Is Merck’s oral pcsk9i a game changer?
Merck has an oral pcsk9i in trials, showing slightly higher LDL reductions than injections, though in a small sample. The pill form would be more accessible and possibly cheaper than current drugs of this nature. If it is found to be safe and well tolerated, would this virtually eliminate CVD risk for a large portion of the population, or would enough residual risk remain to keep Dr Dayspring busy?
The future use of PCSK9-Inhibitors
Dear Peter, I enjoyed listening to your lipidology podcasts. My question today is about PCSK9-Inhibitors. Eugene Braunwald famously said that you can never have too low a LDL, and I am not aware of any side effects of ''too low LDL''. On the contrary, many people we classify as healthy, have higher than even officially recommended levels. Now, take for example Inclisiran: It seems to be highly effective in lowering LDL, while up to now not showing any significant side effects? Do you think the future use of these medications will be much more widespread? (assuming we manage to lower the costs..) Appreciate your work
Stress + CVD risk + Dementia Risk
After reading this article from JAMA (https://jamanetwork.com/journals/jamaneurology/fullarticle/2762514), I'd be very interested in a partner AMA, like you did with Matt Kaeberlein, addressing a couple things: 1) As a physician, how do you intentionally try to find out someone's experiences of stress "disorders" or trauma and how does that inform your treatment; 2) What trauma treatment or stress lowering habits seem to be most effective for diagnosable stress disorders vs. life/family/job stressors? 3) How do you communicate to patients that their mental health risks (assuming you've been able to identify something) put them at increased risk for chronic diseases like cardiovascular disease and/or dementia regardless of family history, perhaps? Maybe Paul Conti could join you again if this type of AMA is interesting.