of lipid management and where enlicitide may ultimately play a role Clinicians may consider the amount of LDL reduction a patient needs when choosing among available therapies.   Links and Resources: 2022 ACC Expert Consensus Decision Pathway on the Role of Nonstatin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk: A Report of the American College of Cardiology Solution Set Oversight Committee 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines   Subscribe Today! Apple Podcasts Spotify YouTube RSS Feed    

Hvor mye forteller egentlig et høyt kolesteroltall om helsen din? Og hvis to mennesker har samme LDL nivå, har de nødvendigvis samme risiko?Lege Pål Branæs er tilbake hos Biohacking Girls. Han er en stemme vi setter stor pris på fordi han tør å stille kritiske spørsmål, også til etablerte sannheter, samtidig som han er tydelig på at medisiner kan være både nødvendige og livreddende.Vi går inn i et av de mest omdiskuterte områdene innen forebyggende helse: kolesterol, statiner og individuell risiko. Hva er forskjellen på relativ og absolutt risiko? Hvem har størst dokumentert gevinst av statiner, og når er det liten eller ingen gevinst? Hvorfor kan to personer med samme LDL ha helt forskjellig risikobilde? Vi snakker også om ApoB og Lp(a), og Monica deler sin egen historie med høyt Lp(a) og behandling med PCSK9-hemmeren Praluent.Men denne episoden handler om mer enn kolesterol. Vi snakker om "deprescribing", spørsmålet om når og hvordan vi bør vurdere å redusere eller avslutte medisiner. Hvorfor blir vi stående på enkelte legemidler år etter år? Og hvordan skiller vi mellom tilbakefall, rebound og seponeringssymptomer?Vi spør også om lavere doser eller «mikrodosering» av medisiner noen ganger kan være fornuftig?Hva har Pål endret mening om siden han skrev Pillefellen?For kanskje handler god medisin ikke bare om hva vi behandler, men hvem vi behandler, hvor stor risikoen er og om behandlingen fortsatt er riktig fem eller ti år senere.En episode om å forstå tallene, stille bedre spørsmål og ta mer informerte valg om egen helse.Du finner Pål her: https://www.instagram.com/dr.branaes/Pillefellen: https://www.norli.no/boker/dokumentar-og-fakta/familie-og-helse/medisin-og-sykdom/pillefellenTakk til Mic Drop media for redigering

Hosts: Ed Jones (Owner – Nutrition World) & Clint Powell A variety of topics to living a healthy life Presented by: Nutrition World www.nutritionw.com Broadcasting from the Nooga Dentistry Studio www.noogadentistry.com Production of: Whitfield Media Group www.vitalhealthradio.com Title: Beyond Cholesterol: The Heart Health Markers That Matter [0:00:00] – Intro: Lettuce Contamination, Social Media & Local Business Impact Discussion of “fear of lettuce,” limited to 15 states (not Tennessee) How social media amplifies food scares Local “Build a Salad” restaurant going out of business and timing around lettuce scare [0:04:39] – Back-to-School Immune Support: Oral Probiotics & Iodine Nasal Spray Back-to-school season and rise in colds/sicknesses Oral probiotics for kids: oral microbiome, throat/sinus benefits Iodine nasal spray for parents and teachers: safety, use during school/gym, personal routines of Ed and Clint [0:08:04] – Supplement Industry & Big Pharma Buyouts Thorne bought by Procter & Gamble for $3.8B History of pharma mocking “granola/hippie” supplement culture, now buying brands Many acquired supplement brands failing under pharma ownership Difference between pharma customers and nutraceutical users (education, mindset) Nutrition World's preference for privately owned brands [0:14:00] – Life Lessons from Flying & Racing: Doing the Hard but Right Thing Ed's story: practicing engine-out landings, re-learning best glide speed Insight: sometimes you must “point the nose down” (do the counterintuitive hard thing) to survive Clint's race-car analogy: “you go where you look” – look down the track, not at the wall [0:18:01] – Food Label Claims: Olive Oil vs. Avocado Oil Products UC Davis testing of products “made with olive oil” – most passed authenticity tests Avocado-oil-labeled products often failing purity tests Takeaway: be more skeptical of “made with avocado oil” claims [0:18:31] – Prostate Cancer & “Treating the Terrain,” Not Just the Tumor Dr. Gio (prostate-focused naturopath): focus on the ground cancer grows in Historical context from Stephen Paget's work on tumor “soil and seed” Lifestyle “soil-building” recommendations: Resistance training, walking 150 minutes/week Waist circumference < half your height Sleep, stress reduction, nutraceuticals, nutrient-dense diet [0:21:58] – Multivitamins, Carotid Stenosis & Functional Benefits COSMOS study: Centrum multivitamin and patients with carotid narrowing Reported improvements in physical function (walking, climbing stairs) and symptoms (shortness of breath, fatigue) Ed's extrapolation: better-designed multis (True Grace, Life Extension, etc.) likely offer even more benefit [0:22:30] – Post-Infectious Cough: Honey + Instant Coffee vs. Prednisone Double-blind RCT comparing: Honey + instant coffee paste Prednisone Guaifenesin Honey + instant coffee dramatically outperformed prednisone in reducing persistent cough frequency Discussion of guaifenesin's role, safety, and its regulatory history in health food vs. pharmacy channels [0:30:12] – Prednisone, COVID & Anxiety: Personal Case Story Guest Dr. Curt Dearing shares: Followed COVID protocol including prednisone Developed severe, prolonged anxiety afterward (twice) Realization that prednisone triggered it Ed's summary of prednisone side effects: bone loss, cataracts, muscle wasting, weight gain; okay short term, risky long term [0:33:30] – Cardiovascular Disease, Statins, & New Drug Lifendra (PCSK9 Inhibitor Pill) CV disease framed as leading cause of death for most people Introduction of Lifendra (oral PCSK9 inhibitor, from Merck) as “breakthrough” LDL-lowering drug Comparison with Repatha (injectable PCSK9 inhibitor) Curt's key points: Lifendra lowers LDL but does not show reduction in cardiovascular death, heart attack, or stroke (per Merck's own wording so far) Repatha's trial data: minimal impact on non-fatal events; no reduction in CV deaths vs. placebo Very high cost (~$300+/month out of pocket; heavy insurance burden) Critique of LDL obsession in cardiology Need to ask: Why is the cardiovascular system inflamed and oxidized? Ed & Curt's “terrain” model: Bad inputs: ultra-processed food, toxins, poor sleep, chronic stress, lack of sun/movement Missing inputs: nutrient-dense foods, minerals, omega-3s, organ meats, sunlight, sleep, movement Example of amlodipine: lowers BP numbers but may increase arterial calcification (calcium channel blocker) For people unwilling to change lifestyle, drugs may offer marginal benefit—but not true health [0:41:05] – Curt's Book & Lab Markers That Matter More Than LDL-C Curt's book: “Beyond Cholesterol: The Ultimate Guide to Testing and Supplements for Heart Health” Emphasis on better markers: ApoB, LDL particle size/number, calcium score, etc. Book's Amazon performance briefly noted (new release bestseller in its category) [0:44:32] – Alternatives to Statins & PCSK9s: Bergamot & Lifestyle Curt's hierarchy: Lifestyle (diet, exercise, stress, sleep) Targeted supplements like bergamot (citrus extract): lowers harmful particles such as ApoB and supports “good” LDL function Only then consider pharmaceuticals, and very selectively Skepticism about recommending Lifendra at all; strong bias toward non-drug approaches [0:45:28] – Dr. Wolfson, Mold, and Cardiovascular Terrain Ed & Curt's respect for Dr. Jack Wolfson, “The Natural Heart Doctor” Mention of mold as a major, under-recognized driver of cardiovascular disease Reference to Dr. Wolfson's educational resources and upcoming podcast plans [0:48:04] – Key Takeaways on Lifendra & Heart Prevention Strategy Lifendra will not fix: seed oils, glyphosate exposure, mold, bad sleep, chronic stress Terrain-building priorities: Real food, omega-3s, sunlight Toxin reduction Mitochondrial support Foundational supplements Contrast: drugs = band-aids with side effects; nutraceuticals = “side benefits” when used correctly [0:52:28] – Wrap-Up Ed mentions Sprouts selling lab-grown meat and his strong opposition Update on Oura Ring: now tracking nighttime blood pressure and importance of BP dipping Listener story: young man post–heart surgery credits Nutrition World's education and support with changing his life Final thanks to Dr. Dearing and closing outro  The post Radio Show / Podcast – August 9, 2026 first appeared on Vital Health Radio.

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we delve into the intricate web of scientific advancements, regulatory updates, and strategic maneuvers shaping the industry. Let's begin with Eli Lilly's impressive financial performance, clocking a record-breaking $23 billion in revenue for Q2 2023. This achievement, driven by the success of Mounjaro and Zepbound in metabolic diseases, underscores the competitive landscape of therapies targeting chronic conditions. However, the slower launch of Foundayo highlights ongoing challenges. Meanwhile, competition in obesity treatments is intensifying as Novo Nordisk's Wegovy continues to dominate despite new entrants like Eli Lilly's Foundayo. This scenario reflects growing patient preference for oral medications over injectables. Gilead Sciences' HIV prevention franchise has exceeded $1 billion in quarterly sales, reflecting an increasing reliance on effective small molecule therapies for infectious diseases. Gilead also remains a focal point with its HIV pre-exposure prophylaxis franchise reaching sales milestones amid legal victories defending their tenofovir-based treatments. These legal precedents could influence future innovation policies across the industry. Artificial intelligence continues to make waves in drug discovery and clinical trials. Icon's partnership with Anthropic aims to integrate AI capabilities to accelerate drug development timelines. Similarly, Phylo and Chugai Pharmaceutical are collaborating to optimize drug discovery workflows using advanced AI platforms. These collaborations highlight a strategic move towards enhancing efficiency in drug development processes. In oncology, Amplia Therapeutics and Eli Lilly are evaluating a combination therapy for non-small cell lung cancer, while Evexta Bio and Roche are exploring a joint study for metastatic breast cancer. These partnerships underscore the industry's focus on combination therapies and precision medicine to improve cancer treatment outcomes. Additionally, AstraZeneca's partnership with CSPC Pharmaceutical to enhance biologics manufacturing in China signifies the importance of localized production capabilities. On the regulatory front, Arrowhead Pharmaceuticals' acquisition of an FDA rare pediatric disease priority review voucher for Plozasiran represents a commitment to addressing unmet needs in rare diseases. This voucher could expedite new drug applications, potentially bringing life-saving treatments to patients more quickly. Despite these advancements, challenges persist. Novo Nordisk's Cagrisema failed to achieve its primary endpoint in a Phase 3 trial for type 2 diabetes, highlighting the complexities of developing combination therapies for metabolic disorders. Similarly, Eli Lilly's discontinuation of its Phase 1/2 trial for GBA1 gene therapy reflects the hurdles faced in advancing gene therapies. Looking at industry dynamics, Amgen's decision to discontinue its early-stage obesity drug signifies a strategic shift towards focusing on more promising pipeline candidates like Maritide. This move aligns with broader trends prioritizing candidates with significant potential impact on patient care. Amgen's 'Repatha' is experiencing renewed interest due to positive cardiovascular risk reduction data, showcasing how robust clinical results can rejuvenate existing products. In regulatory news, Merck's 'Lipfendra' has been spotlighted by the FDA as part of its Complex New Product Validation pilot program. This positions Lipfendra as a potential game-changer in the PCSK9 inhibitor category. Lastly, financial maneuvers such as Attovia Therapeutics' $289 million IPO and Expedition Therapeutics' $115 million Series B funding highlight investor confidence in novel therapeutic areas like dermatological and respiratory treatments. The pharmaceutical landscape remains dynamic with Johnson & Johnson investing heavily in gene therapy ventures like Sail Biomedicines for CAR-T therapies. Meanwhile, regulatory challenges persist as seen with Capricor's cell therapy setback due to statistical complexities during FDA reviews. Despite setbacks faced by some companies, innovations continue to thrive. The launch of personalized genetic therapy centers signals a shift towards individualized medicine while research into safer CAR-T therapies progresses. In conclusion, these developments reflect an industry driven by innovation amidst regulatory challenges and strategic adjustments. As companies navigate this evolving landscape, their decisions will shape future healthcare innovations and patient care outcomes. Thank you for joining us on Pharma Daily; stay tuned for more insights from the world of pharmaceuticals and biotech.Support the show

In this episode of Mind the Meds, host Erica Marini, PharmD, MS, BCPS, welcomes Jenelle Hall Montgomery, PharmD, BCACP, CPP, a clinical pharmacist practitioner with Duke Neurological Disorders Clinic at Duke University Hospital, to discuss highlights from the Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting in Charlotte, North Carolina, where Montgomery was recognized as a Giant of Multiple Sclerosis. Before the CMSC discussion, Marini runs through a roundup of recent neurology news, including approval of at-home initiation dosing for lecanemab-irmb (Leqembi; Eisai, Biogen), fast track designation for remlifanserin (Acadia Pharmaceuticals) in Alzheimer disease psychosis, approval of the oral PCSK9 inhibitor enlicitide (Lipfendra; Merck), and phase 3 data on tavapadon (AbbVie) for Parkinson disease showing a lower rate of impulse control disorders than traditional dopamine agonists.The pharmacists then turn to CMSC sessions on off-label and evolving areas of MS care. They discuss growing interest in neurofilament light chain as a biomarker for tracking subclinical disease progression over time, along with the ongoing debate over when it is safe to discontinue disease-modifying therapy (DMT) in older, stable patients. Both note their practices generally begin this conversation around 60 to 65 years of age, factoring in radiographic and clinical stability over the preceding decade, and describe strategies such as tapering dosing frequency or switching to lower-efficacy agents rather than abrupt discontinuation.The conversation closes with an update on family planning in MS, where new data presented at CMSC reinforce the safety of anti-CD20 therapies during pregnancy and breastfeeding. Montgomery and Marini review a 10-year dataset of about 5000 pregnancies on ocrelizumab (Ocrevus; Genentech), a large safety analysis of ofatumumab (Kesimpta; Novartis Pharmaceuticals) showing no increase in birth malformations, and early transfer-into-breastmilk data on ublituximab (Briumvi; TG Therapeutics). They also touch on the limited but growing evidence for GLP-1 receptor agonists in patients with MS, noting no known drug interactions with DMTs and possible indirect benefit through weight-related disease modulation, though neither pharmacist currently prescribes GLP-1s for an MS indication.Key Takeaways:1. Neurofilament light chain is emerging as a useful, though not yet mainstream, biomarker in MS. Rather than a single value, tracking neurofilament light chain over time alongside clinical status may help identify subclinical disease progression, particularly in patients without clear relapses.2. DMT discontinuation in older, stable patients remains individualized, with most practices starting the conversation around 60 to 65 years of age. Clinicians weigh 10-year clinical and radiographic stability, and some patients opt for a gradual step-down in dosing frequency or a switch to a lower-efficacy agent rather than outright discontinuation.3. New pregnancy and breastfeeding safety data continue to support anti-CD20 therapies as a preferred family planning strategy in MS. A 10-year, 5000-pregnancy dataset on ocrelizumab, reassuring malformation data on ofatumumab, and early breastmilk transfer data on ublituximab are strengthening patient counseling conversations around conception, pregnancy, and postpartum DMT resumption.

Millionen Menschen nehmen täglich Medikamente gegen zu hohes Cholesterin – und trotzdem reicht es bei vielen nicht aus. Jetzt wurde in Amerika ein neues Mittel zugelassen, das LDL, also den bösen Cholesterinwert, um bis zu 60 Prozent senken kann.In dieser Folge sprechen wir darüber, was schlechtes Cholesterin im Körper anrichtet, warum ein niedriger Wert nicht immer besser ist – und wann dieses Medikament auch bei uns zu erwarten ist.Es geht um Schaumzellen, B-Zell-Margarine und PCSK9.02:24 HDL und LDL04:30 Statin09:09 Ernährung als Hebel13:10 „Edel-Klinik“

Artificial Sweeteners & Cognitive Decline, Myosteatosis on Coronary CT, Merck's Oral PCSK9 Inhibitor, Cyclospora Outbreak, Gut-Brain Synchronization, and the Banana Smoothie Mistake Explained Artificial Sweeteners Linked To 62% Faster Cognitive Decline In Landmark Brazilian Study A study tracking more than 12,700 adults (average age 52) over eight years found that people consuming the most artificial and low-calorie sweeteners, roughly 191 mg a day, about what's in a single can of diet soda, showed cognitive decline 62% faster than the lowest-intake group, equivalent to 1.6 extra years of brain aging, with memory hit hardest. Six of the seven sweeteners tested, including aspartame, saccharin, and acesulfame K, were linked to faster decline; tagatose was the lone exception. Researchers point to gut-microbiome disruption, altered glucose and insulin signaling, and possible direct neuronal effects as plausible mechanisms. Host Dave Asprey breaks down why a dose this small was enough to move the curve, why tagatose deserves more scrutiny before being called "safe," and where diet products' short-term weight-loss marketing conveniently ignores the long-term cost to your brain. Source: https://www.inc.com/kevin-haynes/study-links-cognitive-decline-to-surprisingly-small-daily-amount-of-artificial-sweeteners/91376522 ~~ AI Analysis Of 1,722 Heart Scans Finds Muscle Quality Predicts Heart Attacks Independent Of Calcium Score Using data from the SCOT-HEART trial, a University of Edinburgh team ran an AI model against ten years of coronary CT angiogram scans, measuring skeletal muscle attenuation, a marker of myosteatosis, or fat infiltration into muscle tissue. Every 10-point increase in muscle density corresponded to a 31% lower heart attack risk and 39% lower all-cause mortality over the following decade, and critically, this held independent of coronary calcium score, the current gold-standard risk marker. The same low-density-muscle patients also showed higher lung attenuation, lower liver attenuation, and more torso fat volume, a pattern consistent with systemic insulin resistance rather than a muscle-specific issue. Host Dave Asprey unpacks why calcium score isn't capturing the full risk picture, why myosteatosis is really a readout of whole-body insulin sensitivity, and what he'd add to a routine workup on top of a calcium score. Source: https://www.theguardian.com/science/2026/jun/30/strong-chest-back-less-likely-heart-attack-analysis ~~ FDA Approves First Oral PCSK9 Inhibitor, Cutting LDL By Up To 60% Without Injections Merck's enlicitide (brand name Lipfendra) is now FDA-approved as the first once-daily oral PCSK9 inhibitor, lowering LDL cholesterol by up to 60% in a phase 3 trial of 2,912 patients, routinely bringing levels down to 50-60 mg/dL. It works by blocking PCSK9, a liver protein that tags LDL receptors for destruction, the same target as injectable drugs like Repatha and Praluent, which have shown roughly 20% reductions in heart attacks and strokes in high-risk patients. Lipfendra is priced at $315 for a 30-day supply, with no excess side effects reported versus placebo over six months, though long-term outcome data is still pending. Host Dave Asprey explains why crushing total LDL without checking ApoB, LDL particle number, or oxidized LDL is optimizing the wrong variable, and what he'd want on his labs before considering a drug like this. Sources: https://www.nytimes.com/2026/07/16/science/the-fda-approves-a-new-pill-to-slash-cholesterol-levels.html https://www.cnbc.com/2026/07/16/mercks-cholesterol-pill-gets-us-fda-approval.html ~~ Cyclospora Outbreak Tied To Taylor Farms Lettuce Spreads To 34 States, Prompts Nationwide Recall Federal investigators have linked a multistate cyclosporiasis outbreak to shredded iceberg lettuce from Taylor Farms de Mexico, with Michigan alone logging over 5,000 cases and 100+ hospitalizations, much of it traced to lettuce used at Taco Bell. Taylor Farms has recalled all iceberg lettuce sourced from central Mexico, and Walmart has pulled Marketside Iceberg Salad and Marketside Shredded Lettuce with specific date codes across 27 states. Cyclospora spreads through fecal contamination and causes weeks of watery, explosive diarrhea if untreated; washing doesn't reliably eliminate it, since the parasite requires heat above 158°F to inactivate. Host Dave Asprey explains why pre-washed, pre-cut bagged greens remain a recurring contamination risk no matter what the label claims, and connects the outbreak's gut damage to lingering gut-brain consequences long after symptoms resolve. Sources: https://www.usatoday.com/story/news/health/2026/07/18/taylor-farms-shredded-lettuce-sample-cyclospora/90969103007/ https://www.fda.gov/food/outbreaks-foodborne-illness/investigation-5-state-outbreak-cyclospora-illnesses-iceberg-lettuce-july-2026 ~~ New Research Links Excessive Gut-Brain Synchronization To Anxiety And Depression Emerging research on the enteric nervous system, which contains over 100 million neurons and sends more signals to the brain than it receives, finds that when the gut's electrical rhythm synchronizes too tightly with the brain's, that over-coupling correlates with higher rates of anxiety and depression. The gut communicates with the brain through the vagus nerve, hormones, and immune signaling, and dysbiosis or ENS dysfunction has separately been linked to mood disorders in both human and animal studies. Host Dave Asprey breaks down why the goal isn't maximum gut-brain connection but the right kind of connection, questions whether the coupling is driving the anxiety or the anxiety is driving the coupling, and makes the case for treating mood from the gut up instead of the brain down. Source: https://refractor.io/medical/enteric-nervous-system-brain-link-mental-health/ ~~ Rhonda Patrick Explains Why She Never Adds Bananas To Her Berry Smoothies Rhonda Patrick has been telling audiences she skips bananas in her berry smoothies because of polyphenol oxidase, an enzyme in bananas that degrades the polyphenols in blueberries linked to improved cognition and vascular health, based on in-vitro and food chemistry data. She now builds her smoothies on an avocado base instead, and notes that vitamin C from citrus can partially inhibit the enzyme for anyone unwilling to drop the banana. Host Dave Asprey weighs in on the gap between lab chemistry and clinical outcome data, why that gap doesn't make the mechanism any less real, and why this is a low-cost swap worth making even without a human trial behind it. Sources: https://www.reddit.com/r/Biohackers/comments/1v2jbib/dr_rhonda_patrick_i_dont_add_bananas_to_my/ https://www.foundmyfitness.com/episodes/polyphenol-oxidase-bananas-smoothies ~~ This episode is designed for biohackers, longevity enthusiasts, and high-performance listeners who want mechanism-level insight into a sweetener risk hiding in everyday diet products, a heart attack predictor buried inside routine CT scans, the tradeoffs of a new cholesterol drug, a produce recall worth paying attention to, the science behind gut-driven anxiety, and a smoothie mistake that's quietly undercutting your polyphenol intake. Host Dave Asprey connects clinical research, cohort data, and food chemistry into practical frameworks for protecting brain health, cardiovascular health, and gut-brain resilience. New episodes every Tuesday, Thursday, Friday, and Sunday. Keywords: artificial sweeteners cognitive decline, aspartame brain aging, tagatose safety, diet soda memory loss, myosteatosis coronary CT, skeletal muscle attenuation heart attack, SCOT-HEART trial, coronary calcium score insulin resistance, enlicitide Lipfendra FDA approval, oral PCSK9 inhibitor, LDL particle number ApoB, cyclospora outbreak 2026, Taylor Farms lettuce recall, cyclosporiasis symptoms treatment, enteric nervous system anxiety, gut brain synchronization, vagus nerve mental health, Rhonda Patrick polyphenol oxidase, banana blueberry smoothie mistake, biohacking news 2026, Dave Asprey, The Human Upgrade Thank you to our sponsors! - Suppgrade Labs | Get real restorative sleep with Quiet Mode. Use code DAVE15 at shopsuppgradelabs.com. - EMR-Tek | https://www.emr-tek.com/DAVE and use code DAVE for 40% off. - iRestore | Reverse hair loss at www.irestore.com/DAVE and get exclusive savings on the iRestore Elite, use code DAVE Resources: • Get My 2026 Clean Nicotine Roadmap | Enroll for free at https://daveasprey.com/2026-clean-nicotine-roadmap/ • Get My 2026 Biohacking Trends Report: https://daveasprey.com/2026-biohacking-trends-report/ • Dave Asprey's Latest News | Go to https://daveasprey.com/ to join Inside Track today. • Danger Coffee: https://dangercoffee.com/discount/dave15 • My Daily Supplements: SuppGrade Labs (15% Off) • Favorite Blue Light Blocking Glasses: TrueDark (15% Off) • Dave Asprey's BEYOND Conference: https://beyondconference.com • Dave Asprey's New Book – Heavily Meditated: https://daveasprey.com/heavily-meditated • Join My Substack (Live Access To Podcast Recordings): https://substack.daveasprey.com/ • Upgrade Labs: https://upgradelabs.com Timestamps: 00:00 – Intro 00:19 – Story 1: Artificial Sweeteners 02:05 – Story 2: Muscle Fat & Heart Risk 04:36 – Story 3: PCSK9 Cholesterol Pill 06:27 – Story 4: Cyclospora Lettuce Outbreak 07:56 – Story 5; Gut-Brain Axis & Anxiety 09:29 – Story 6: Banana vs. Blueberry 11:08 – Predictions for Next 5 Years See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

The first oral PCSK9 inhibitor, another study finding safe MRI scanning in patients with nonconditional CIEDs, the PFA-SHAM trial, and the curious case of orthopedic injuries in cardiology are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic   I Enlicitide Approved First Oral PCSK9 Inhibitor Welcomed for Potential Primary Care Impact https://www.medscape.com/viewarticle/first-oral-pcsk9-inhibitor-welcomed-potential-primary-care-2026a1000own Dr Gregory Katz Substack https://gregorykatz.substack.com/p/are-we-sure-mercks-new-cholesterol CORALreef Lipids Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2511002 CORALreef HeFH Trial https://jamanetwork.com/journals/jama/fullarticle/2841258 CORALreef Outcomes Trial https://clinicaltrials.gov/study/NCT06008756 II MRI Scans in Non-conditional CIEDs Specialized Nurse Practitioners Safely Manage MRI in Patients With Cardiac Implantable Devices https://www.medscape.com/viewarticle/specialized-nurse-practitioners-safely-manage-mri-patients-2026a1000ozt Nurse Practitioner-Led CIED Monitoring During MRI 10.1016/j.hroo.2026.04.031 External Link MRI in Nonconditional Pacemakers and ICDs https://academic.oup.com/europace/article/22/2/288/5717383 Heart Rhythm Society Consensus Document 10.1016/j.hrthm.2017.04.025 External Link III PFA-SHAM trial PFA-SHAM Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.126.079484 SHAM-PVI Trial https://jamanetwork.com/journals/jama/fullarticle/2823283 IV Orthopedic Injuries in Cardiology What Will It Take to Make Fluoroscopy Labs Safer? https://www.medscape.com/viewarticle/what-will-it-take-make-fluoroscopy-labs-safer-2026a1000ox6 Expert Consensus Statement on Enhanced Radiation Protection https://www.jacc.org/doi/10.1016/j.jcin.2026.06.011 'Shed the Lead' and the Injuries. Should Cath Labs Go Lead-Free? https://www.medscape.com/viewarticle/shed-lead-and-injuries-should-cath-labs-go-lead-free-2024a1000hnb Health Hazards of Working in the Interventional Laboratory https://doi.org/10.1016/j.jacc.2014.11.056 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

This week, Dr. Kahn discusses the FDA approval of the first oral PCSK9 inhibitor, Lipfendra (enclicitide), taken as a 20 mg daily tablet. In a study of nearly 3,000 patients with elevated LDL cholesterol despite treatment with statins and, in many cases, ezetimibe, LDL-C dropped by more than 50% while Lipoprotein(a) levels fell by 28%, with an excellent safety profile. The medication is expected to retail for approximately $315 per month and will be available in pharmacies soon. A larger outcomes trial evaluating its impact on heart attack and stroke rates is currently underway. Other topics include oatmeal for diabetes, avocados for cholesterol, ketogenic diets and cancer, serotonin and heart valve disease, air pollution and cardiovascular events, and the relationship between sweetened beverages, fruit juice, and high blood pressure. Dr. Kahn also mentions the air filtration system he uses at home and in his office, available at: airdoctorpro.com Finally, thanks to this week's sponsor, the Fresh Pressed Olive Oil Club. Learn more at getfreshDrKahn.com.

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we delve into a series of industry-shaping events, reflecting the ever-evolving landscape of drug development, regulatory challenges, and strategic maneuvers. In a significant move within the sector, Jasper Therapeutics has merged with Kira Pharmaceuticals, a strategic decision aimed at expanding its footprint in autoimmune therapeutics. This merger brings to Jasper a valuable asset in KP-104, a dual-inhibitor with the potential to address rare diseases—an area of considerable unmet need. Such consolidations highlight an industry trend where companies seek to bolster their portfolios with promising candidates that can tackle complex medical conditions. The merger exemplifies how strategic expansions are becoming increasingly integral to maintaining competitive edges in the biotech arena. Turning to clinical trials, Takeda's Zasocitinib has demonstrated promising results for patients suffering from moderate-to-severe plaque psoriasis. In Phase 3 trials, a significant 75% of patients achieved clearance of scalp psoriasis. Zasocitinib operates as a TYK2 inhibitor, targeting the IL-23 pathway—a crucial mechanism in autoimmune diseases like psoriasis. This breakthrough promises to enhance patient care by providing a more effective treatment option for those struggling with difficult-to-treat psoriasis. On the regulatory front, Novartis' Fabhalta (Iptacopan) has gained FDA approval for its role in slowing kidney function decline in patients with primary immunoglobulin A nephropathy. As a small molecule complement inhibitor, Iptacopan introduces a novel treatment class for this autoimmune kidney disorder. This approval underscores ongoing innovation within nephrology and offers renewed hope for improved patient outcomes. Recent regulatory updates also saw Novartis securing full FDA approval for Fabhalta—an affirmation of progress in addressing immunoglobulin A nephropathy through innovative therapeutic options. Business development remains a driving force in shaping industry landscapes. The acquisition of Mission Therapeutics' AKI candidate MTX652 by Dimerix is a prime example. This $5 million deal, with potential milestones up to $292 million, reflects high stakes and ambitions to advance treatments for acute kidney injuries—a field with significant unmet medical needs. The integration of artificial intelligence continues to revolutionize drug discovery processes. Aqemia's collaboration with Sanofi highlights this trend, showcasing AI's crucial role in expediting drug development and uncovering novel therapeutic targets. Their partnership potentially worth $140 million underscores AI's transformative potential within pharmaceutical research. Notably, Nobel laureate Jennifer Doudna's foray into AI-powered protein design signifies an exciting intersection between gene-editing technology and artificial intelligence. Her involvement signals potential revolutions in drug discovery through enhanced precision in protein engineering. However, regulatory challenges persistently loom over the industry. Novo Nordisk and Alvotech have faced FDA scrutiny concerning manufacturing deficiencies—an issue that accentuates the importance of stringent quality control and operational excellence in biologics manufacturing. The American Society of Health-System Pharmacists (ASHP) report on U.S. drug shortages during Q2 2026 reveals vulnerabilities within supply chains, notably impacting oncology drugs. These shortages emphasize the critical need for robust strategies to ensure consistent drug availability for essential therapies. Furthermore, geopolitical dynamics are influencing pharmaceutical supply chains. A U.S. Senate bill aimed at increasing transparency highlights concerns over China's dominance in drug ingredient supplies—an issue necessitating strategic adjustments by globally operating companies. Elsewhere within the sector, GSK made headlines by discontinuing the development of its chronic cough treatment camlipixant following mixed Phase 3 trial results—a setback illustrating the critical nature of trial outcomes in determining drug viability and market potential. In market trends, biotech IPOs have surged during the first half of 2026—a sign of robust investor interest fueled by innovations and favorable funding environments despite associated market volatility risks. Strategic adjustments continue across companies with mergers and acquisitions leading to workforce reductions—projected layoffs exceeding 14,000 within biopharma during H1 2026—as organizations streamline operations or pivot towards more promising research domains. Lastly, Merck's FDA approval for an oral PCSK9 inhibitor marks a significant achievement in cardiovascular care—representing another stride forward in therapeutic innovation. In summary, these developments encapsulate a landscape defined by scientific pursuits yielding mixed results amidst evolving regulatory interactions and strategic realignments—all contributing towards innovative healthcare solutions while navigating complex industry dynamics.Support the show

In episode 624, James and Mike K invite Tony Nickonchuk to go over all the new evidence we have for the PCSK9 inhibitors. First, we discuss whether or not the evidence addresses the issue of primary versus secondary prevention. We then give you all the numbers and the context you need to allow you to […]

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. The industry continues to forge ahead, making significant strides in scientific advancements, regulatory approvals, and strategic business developments. These moves are reshaping the landscape of drug development and patient care. Starting with Merck & Co.'s recent FDA approval for Lipfendra, the world's first oral PCSK9 inhibitor, this marks a pivotal shift in managing hypercholesterolemia. Traditionally, PCSK9 inhibitors have been administered via injection, but Lipfendra offers a more convenient oral alternative. This could significantly improve patient adherence and outcomes by easing the administration process for those managing cholesterol levels. The drug's approval highlights a crucial advancement in cardiovascular treatment, with expectations of reaching peak annual sales of $5 billion, underscoring its market potential. In another significant development, Eli Lilly has entered the burgeoning field of psychedelic therapeutics with its acquisition of Ataibeckley for up to $3.8 billion. This move reflects a growing trend toward exploring novel therapeutic avenues for psychiatric disorders. Psychedelic compounds promise new hope for patients with depression and other mental health conditions where conventional therapies have shown limited efficacy. Eli Lilly's investment signals confidence in the transformative potential of psychedelics, which could revolutionize treatment paradigms for conditions like depression and PTSD. Turning to obesity treatment, Novo Nordisk's Wegovy pill has received European Commission approval for obesity and overweight adults. As a small molecule GLP-1 receptor agonist, semaglutide enhances satiety and reduces caloric intake. This development underscores the increasing focus on metabolic disorders and highlights the competitive landscape as companies race to dominate the weight management sector with innovative oral formulations. In oncology news, Merck & Co.'s Keytruda has achieved a milestone in becoming the first PD-1 inhibitor to demonstrate phase 3 benefits as a single agent in frontline mismatch repair-deficient endometrial cancer. This success not only reinforces Keytruda's role in oncology but also emphasizes the importance of precision medicine approaches targeting specific genetic mutations in cancer therapy. The industry is also seeing substantial financial maneuvers aimed at bolstering research capabilities and market reach. Johnson & Johnson has raised its 2026 financial guidance following Tremfya's impressive $2 billion revenue milestone with its IL-23 inhibitor for autoimmune diseases. Additionally, their strategic supply chain restructuring reflects efforts to enhance operational efficiency amid a broader U.S. manufacturing push. On the regulatory front, Johnson & Johnson received UK MHRA approval for Akeega in BRCA1/2-mutated metastatic prostate cancer, highlighting ongoing focus on precision medicine and targeted therapies in oncology. Meanwhile, Medtronic's recall of Harmony Catheter Delivery Systems due to safety concerns serves as a reminder of ongoing vigilance in medical device safety regulations. In clinical trial advancements, InnoCare Pharma's TYK2 inhibitor demonstrated efficacy in a Phase 2 trial for nonsegmental vitiligo, achieving its primary endpoint and paving the way for Phase 3 studies. This highlights TYK2 inhibition as a promising strategy for autoimmune diseases like vitiligo. Moreover, we witness movements towards public offerings with companies like Vogenx and Braveheart Bio aiming for IPOs to fund their respective drug development projects. These efforts underscore the continuous drive for capital to propel innovative therapies through clinical trials and towards commercialization. Finally, turning to regulatory updates, Sanofi has entered new chapters in mRNA patent litigation against Pfizer and Moderna, reflecting ongoing tensions over intellectual property rights within the high-stakes realm of COVID-19 vaccines and mRNA technology. The outcomes here could have far-reaching implications for mRNA-based therapeutics and vaccine development. As we look at these developments collectively, they illustrate a vibrant period for pharmaceutical and biotech companies innovating new treatments while navigating complex regulatory terrains. The implications for patient care are profound, with potential improvements in therapeutic options driven by new scientific breakthroughs and strategic industry shifts. These dynamics promise to reshape the future landscape of global healthcare delivery and pharmaceutical innovation as these trends continue to unfold.Support the show

On today's episode, Yaron Werber, John Maraganore, Sam Fazeli, and Matt Gline open with a discussion of biotech market volatility, with Matt noting that it often seems driven more by opaque factor dynamics than company-specific fundamentals. The group then turns to Eli Lilly's continued “Amazonification” and reinventing the pharma business as it acquires a variety of different companies, including this week's $2.8B upfront acquisition of Atai Beckley, a psychedelic-focused company. The conversation turns to BioCentury's reporting on Asia-to-West NewCos, prompting a debate about whether China is uniquely changing the market or simply reflects broader shifts in cheaper, faster development. On policy, the group covers BIO's response to the OMB proposal that could inject political review into federal grant decisions. The co-hosts also debate Kalshi's move to create prediction markets around clinical trial and regulatory outcomes. On pipeline updates, the group discusses Merck's approval of Lipfendra, the first oral PCSK9 drug, and the broader class implications. In CNS, Biogen and Ionis' diranersen tau ASO data spark a discussion of aconfusing dose response, ASO tolerability, tau as a target in Alzheimer's disease, and the promise of alternative modalities from Arrowhead and Alnylam. The episode closes with M&A and financing, including AstraZeneca's licensing deal with Dizal for the EGFR exon 20 inhibitor sunvozertinib andErasca's RAF data plus its $500M financing, which Sam views as a strong market signal despite a volatile biotech backdrop. This episode aired on July 17, 2026.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning discusses the transcatheter aortic valve replacement (TAVR) heart team potentially losing a member. He explores the current composition of the TAVR heart team, proposed changes, the thoughts of cardiothoracic societies, and future actions regarding this issue. Chapters  00:00 Intro  01:53 TAVR Heart Team  07:48 JANS 1, Base Editing of PCSK9  09:47 JANS 2, High Volume Valve Sparing ARR  12:03 JANS 3, Western Rheumatic Heart Disease  14:05 JANS 4, Non-Intubated Uniportal VATS SL  15:38 Video 1, Miami Method-Bentall  17:02 Video 2, ALCAPA Repair  18:29 Video 3, Robotic Cardiac Podcast  22:17 Dr. Sundt, Mantle Radiation Patients  31:17 Upcoming Events  Additionally, he spoke with Dr. Thoralf Sundt, Chief of the Division of Cardiac Surgery and Director of the Corrigan Minehan Heart Center at Massachusetts General Hospital, Boston, MA, USA, about patients who have undergone mantle radiation. They discuss the challenges these patients face postoperatively, including the mortality rate associated with reoperations. The conversation also highlights the significance of employing a heart team approach for these patients, emphasizing the importance of preoperative planning and the application of TAVR, which is potentially suitable for these patients. Furthermore, they touch upon topics such as mechanical valves, porcelain aorta, and the importance of conducting careful operations on these patients. Joel also highlights recent JANS articles on in vivo base editing of PCSK9 with VERVE-102 for hypercholesterolemia, defining high-volume centers using prospective data for valve-sparing aortic root replacement, insights from the Netherlands Heart Registration on surgical care for rheumatic heart disease patients, and a cohort study on surgical techniques and outcome analysis of non-intubated uniportal VATS sleeve lobectomy. In addition, Joel explores a step-by-step technique for a minimally invasive Bentall procedure via right axillary access, the repair of an anomalous left coronary artery from the pulmonary artery via direct coronary transfer, and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Dr. Husam Balkhy about multi-spectrum robotic cardiac surgery. Before closing, Joel highlights upcoming events in CT surgery. JANS Items Mentioned In Vivo Base Editing of PCSK9 With VERVE-102 for Hypercholesterolemia Valve-Sparing Aortic Root Replacement: Defining High-Volume Centres Using Prospective Data Surgical Care for Rheumatic Heart Disease Patients: Insights From the Netherlands Heart Registration Surgical Techniques and Outcome Analysis of Non-Intubated Uniportal VATS Sleeve Lobectomy: A Cohort Study CTSNet Content Mentioned Minimally Invasive Bentall Procedure via Right Axillary Access: A Step-by-Step Technique Repair of Anomalous Left Coronary Artery From the Pulmonary Artery via Direct Coronary Transfer The Atrium: Multi-Spectrum Robotic Cardiac Surgery Other Items Mentioned Cardiac Reoperations in Patients With Prior Thoracic Radiation: A Single-Center Analysis of Outcomes and Key Lessons CTSNet Innovation Video Competition Career Center CTSNet Events   Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

The newest AHA and ACC guidelines for treating dyslipidemia are here — and according to Dr. Kim Williams, they mark a powerful shift toward prevention, earlier testing, and whole-food, plant-based nutrition as the foundation of cardiovascular care.Rip welcomes back Dr. Kim Williams, past president of the American College of Cardiology, for a practical and deeply encouraging breakdown of what these updated cholesterol guidelines mean for everyday people.Dr. Williams explains why cardiovascular risk is no longer just about one cholesterol number. Instead, clinicians are being encouraged to look at the whole picture: LDL cholesterol, ApoB, Lp(a), inflammation, blood pressure, blood sugar, kidney function, family history, lifestyle, and coronary artery calcium when appropriate.The most exciting part for the PlantStrong community? Lifestyle optimization is now treated as the clinical foundation — and Dr. Williams is clear about what that means: a whole-food, plant-based diet built around beans, grains, nuts, seeds, fruits, vegetables, and mushrooms, along with exercise, sleep, mindfulness, strong social connections, and avoidance of tobacco, alcohol, and other harmful substances.This conversation also tackles statins, PCSK9 inhibitors, Lp(a), coronary calcium scoring, and the new philosophy of treating risk lower, earlier, and longer — always with food first, and medication when needed.Key TakeawaysThe new cholesterol guidelines emphasize lifestyle first, not lifestyle as an afterthought.Dr. Williams says a whole-food, plant-based diet should be built around beans, grains, nuts, seeds, fruits, vegetables, and mushrooms.LDL cholesterol is still important, but it is no longer the only number that matters.ApoB may give a clearer picture of risk in some people, especially those with diabetes, high triglycerides, or central obesity.Lp(a) is largely genetic and should be measured at least once in adulthood; the 2026 guideline includes updated recommendations for elevated Lp(a).Coronary artery calcium scoring can help personalize risk and guide LDL targets.Dr. Williams emphasizes that the goal is not “plants versus statins.” It is whole plant foods first, medications when needed.The overall prevention philosophy is: lower, earlier, longer.Watch the Episode on YouTube: https://youtu.be/6cD8tGpsAggLearn More About our 2026 Live PLANTSTRONG Events: https://plantstrongevents.com/ Let Us Help Your PLANTSTRONG JourneyLearn More About Our Corporate Wellness Program: https://liveplantstrong.com/corporate-wellness/ COMPLEMENT: Use code PLANTSTRONG for 30% off at https://lovecomplement.com/pages/plantstrong-special-offer Follow PLANTSTRONG and Rip Esselstynhttps://plantstrong.com/ https://www.facebook.com/GoPlantstrong https://www.instagram.com/goplantstrong/https://www.instagram.com/ripesselstyn/ Follow the PLANTSTRONG Podcast and Give the Show a 5-star RatingApple PodcastsSpotify

He carried two copies of ApoE4, the highest genetic risk factor for Alzheimer's disease, went through medical school knowing exactly what his LDL of 700 meant, decided the experts were wrong, and then published the case report to prove it. In this episode, Louisa sits down with Dr. Nick Norwitz, PhD researcher and metabolic scientist, for one of the most scientifically dense conversations on brain health, cholesterol biology, and Alzheimer's prevention ever recorded on this show. They cover why the phospholipid form of DHA reaches the brain more effectively than standard fish oil, how ApoE4 carriers burn through omega-3s differently and what to do about it, the lithium orotate data that sold out supplement shelves worldwide, and why GSK-3 beta, the enzyme that phosphorylates tau, may be the most under appreciated target in Alzheimer's research today. Then Dr. Nick Norwitz lays out the case that challenges the "LDL is always the enemy" consensus: why metabolically healthy individuals may not benefit from aggressive lipid-lowering therapy, what his viral coronary CT angiogram showed after seven years of 700+ cholesterol, why the EZPAVE trial headlines don't hold up under scrutiny, and what GLP-1s are doing inside the brain completely independent of weight loss. You'll also hear about the sardine diet experiment, the omega-3 thermogenesis connection, ketones as misfolded protein clearance agents, creatine for depression, retatrutide and PCSK9, BPC-157 risks, and what Dr. Nick Norwitz believes is coming in Alzheimer's gene therapy within the next decade. *Reduce your risk of Alzheimer's with my science-backed protocol for women 30+:*https://go.neuroathletics.com.au/youtube-sales-page Subscribe to The Neuro Experience for evidence-based conversations at the intersection of brain science, longevity, and performance. _____ *TOPICS DISCUSSED*(00:00:00) Intro: The ApoE4 Paradox and the Case Report That Broke the Internet (00:00:57) Why Standard Omega-3 Supplements Fail and What to Take Instead (00:05:13) DHA and the Phospholipid Carrier: How It Crosses the Blood-Brain Barrier (00:10:19) ApoE4 Explained: Risk, Genetics, and Why Nick Is Optimistic (00:17:38) Why ApoE4 Carriers Burn Through DHA Faster and Need More (00:20:31) Women, Omega-3s, Menopause, and Brain Insulin Resistance (00:21:41) Statins, Sex Differences, and the DHA-Blood Sugar Connection (00:26:01) Statins and Dementia: What the Data Actually Say (00:32:24) Tau, GSK-3 Beta, Lithium Orotate, and Targeting Alzheimer's Pathology (00:42:19) The Glymphatic System, 40Hz Devices, and Sleep as Brain Clearance (00:45:21) Gene Editing, Prime Editing, and the Future of ApoE4 Therapy (00:49:33) Nick's Case Report: 700 LDL, Zero Plaque, and Seven Years of Data (00:55:10) The EZPAVE Trial: Why the Headlines Don't Hold Up (01:00:33) KetoneIQ: Ketones for Brain Energy and Focus (01:01:29) Cheers Health: Supporting Liver Function and Cognitive Recovery (01:03:54) If Not LDL, What Causes Heart Disease in Metabolically Healthy People? (01:12:05) The Oreo Experiment and the Sardine Diet: Self-Experiments in Metabolism (01:19:10) Ketones, Women's Brains, and Clearing Misfolded Proteins (01:21:08) The Full Brain Health Protocol: Omega-3s, Creatine, NAD, Lithium, and More (01:24:01) GLP-1s for the Brain: Independent of Weight, Targeting Amyloid and Tau (01:25:28) Peptides: BPC-157 Risks, Retatrutide, MOTS-c, and What's Worth Watching (01:29:02) Why Nick Is Controversial And Why He Doesn't Mind _______ *Thank you to our sponsors*Fenix Health Science: fenixhealthscience.com Use code NEUROEXPPulsetto: https://pulsetto.tech/pages/NEURO or use Code NEURO for some off your orderFunction Health: https://www.functionhealth.com/louisanicolaBASED Bodyworks: https://basedbodyworks.com/ and use code NEURO for 20% offKetoneIQ: https://ketone.com/NEURO for 30% OFFCheers Health: https://CheersHealth.com/NEURO or use code NEURO for 20% off _______ I'm Louisa Nicola - clinical neurophysiologist - Alzheimer's prevention specialist - founder of Neuro Athletics. My mission is to translate cutting-edge neuroscience into actionable strategies for cognitive longevity, peak performance, and brain disease prevention.If you're committed to optimizing your brain- reducing Alzheimer's risk - and staying mentally sharp for life, you're in the right place. Stay sharp. Stay informed. Join thousands who subscribe to the Neuro Athletics Newsletter → https://bit.ly/3ewI5P0Instagram: https://www.instagram.com/louisanicola_/Twitter : https://twitter.com/louisanicola_ Learn more about your ad choices. Visit megaphone.fm/adchoices

He carried two copies of ApoE4, the highest genetic risk factor for Alzheimer's disease, went through medical school knowing exactly what his LDL of 700 meant, decided the experts were wrong, and then published the case report to prove it. In this episode, Louisa sits down with Dr. Nick Norwitz, PhD researcher and metabolic scientist, for one of the most scientifically dense conversations on brain health, cholesterol biology, and Alzheimer's prevention ever recorded on this show. They cover why the phospholipid form of DHA reaches the brain more effectively than standard fish oil, how ApoE4 carriers burn through omega-3s differently and what to do about it, the lithium orotate data that sold out supplement shelves worldwide, and why GSK-3 beta, the enzyme that phosphorylates tau, may be the most under appreciated target in Alzheimer's research today. Then Nick lays out the case that challenges the "LDL is always the enemy" consensus: why metabolically healthy individuals may not benefit from aggressive lipid-lowering therapy, what his viral coronary CT angiogram showed after seven years of 700+ cholesterol, why the EZPAVE trial headlines don't hold up under scrutiny, and what GLP-1s are doing inside the brain completely independent of weight loss. You'll also hear about the sardine diet experiment, the omega-3 thermogenesis connection, ketones as misfolded protein clearance agents, creatine for depression, retatrutide and PCSK9, BPC-157 risks, and what Nick believes is coming in Alzheimer's gene therapy within the next decade. Reduce your risk of Alzheimer's with my science-backed protocol for women 30+:https://go.neuroathletics.com.au/youtube-sales-page Subscribe to The Neuro Experience for evidence-based conversations at the intersection of brain science, longevity, and performance. _____ TOPICS DISCUSSED 00:00 Intro: The ApoE4 Paradox and the Case Report That Broke the Internet 00:57 Why Standard Omega-3 Supplements Fail and What to Take Instead 05:13 DHA and the Phospholipid Carrier: How It Crosses the Blood-Brain Barrier 10:19 ApoE4 Explained: Risk, Genetics, and Why Nick Is Optimistic 17:38 Why ApoE4 Carriers Burn Through DHA Faster and Need More 20:31 Women, Omega-3s, Menopause, and Brain Insulin Resistance 21:41 Statins, Sex Differences, and the DHA-Blood Sugar Connection 26:01 Statins and Dementia: What the Data Actually Say 32:24 Tau, GSK-3 Beta, Lithium Orotate, and Targeting Alzheimer's Pathology 42:19 The Glymphatic System, 40Hz Devices, and Sleep as Brain Clearance 45:21 Gene Editing, Prime Editing, and the Future of ApoE4 Therapy 49:33 Nick's Case Report: 700 LDL, Zero Plaque, and Seven Years of Data 55:10 The EZPAVE Trial: Why the Headlines Don't Hold Up 01:00:33 KetoneIQ: Ketones for Brain Energy and Focus 01:01:29 Cheers Health: Supporting Liver Function and Cognitive Recovery 01:03:54 If Not LDL, What Causes Heart Disease in Metabolically Healthy People? 01:12:05 The Oreo Experiment and the Sardine Diet: Self-Experiments in Metabolism 01:19:10 Ketones, Women's Brains, and Clearing Misfolded Proteins 01:21:08 The Full Brain Health Protocol: Omega-3s, Creatine, NAD, Lithium, and More 01:24:01 GLP-1s for the Brain: Independent of Weight, Targeting Amyloid and Tau 01:25:28 Peptides: BPC-157 Risks, Retatrutide, MOTS-c, and What's Worth Watching 01:29:02 Why Nick Is Controversial And Why He Doesn't Mind _______ Thank you to our sponsors Fenix Health Science: fenixhealthscience.com Use code NEUROEXP Pulsetto: https://pulsetto.tech/pages/NEURO or use Code NEURO for some off your order Function Health: https://www.functionhealth.com/louisanicola BASED Bodyworks: https://basedbodyworks.com/ and use code NEURO for 20% off KetoneIQ: https://ketone.com/NEURO for 30% OFF Cheers Health: https://CheersHealth.com/NEURO or use code NEURO for 20% off _______ I'm Louisa Nicola - clinical neurophysiologist - Alzheimer's prevention specialist - founder of Neuro Athletics. My mission is to translate cutting-edge neuroscience into actionable strategies for cognitive longevity, peak performance, and brain disease prevention. If you're committed to optimizing your brain- reducing Alzheimer's risk - and staying mentally sharp for life, you're in the right place. Stay sharp. Stay informed. Join thousands who subscribe to the Neuro Athletics Newsletter → https://bit.ly/3ewI5P0 Instagram: https://www.instagram.com/louisanicola_/ Twitter : https://twitter.com/louisanicola_ Learn more about your ad choices. Visit megaphone.fm/adchoices

Matthew "Oki" O'Connor is the CEO of Scientific Affairs at Cyclarity Therapeutics, a clinical-stage biotech building a new class of medicines designed not to slow the accumulation of vascular damage but to reverse it. Oki and Chris first crossed paths as postdocs at Lawrence Berkeley National Lab in the mid-2000s — Oki was in Irina Conboy's lab, not far from the late Judy Campisi's group, where Chris was then working on cellular senescence. After Berkeley, Oki spent nearly a decade running the research program at the SENS Research Foundation, the organization most identified with the "damage repair" framing of aging biology, before co-founding Cyclarity (then known as Underdog Pharmaceuticals) in 2019 to translate one of SENS's most drug-tractable ideas into an actual molecule.When Oki was last on the show in March of 2023 (Episode 36), Cyclarity was deep in IND-enabling work and its lead asset, UDP-003, had only ever seen the inside of a mouse artery. At the end of that conversation, Chris asked what Oki hoped to be discussing the next time he visited. He answered, bluntly, that he wanted to be presenting human data. Last month, at the AHA Vascular Discovery Sessions, Cyclarity reported the results of their first-in-human Phase 1 trial of UDP-003 — a designed cyclodextrin that selectively binds 7-ketocholesterol, the oxidized cholesterol species that drives foam cell formation and arterial plaque. He's back to discuss what the drug actually did when it went hunting for 7KC inside a living human being.In this episode, Chris and Oki cover the unmet need that lipid-lowering drugs — statins, PCSK9 inhibitors, the coming Lp(a) agents — still don't address: none of them remove the damage already sitting in an artery wall. Oki explains the basic chemistry of 7-ketocholesterol and why macrophages, lacking the machinery to recycle it, collapse into foam cells and seed the necrotic core of advanced plaque. They walk through the engineering of UDP-003 as a dimeric beta-cyclodextrin "double cone" tuned for a single oxidized cholesterol species, the design of the 72-volunteer Australian Phase 1, and the exploratory pharmacodynamic readout that has the field's attention: dose-dependent urinary excretion of 7KC, stoichiometric with drug, cleared within a day. The conversation then turns to the 150-patient Phase 2 plan in coronary artery disease patients with plaque imaging as the primary biological readout, the funding math that stands between Cyclarity and that trial, the platform's reach into NASH, vascular dementia, AMD, and aging itself, and how all of this descends from the SENS damage-repair philosophy that Oki has been carrying since LBL.The Finer Details:- Why current standard of care is not enough — statins, PCSK9 inhibitors, GLP-1s, and the soon-to-arrive Lp(a) lowering agents all act by slowing the accumulation of arterial damage, not by reversing what's already there; despite 30 years on the market, statins have never demonstrated an all-cause mortality benefit in a clinical trial, and even the best statin imaging data shows only 1–2% plaque volume regression at very high doses in a subset of patients- The scale of the problem — atherosclerosis is estimated to contribute to roughly 40% of all human deaths once heart attack, stroke, and a surprisingly large COPD contribution are risk-adjusted in, on top of an enormous morbidity tail that includes angina, peripheral artery disease (up to and including amputation), and a growing case for vascular dementia as an undercounted driver of cognitive decline- The biology of 7-ketocholesterol — when an oxygen free radical reacts with cholesterol, it preferentially attacks the 7 position, and a second oxidation step locks the molecule into 7KC, a stable toxic species cells were essentially never equipped to recycle; it builds up in long-lived cells like macrophages, eventually shutting down their ability to traffic lipids back to the liver via HDL and converting them into foam cells that seed soft plaque and, over years, the necrotic core of advanced lesions- The molecular design of UDP-003 — cyclodextrins are naturally occurring carbohydrate rings; the beta size fits half a cholesterol molecule, and Cyclarity's in silico work showed that two beta-cyclodextrins facing wide-side to wide-side form a "double cone" that can fully encapsulate a single cholesterol; engineered correctly, that wrapper can be made selective for 7KC over native membrane cholesterol, which is what gives the drug its therapeutic window- The Phase 1 trial design and result — a traditional 72-volunteer safety study in Australia, split between single ascending dose and multiple ascending dose arms, escalating up to six doses at what Cyclarity believes will be the efficacious level; no serious adverse events, no bioaccumulation, drug excreted essentially completely in the urine (as predicted preclinically), and — the headline exploratory endpoint — dose-dependent urinary 7-ketocholesterol appearing on the same timescale as the drug, consistent with one molecule of UDP-003 binding one molecule of 7KC and leaving the body together- What the urinary 7KC readout can and cannot tell you — the easiest 7KC to mobilize is the free pool in circulation, but there is not nearly enough of it floating in the bloodstream to account for what came out in urine, which means the drug is reaching deeper compartments; how much is coming from vessel wall plaque versus liver versus other peripheral tissues will require the imaging endpoints of Phase 2 to answer- The Phase 2 plan — 150 coronary artery disease patients (the coronary being, as Oki puts it, the artery most likely to kill you), with baseline plaque imaging, a year of dosing, and a repeat scan; safety and PK continue, inflammatory biomarkers come on, and plaque volume change is the prize — for context, a 1% change in plaque volume is associated with roughly a 20% change in next-year risk of heart attack or stroke- The funding math and the platform — Cyclarity has raised $33M to date and needs roughly $45M more to run the Phase 2, with Phase 3 cardiovascular outcomes trials running into the hundreds of millions and likely requiring a pharma partner; beyond atherosclerosis, 7KC is elevated in NASH livers, in Alzheimer's brains, and in the retinal cells that die in age-related macular degeneration, and the underlying chemistry — designed binders that drag a specific toxic molecule out of the body — is meant to generalize into a pipeline against other accumulated damage species, the direct intellectual descendant of the SENS damage-repair programQuotes:"Atherosclerosis, or the plaque that builds up in your blood vessels in your arteries, is estimated to cause approximately 40% of all human death.""When [the macrophage] eats up too much oxidized cholesterol, it just accumulates it… And that's when you get this transition to these kind of monster blob cells called foam cells.""One molecule of our drug is supposed to bind one molecule of 7-ketocholesterol and then go away and never be seen again. You excrete both of them together.""A 1% change in plaque volume is associated with a 20% risk in the next year of your probability of having a heart attack or a stroke.""You pick one target at a time, you do it well, and you take it all the way to the clinic and hopefully prove that you can actually cure patients, help them get better, help their plaque shrink away, and prove that this approach can work."Links:Cyclarity Therapeutics: https://cyclarity.com

This week we talk about LDL, HDL, and cardiovascular issues.We also discuss one-time therapies, statins, and pharmaceutical economics.Recommended Book: Blood by Dr. Jen GunterTranscriptCholesterol is the most common type of what's called a sterol, which is a type of steroid, but also structurally technically an alcohol. But functionally, and classified by scientists, cholesterol is a lipid, which in this case is similar to a fat in all but how the body uses it. Cholesterol is the type of sterol most commonly found in animals—other types are found in plants and fungi—and its function, and this is where it varies from fats, which are used to store energy, is to basically help hold the cell membrane together, and it also serves as an intracellular messenger.Cholesterol is especially prevalent in the brain and spinal cord of animals, but it's found throughout their bodily tissues, as well, and again, it's vital for holding everything together and helping things communicate, in addition to being a precursor for vitamin D, steroid hormones, and bile.You want to have cholesterol, then, as without it you would be dead.Too much cholesterol in the blood, however, can also make you dead, especially when it's bound to what's called low-density lipoprotein, or LDL, as that contributes to cardiovascular disease like heart attacks and aneurysms, which can massively impact one's overall wellness and quality of life, and at extremes lead to the whole system shutting down as a consequence of heart attack, stroke, and the like.A lot of things can contribute to the development of cardiovascular disease, including habits like smoking, genetic predisposition, and the enthusiastic consumption of alcohol and unhealthy foods. But high blood cholesterol, of the LDL variety, is one of the top contributors, as these low-density clusters of lipoprotein can clog the pathways that blood takes throughout our bodies. Other, denser types of lipoproteins, HDLs, can clear it, like a heavier, denser substance pushing through clogs of less-dense materials that are gumming up a pipe, but LDL is at times accumulated as a result of consuming delicious but unhealthy foods, which are hard to avoid, and for some people the only consistently available and affordable foods; and for other people LDL accumulates as a result of their genetic predispositions—two things that are devilishly difficult to change.What I'd like to talk about today is a new type of therapy that may be very good news for people who struggle with the accumulation of LDL, and why this is being seen as very good news more broadly, at the scale of entire nations, as well.—Pharmaceutical company Eli Lilly is testing a new, experimental drug called VERVE-102 which is a one-time infusion that is currently administered over the course of about four hours, and once completed, it turns off a gene called PCSK9, which is responsible for making a protein that regulates cholesterol levels in humans.As I said, this drug is still being tested, so these are early results. But in a study of 35 people with high cholesterol levels, high levels of LDL or LDL-C, which is short for lipoprotein cholesterol, they found that this infusion, which again, is a one-time treatment, so get it once and then theoretically at least you never have to get anything done ever again, it reduced those LDL and LDL-C levels by as much as 62%, and that reduction was maintained a year and a half after the infusion; that's how far out they're retested so far, and the hope is that each retest will continue to show the same.On the strength of those very promising results, a Phase 2 study has been planned by the end of 2026, and the US Food and Drug Administration, the FDA, previously fast-tracked this existing study, because of the promise and potential this drug already demonstrated in early studies; all of which is considered to be very significant progress and possibility.To understand that significance, though, it's useful to know some health stats. And I'm going to focus on the US here, as that's where this drug is being developed, but many wealthy countries have similar stats, at least in terms of cardiovascular disease struggles.As of 2024, which is the last year we had good, cohesive data on this in the US, it was estimated that about 11-12% of the US adult population has high cholesterol levels. This typically doesn't come with any symptoms, but it can contribute a higher risk for all those cardiovascular diseases, including heart attack and stroke. A further 86 million US adults have borderline or elevated cholesterol levels, which can easily tip higher, but also, even in that existing, elevated state, contribute to negative cardiovascular outcomes.There are treatments for high cholesterol, the most common of category of which are called statins, which reduce the production of LDL by inhibiting an enzyme that produces cholesterol in the body.Unfortunately, these drugs do come with some usually minor side effects, which can cause patients to stop using them, and they have to be taken daily, ideally at the same time each day. That necessity for consistency leads to a lot of incorrect or incomplete usage, which reduces the effectiveness of these drugs. But it's also estimated that only about 54.5% of US adults who would benefit from statins are currently taking one—so that's people who could benefit and who have it prescribed, and then within that number are all the people who are taking this drug incorrectly or incompletely, reducing the effectiveness. So a relatively small number of people who should probably be on these things are getting the full benefit they offer because of the nature of the drug.And that's not great, because in the US alone, heart disease is the leading cause of death for pretty much every adult demographic; men, women, people of most racial and ethnic and economic groups, you name it, heart disease is the biggest threat to their lives.One US citizen dies every 34 seconds of some kind of cardiovascular condition, and as of 2023, 1 in every 3 deaths in the US was caused by the same, adding up to just over 919,000 people that year.Between 2021 and 2022, alone, the cost of services and medications related to heart disease added up to more than $168 billion; again, that's just in that period, and just in the US.And once more, these are ailments that are caused or heavily influenced by high levels of cholesterol, which are themselves amplified by common lifestyle choices, environmental factors that are hard for many people to avoid, and just by raw, dumb luck because of genetics.This treatment category, then, is being seen as a pretty big deal because a one-time infusion means those who receive it don't have to remember to take a pill every day at the same time, and won't experience those statin-based side-effects.It also means that people who are currently costing the medical system a bunch of money each year, because they need treatments for all the issues they suffer as a result of high cholesterol, will suddenly cost the system a lot less money, for treatments and medications. Not for nothing, their health and quality of life will likely improve as well. So in addition to having better, healthier outcomes personally, their cost to healthcare systems will drop.Eli Lilly's drug isn't the only one currently working its way through clinical trials, either.Amgen is working on a similar treatment, and Novartis and Ionis Pharmaceuticals have drugs that are even further along in the process, their medicines that cut heart attacks, strokes, and cardiovascular deaths could be approved by the FDA as soon as next year.There are a lot of caveats worth noting here, including that the science is still out as to whether this approach, silencing proteins that lead to the creation of more LDL and a similar substance called Lp(a)—which is more dangerous because it's stickier and thus more likely to get stuck in important blood pathways, and it's also more likely to be caused by genetics than lifestyle—the word is still out on whether reducing these things in the body actually reduces hearth attacks and stroke.Some people have had this particular risk variable dramatically reduced, but have still suffered from cardiovascular events, which raises the question of whether this path is the right one to take in trying to reduce this category of health issues; the correlation between LDL and heart attacks and strokes might not be a clear-cut as long assumed.There's also the issue of price. Drug-makers are economically incentivized to sell treatments over cures, because that means they can continue selling their product over time, potentially for the life of the patient, and a cure, in contrast, is a one-time hit that in theory should alleviate the need for future treatment.There's a chance, then, that the drug-makers will decide they need to make these one-hit treatments really, really expensive in order to make their R&D dollars back and to make the kinds of profits their investors expect from them. That could then reduce the potential audience for these treatments, even if they are effective, and could further slow their deployment and future research in this space.If these trials continue to go well, though, there's a good chance that this combination of similar but distinct treatment types will provide a more sustainable alternative to current options, and that, like the recent bogglingly rapid and widespread deployment of GLP-1 treatments for all sorts of issues, could lead to a new paradigm in this facet of the medical world.Show Noteshttps://en.wikipedia.org/wiki/Cholesterolhttps://en.wikipedia.org/wiki/Cardiovascular_diseasehttps://en.wikipedia.org/wiki/High_cholesterolhttps://pmc.ncbi.nlm.nih.gov/articles/PMC10982736/https://www.cdc.gov/heart-disease/data-research/facts-stats/index.htmlhttps://www.who.int/health-topics/cardiovascular-diseases#tab=tab_1https://www.ama-assn.org/public-health/chronic-diseases/what-doctors-want-patients-know-about-high-cholesterolhttps://en.wikipedia.org/wiki/Statinhttps://pubmed.ncbi.nlm.nih.gov/42187087/https://abcnews.com/GMA/Wellness/new-drug-game-changer-people-high-cholesterol/story This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit letsknowthings.substack.com/subscribe

Heart Disease Prevention: The Complete Cardiologist's Guide to Statins & Early Detection 700,000 Americans die from heart disease every year but most of these deaths are PREVENTABLE. In this groundbreaking episode, Dr. McConnell from Stanford reveals how to treat your heart like cancer: with early detection, proper treatment, and personalized prevention strategies that actually save lives.

In this episode, we review key updates from the 2026 ACC-AHA Guidelines on the Management of Dyslipidemia. Key Concepts The PREVENT ASCVD equation is now recommended to calculate ASCVD risk, with thresholds at 3%, 5%, and 10%. The previous 7.5% threshold for statin treatment is now 5%. In addition to the 10-year ASCVD estimate, clinicians should consider the use of Lp(a), "risk enhancers", and coronary artery calcium (CAC) scans as a "tie breaker" with shared decision-making when the decision to treat is not clear. In addition to LDL goals of < 100, < 70, or < 55 (depending on risk), the new guidelines also suggest non-HDL-C and apoB goals once LDL cholesterol is at goal. Many patients will require non-statin therapies to achieve lipid goals. The recommended non-statin therapies include ezetimibe, PCSK9 mAb, PCSK9-interfering RNA, and bempedoic acid. References Writing Committee Members, Blumenthal RS, Morris PB, et al. 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2026;153(17):e1154-e1276. doi:10.1161/CIR.0000000000001423 Wiggins BS, Barac A, Benziger CP, et al. 2026 Dyslipidemia Guideline-at-a-Glance. J Am Coll Cardiol. 2026;87(19):2617-2623. doi:10.1016/j.jacc.2026.02.4872 Superko H, Garrett B. Small Dense LDL: Scientific Background, Clinical Relevance, and Recent Evidence Still a Risk Even with 'Normal' LDL-C Levels. Biomedicines. 2022;10(4):829. Published 2022 Apr 1. doi:10.3390/biomedicines10040829

Dr. Joel Kahn dives into a groundbreaking Phase 1 trial of Verve 102, a one-time intravenous gene-editing treatment that silences the PCSK9 gene to produce lasting LDL cholesterol reduction. Among 35 participants, the high-dose group saw LDL drop by 62% with mostly mild side effects — promising results, though Phase 2 and 3 trials and 15 years of follow-up still lie ahead. Also covered: updated colorectal cancer screening guidelines now starting at age 45, healthy lifestyle habits cutting mortality risk in cancer survivors by one-third, real-world weight regain data after stopping GLP-1 medications, why your B12 "normal" range may be too low, a blood test that may predict Alzheimer's years in advance, and a longevity preparedness tool from MIT AgeLab. Sponsored by Igennus — visit igennus.com/drkahn for 20% off.

The conversation delves into the rediscovery of ApoB as a significant cardiovascular marker and its suspiciously aligned timing with pharmaceutical profit motives. It explores the comparison between ApoB and LDLC, the rise of statins, the emergence of PCSK9 inhibitors, the controversy around ApoB, the context of metabolic dysfunction, and the pharmaceutical vs. metabolic approach to ApoB. It concludes with the distinction between treating a number and treating a disease.TakeawaysApoB has become a significant cardiovascular markerThe timing of ApoB's rediscovery is suspiciously aligned with pharmaceutical profit motivesChapters00:00 Treating a Number vs. Treating a Disease

The NACE Journal Club with Dr. Neil Skolnik, provides review and analysis of recently published journal articles important to the practice of primary care medicine. In this episode Dr. Skolnik and guests review the following publications:1. Orforglipron for maintenance of body weight reduction  - Nature Medicine2026. Discussion by:Guest:Joe Gonella, MD Resident - Abington Family Medicine Residency Program Jefferson Health2. Tirzepatide for maintenance of bodyweight reduction in people with obesity in the USA (SURMOUNT-MAINTAIN) Lancet 2026.  Discussion by: Guest:Neil Skolnik, MDProfessor of Family and Community MedicineSidney  Kimmel  Medical College Thomas Jefferson UniversityAssociate Director - Family Medicine Residency ProgramJefferson Health – Abington3. Survival and Recurrence with GLP-1 Receptor Agonists in Breast Cancer" – JAMA Network Open Discussion by:Guest:Neil Skolnik, MDProfessor of Family and Community MedicineSidney  Kimmel  Medical College Thomas Jefferson UniversityAssociate Director - Family Medicine Residency ProgramJefferson Health – Abington4. In Vivo Base Editing of PCSK9 with VERVE-102 for Hypercholesterolemia.   NEJM 2026 Discussion by:Guest:Alex Sauer, MD Resident - Abington Family Medicine Residency ProgramJefferson HealthMedical Director and Host, Neil Skolnik, MD, is an academic family physician who sees patients and teaches residents and medical students as professor of Family and Community Medicine at the Sidney Kimmel Medical College, Thomas Jefferson University and Associate Director, Family Medicine Residency Program at Abington Jefferson Health in Pennsylvania. Dr. Skolnik graduated from Emory University School of Medicine in Atlanta, Georgia, and did his residency training at Thomas Jefferson University Hospital in Philadelphia, PA. This Podcast Episode does not offer CME/CE Credit. Please visit  http://naceonline.com to engage in more live and on demand CME/CE content.

The Tim Conway Jr. Show Hour 1 (5.29) Friday is here, and Conway is ready to take the edge off! The crew kicks things off with weekend buzz talk, student love for Fridays, and the universal mission of getting through the week and into relaxation mode. But nothing kills a good buzz faster than the wrong snack — especially when Trader Joe’s candy starts giving people the runs. That’s right, the crew gets into the ultimate Friday night disaster: trying to feel loose and happy, only to have candy turn your weekend into a bathroom sprint. The show also dives into the wild fact that 60 Minutes has been on the air for 57 years, Conway hosting the massive OC Business Awards, and a possible medical breakthrough involving a new gene-editing cholesterol drug that could change how high cholesterol is treated. Then things get weird with the internet’s latest obsession: “hot rodent men.” From Timothée Chalamet-style features to Hollywood’s strangest beauty trend, the crew breaks down why rat-like is somehow now attractive. Conway also admits he likes gambling on new medicine, comparing it to carnival rides, Vegas casinos, Whiskey Pete’s, and his love for Primm Casino. Plus, he pitches a genius idea for reviving Primm with “The Oasis.” Later, the show turns serious with a Riverside apartment complex fire that displaced around 150 people, including UC Riverside students forced out during finals. And somehow, it all circles back to viral fire interviews, Michelle Dobney’s unforgettable “Not today!” moment, Elvis Presley’s legendary bathroom demise, and a Friday night reminder: protect your buzz, choose your candy wisely. Trader Joe’s candy, Friday vibes, weekend buzz, buzzkill, funny podcast, hot rodent men, Timothée Chalamet, gene editing, cholesterol drug, PCSK9, Eli Lilly, Primm Casino, Vegas stories, Riverside fire, UC Riverside, viral moments, Conway Show See omnystudio.com/listener for privacy information.

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. The landscape of these industries continues to evolve with significant scientific advancements, regulatory breakthroughs, and strategic maneuvers that are reshaping drug development and patient care. One of the noteworthy developments is the U.S. FDA's recent approval of Gilead Sciences' Hepcludex (bulevirtide) for hepatitis D. This approval marks a comeback for Gilead after previous setbacks due to manufacturing and delivery issues, highlighting the critical importance of addressing regulatory feedback. It's a testament to persistence in overcoming manufacturing challenges to ensure vital therapies reach those in need. This approval signifies a milestone as it's the first FDA-approved therapy targeting chronic hepatitis D virus infection—a niche condition with limited treatment options. Similarly, Pfizer's Braftovi (encorafenib) is expanding its global reach beyond U.S. borders with regulatory approvals in the EU and Canada for colorectal cancer treatment. This broadening geographic footprint reflects a broader industry trend where companies aim to maximize the therapeutic impact of oncology drugs across diverse patient populations. Meanwhile, Astellas Pharma is navigating the looming patent cliff for its prostate cancer drug Xtandi by actively pursuing new licensing deals and implementing cost-cutting measures. This dual approach underscores a widespread industry strategy where companies balance acquisitions with operational efficiency to sustain growth. In the radiopharmaceutical sector, there's notable activity with Lantheus Holdings possibly being acquired by Curium for $7 billion. This potential deal underscores growing interest in radiopharmaceuticals due to their precision in targeting specific cancer types. Complementing this is Niowave's $75 million investment in a radiopharmaceutical isotope plant in Michigan, set to produce actinium-225 by 2028—an isotope crucial for targeted cancer therapies. Regulatory landscapes are also in flux with continued reforms at the FDA despite leadership changes. Initiatives like the Commissioner's National Priority Voucher program illustrate regulatory bodies' commitment to streamlining drug approvals and fostering innovation. On an international note, SK Bioscience is partnering with Colombia to locally produce the chickenpox vaccine Skyvaricella, enhancing vaccine accessibility through technology transfer. Similarly, Eli Lilly's acquisition spree in infectious disease research signals a robust push toward expanding its R&D pipeline for viral and bacterial pathogens. Eli Lilly has announced plans to acquire Curevo, Limmatech Biologics, and another vaccine company for up to $3.8 billion. This strategic acquisition underscores a commitment to enhancing capabilities in infectious diseases—a field that has gained focus post-COVID-19 pandemic. By integrating these companies, Eli Lilly aims to leverage their platforms and expertise for advanced therapeutic solutions against infectious diseases. In gene editing, Eli Lilly is preparing for a Phase 2 trial of a lipid-lowering gene editor from Verve Therapeutics, showing promising cholesterol reductions akin to PCSK9 inhibitors. This highlights gene editing's potential in addressing cardiovascular diseases. A significant development from Lilly's pipeline includes promising results from their base editor technology acquired through Verve Therapeutics—an exciting breakthrough suggesting substantial potential for gene-editing technologies addressing genetic disorders like high cholesterol. In oncology, AstraZeneca and Daiichi Sankyo's Datroway gained FDA approval for triple-negative breast cancer as a first-line treatment. This antibody-drug conjugate targets Trop2, demonstrating the potential of targeted therapy in difficult-to-treat cancers. Kura Oncology's combination therapy featuring darlifarnib and Krazati showed up to a 69% response rate in KRAS G12C-mutated solid tumors during Phase 1 trials, emphasizing precision medicine's potential in targeting specific genetic mutations driving cancer progression. In obesity management, Eli Lilly's retatrutide achieved Phase 3 success with bariatric surgery-like outcomes. The drug acts as a triple hormone receptor agonist, showcasing advancements in metabolic therapies targeting obesity—a condition linked with numerous comorbidities. Moderna's mFlusiva is poised for an FDA advisory committee review as an influenza preventative for older adults—an extension of Moderna's mRNA technology initially used against COVID-19. Collectively, these developments highlight an industry leveraging cutting-edge science and technology to tackle complex medical challenges. As pharmaceutical giants like Eli Lilly consolidate their positions through acquisitions and research collaborations, transformative advancements promise to reshape patient care across various therapeutic areas. These initiatives not only reflect the industry's dynamic nature but also its pivotal role in addressing unmet medical needs worldwide. Eli Lilly's recent strategic acquisitions underscore its commitment to advancing pharmaceutical innovations, particularly in vaccines and cholesterol management sectors. Acquiring three vaccine-focused biotech firms signifies substantial investment in expanding its vaccine portfolio—a move aligned with global immunization strategies. This follows hiring Peter Marks from the FDA, indicating a strategic focus on bolstering expertise within the vaccine domain. The company has been recognized by IDEA Pharma as a leader in pharmaceutical innovation—a testament to its robust pipeline and successful integration of scientific advancements into marketable therapies. Across oncology landscapes highlighted at ASCO conferences are exciting potentials like Summit Therapeutics and Akeso's potential Keytruda rivals that could reshape cancer treatment paradigms if proven effective. As pharmaceutical landscapes continue evolving rapidly through scientific strides tempered by regulatory hurdles—the current environment promises significant advancements offering new hope while demanding strategic agility within healthcare sectors globally.Support the show

Text Dr. Lenz any feedback or questions The 2026 Cholesterol Revolution: PREVENT Scores, Hidden Risk Markers, and CAC ScansThe script explains how 2026 ACC/AHA guideline changes aim to make heart attacks more preventable by shifting from short-term “10-year risk” thinking to “lower for longer,” precision prevention, and primordial prevention starting earlier in life. It critiques the older Pooled Cohort Equations for underestimating risk in younger people and introduces the PREVENT equation, which adds 30-year risk plus kidney, metabolic, and social factors. It highlights lipoprotein(a) as a largely genetic once-in-a-lifetime test and hs-CRP as an inflammation marker, and emphasizes coronary artery calcium (CAC) scoring as a tiebreaker for statin decisions (0, 1–99, ≥100). Cases illustrate these tools, including tighter LDL goals (

Statin use in the elderly, push for PCSK9 drugs, and pressures on clinicians show how economic interests shape patient care. #StatinsAndSeniors #PCSK9 #DrugMarketing #HealthTalks

For decades, a tight carotid stenosis felt like a ticking time bomb — a plaque waiting to throw an embolus and cause the next stroke. We were taught that severe narrowing meant surgery, and trials like ACAS and ACST-1 seemed to prove it. But medicine has changed. Statins, antiplatelets, tighter blood pressure control, even PCSK9 and GLP-1 therapies have quietly slashed stroke risk, and now newer data from CREST-2 suggest that for many asymptomatic patients, the knife — or the stent — may not add much at all. So if modern medical therapy works better than ever… who actually benefits from intervention anymore? Today, we unpack the evidence, the controversies, and how to counsel the patient who feels perfectly fine but has high-grade stenosis.Hosts: Carolyn Judge, Andrew Huang, Luciano Delbono, Frank Davis, Robert BeaulieuInstitution: University of Michigan, Department of Surgery, Section of Vascular SurgeryLearning objectives: Describe how modern intensive medical therapy has transformed the natural history of asymptomatic carotid stenosis and explain why contemporary patients experience substantially lower annual stroke risk than those in earlier eras. Interpret and compare the results of landmark trials—including ACAS, ACST-1, and CREST-2—to assess the relative benefits of medical therapy, endarterectomy, and stenting. Apply current evidence and guideline recommendations to patient care by selecting which asymptomatic patients are most likely to benefit from carotid revascularization versus optimized medical therapy alone. References:SVS Guidelines:Brook, R. D., et al. (2022). Society for Vascular Surgery clinical practice guidelines for management of extracranial carotid artery disease. Journal of Vascular Surgery, 75(1), e1–e67. https://doi.org/10.1016/j.jvs.2021.09.031CREST (1)Brott, T. G., Hobson, R. W., Howard, G., et al. (2010). Stenting versus endarterectomy for treatment of carotid-artery stenosis. New England Journal of Medicine, 363(1), 11–23. https://doi.org/10.1056/NEJMoa0912321CREST-2Brott, T. G., Howard, G., Fong, P., et al. (2024). Randomized trial of carotid artery stenting or carotid endarterectomy vs best medical therapy for asymptomatic carotid stenosis: CREST-2 results. [Manuscript in preparation]. ClinicalTrials.gov Identifier: NCT02089217. Retrieved from https://clinicaltrials.gov/ct2/show/NCT02089217ACST-1Halliday, A., Mansfield, A., Marro, J., et al. (2004). Randomised trial of carotid artery surgery for asymptomatic stenosis. Lancet, 363(9420), 1491–1502. https://doi.org/10.1016/S0140-6736(04)16153-1ACST-2Halliday, A., Bulbulia, R., Bonati, L. H., et al. (2021). Carotid artery stenting versus carotid endarterectomy in patients with asymptomatic carotid stenosis (ACST-2): A randomised trial. Lancet, 398(10291), 1065–1073. https://doi.org/10.1016/S0140-6736(21)01980-1ACASExecutive Committee for the Asymptomatic Carotid Atherosclerosis Study. (1995). Endarterectomy for asymptomatic carotid stenosis. JAMA, 273(18), 1421–1428. https://doi.org/10.1001/jama.1995.03520420033036Sponsor URL: https://www.goremedical.com/Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium: https://behindtheknife.org/premiumOral Board Review: https://behindtheknife.org/oral-boardOral Board Simulator: https://behindtheknife.org/oral-board/simulatorGeneral Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

In this sponsored episode from Novartis Pharmaceuticals Corporation, a leading preventive cardiologist walks through the 2026 cholesterol guideline update and what it means in practice. Seth J. Baum, a Columbia-trained preventive cardiologist, founder of Flourish Research, chairman of the Family Heart Foundation, and past president of the American Society of Preventive Cardiology, breaks down the major changes in the March 2026 ACC and AHA guideline release. You will hear why LDL targets are explicit again after nearly a decade, why universal lipoprotein A screening is now recommended, why a coronary calcium score above 300 places a patient in the highest-risk treatment tier, and why apolipoprotein B measurement can refine risk assessment when LDL is at goal. Baum also covers the alternatives available when a patient cannot tolerate a statin, including ezetimibe, PCSK9 inhibitors, inclisiran, and bempedoic acid, along with practical framing for the statin-hesitant patient. You will also hear his approach to discussing cholesterol with patients, from the science of lipoprotein physiology to the case for earlier and more aggressive lipid-lowering treatment. Dr. Baum was not compensated for his participation in today's episode. The opinions expressed are his alone and do not represent the opinions of Novartis Pharmaceuticals Corporation. At Novartis, our mission is to ensure no heart is lost too soon. We envision a world where preventable CV deaths are no longer part of our lives. We're proud of the positive impact we've made over the past 40 years and remain dedicated to tackling the most challenging problems in CVD. Through cutting-edge science and technology, we are focusing on areas of high unmet need, including scaling our xRNA platform across multiple risk factors and pioneering breakthroughs for genetically driven CVD risk factors and common heart conditions, including atrial fibrillation. We also work with patients, healthcare professionals, and organizations around the world to improve CV care beyond medicine alone. Together, we can help people with CVD enjoy longer, healthier lives and more time with their loved ones. Learn more here: https://Novartis.us/cardiovascular-disease VISIT SPONSOR → https://Novartis.us/cardiovascular-disease SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

This week, Dr. Kahn reviews new data from the Global Burden of Disease study analyzing the relationship between diet and death from heart disease. In 2023, an estimated 5.9 million deaths worldwide were linked to poor dietary choices, led by excessive sodium intake and insufficient consumption of fruit and whole grains. It's a fascinating and important study with clear takeaways. Other topics include stents for angina, causes of sudden cardiac death, daytime napping and health outcomes, plastic-free diets, PCSK9 inhibitors vs. statins, calcium supplements, and the purity of fish oil samples. Thanks to the Fresh Pressed Olive Oil Club. Visit getfreshdrkahn.com for an incredible introductory offer.

PCSK9 inhibitors in high-risk diabetes without ASCVD, the CAAN-AF trial, conduction system pacing vs biventricular pacing, PFA and stroke, and therapeutic fashion infects expert consensus are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I VESALIUS-CV  VESALIUS-CV Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2514428 JAMA Substudy https://jamanetwork.com/journals/jama/fullarticle/2847162 II How Best to Maximize CRT Benefit in Patients with AF CAAN-AF Trial https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehag206/8654625?searchresult=1 Role of AV Node Ablation: Meta-analysis of Observational Studies https://www.jacc.org/doi/10.1016/j.jacc.2011.10.891 III Stroke Rates in PFA vs Thermal Ablation Comparative Safety of RF versus PFA for AF in a High-Volume US Medical Center https://esc365.escardio.org/Ehra-congress/sessions/18281 IV Five New CSP Studies Presented and Published HeartSync-LBBP Trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2845803 PhysioSync-HF Trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2845802 LEFT-BUNDLE-CRT Trial https://doi.org/10.1093/eurheartj/ehag225 Long-Term Follow-up of His-Alternative I Trial https://www.jacc.org/doi/10.1016/j.jacep.2026.02.016 LECART Trial https://esc365.escardio.org/Ehra-congress/sessions/17140 V New EP Training Document Published Advanced Training Statement on Clinical Cardiac Electrophysiology  https://www.jacc.org/doi/10.1016/j.jacc.2026.01.074 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Shingles vaccination in adults with established cardiovascular disease was associated with dramatic reductions in heart attack, stroke, and mortality in a large real-world analysis, supporting its role as a cardiovascular risk-reduction tool beyond infection prevention. The VESALIUS-CV trial found evolocumab significantly reduced major cardiovascular events in high-risk diabetic patients without known ASCVD, challenging the convention of reserving PCSK9 inhibitors for secondary prevention only. AI-analyzed smartwatch data predicted heart failure hospitalizations days to weeks in advance, signaling a shift toward continuous remote monitoring in heart failure management.

My guest today is Alex Karnal. Alex is the co-founder and managing partner of Braidwell, a life sciences investment firm he built after spending 15 years at Deerfield Management. The frame we use throughout the episode is the health stack. Alex talks about how most of the diseases that will claim most of our lives are already addressable with medicines that exist today. We work through the five layers of what a defensive health strategy looks like, why GLP-1 medicines represent the first commercial proof that people are ready to be proactive about their health, and why PCSK9 inhibitors may ultimately be the more important drug class even though they get far less attention. We also get into the science and business of drug discovery itself — why most of the published literature that AI companies are training on cannot be replicated, what it would mean to have a truly agentic scientific lab running 24 hours a day, and why Alex believes we are now on a deterministic curve toward scientific superintelligence in biology. For the full show notes, transcript, and links to mentioned content, check out the episode page ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠here⁠⁠⁠⁠⁠.  ----- Become a Colossus member to get our quarterly print magazine and private audio experience, including exclusive profiles and early access to select episodes. Subscribe at ⁠colossus.com/subscribe⁠. ----- ⁠Ramp's⁠ mission is to help companies manage their spend in a way that reduces expenses and frees up time for teams to work on more valuable projects. Go to⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠ramp.com/invest⁠⁠ to sign up for free and get a $250 welcome bonus. ----- Trusted by thousands of businesses, ⁠Vanta⁠ continuously monitors your security posture and streamlines audits so you can win enterprise deals and build customer trust without the traditional overhead. Visit ⁠vanta.com/invest⁠.  ----- ⁠WorkOS⁠ is a developer platform that enables SaaS companies to quickly add enterprise features to their applications. Visit⁠⁠ ⁠WorkOS.com⁠⁠⁠ to transform your application into an enterprise-ready solution in minutes, not months. ----- ⁠Rogo⁠ is the AI platform for finance. They're building agents for Wall Street that are trained to understand how bankers and investors actually do work: from diligence and modeling, to turning analysis into deliverables. To learn more, visit rogo.ai/invest. ----- ⁠Ridgeline⁠ has built a complete, real-time, modern operating system for investment managers. It handles trading, portfolio management, compliance, customer reporting, and much more through an all-in-one real-time cloud platform. Visit⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ridgelineapps.com⁠. ----- Editing and post-production work for this episode was provided by The Podcast Consultant (⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://thepodcastconsultant.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠). Timestamps: (00:00:00) Welcome to Invest Like the Best (00:02:29) Intro: Alex Karnal (00:03:15) State of the Union: GLP1s and Life Sciences (00:07:01) The Health Stack Framework (00:12:49) Breaking Down the 5 Defensive Layers (00:21:18) GLP-1: What's Driving the Inflection (00:28:28) Diet vs. Drugs: Is Food Enough? (00:31:15) Barriers to Access: Complexity, Cost & Compliance (00:35:04) PCSK9: The Closest Thing to a Free Lunch (00:44:10) Alzheimer's & Neurodegenerative Disease (00:46:59) Cancer: Early Detection & New Treatments (00:54:49) Body Imaging & Diagnostic Trade-offs (00:56:31) How Drugs Are Discovered (01:02:39) AI in Drug Discovery (01:10:57) The Automated Lab of the Future (01:13:05) Peptides & Citizen Pharmacology (01:16:45) Alex's Background (01:28:25) Braidwell's Investment Approach (01:30:39) The Kindest Thing

I'm confused by information presented on diets containing meat as being dangerous. Could you shed some light?Assisted living models that would be of benefit to older adults

Three imaging-guided PCI trials (two with surprising results), LDL targets, an oral PCSK9 inhibitor, and another beta-blocker withdrawal trial are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I IVUS-Guided PCI OPTIMAL Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2600440 IVUS-CHIP Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2601521 ILUMIEN IV Trial https://www.nejm.org/doi/10.1056/NEJMoa2305861 DKCRUSH VIII Trial https://doi.org/10.1016/j.jacc.2026.01.081 II Ez-PAVE Trial — Low vs Very Low LDL-targets Does Ez-PAVE Support 'Lower Is Better' for LDL-C? https://www.medscape.com/viewarticle/does-ez-pave-support-lower-better-ldl-c-2026a1000akx Ez-PAVE Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2600283 2026 ACC/AHA Lipid Guidelines https://www.ahajournals.org/doi/10.1161/CIR.0000000000001423 III CORALreef AddOn CORALreef AddOn Trial https://www.jacc.org/doi/abs/10.1016/j.jacc.2026.03.036 This Week in Caardiology 2-6-26 https://www.medscape.com/viewarticle/1003240 CORALreef Lipids Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2511002 IV Another Post-MI Beta-blocker Withdrawal Study: SMART-DECISION SMART-DECISION Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2601005 ABYSS Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2404204 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net