Dr. Michael Koren shares insights from his presentation at the American College of Cardiology meeting in Chicago about a groundbreaking oral PCSK9 inhibitor that could lower cholesterol by 80% when combined with a statin. The development represents a significant advancement in treatment options for the 20% of patients who don't respond adequately to statins alone or experience statin intolerance. They also chat about Chicago and the importance of things in moderation.
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Episode Transcript
Huge hit for Fleetwood Mac back in the day,
right Nine minutes after 8o'clock.
Joining me live on the studioline right now, dr Michael Korn,
and he normally joins us onMonday, but I had to ask him to
change and hook up with us onthis Thursday morning and he
just returned from Chicago wherehe was able to make a
presentation, was asked to makea presentation in front of the
American College of Cardiologyand some pretty interesting
(00:32):
stuff relating to cholesterolmedications.
Right, doctor?
Dr. Michael Koren (00:38):
It was a program that I gave that was
related to the first release ofdata on a drug that is called a
PCSK9 inhibitor, and these drugsare on the market, but they're
all injectables, and this was awhole discussion around new data
looking at a pill thatbasically reproduces what we're
(00:59):
able to do with an injectabletoday.
So that led to really, reallyinteresting discussions about
whether or not people wouldrather take a pill once a day,
especially if the pill wasconnected to a statin drug,
whereby one pill would loweryour cholesterol by 80%, versus
taking injections periodically.
And there are technologies outthere that allow you to take
(01:21):
injections very infrequently,even every six months, but it
still requires you to take apill every day, which is the
statin drug that's alsoconsidered part of the regimen.
So very, very interestingdiscussions around this concept
of, ultimately, what doconsumers want a pill a day, or
do they want injectables thatyou take less frequently but
still have to take a pill?
Kevin Geddings (01:41):
So are these folks that are driving around
listening to us?
Does this impact the peoplethat just don't benefit from
taking, like I do, you know, anormal statin or a statin of
some dosage every evening beforeyou go to bed?
Dr. Michael Koren (01:54):
Right.
So you're like most people Iwould say 80% of people that
have a cholesterol problem arehandled with a statin.
Statins are great drugs.
They're safe, they're effective.
I like to tell people that thenumber one side effect of
statins is that you live longer.
So from that standpoint, mostpeople do okay.
But it's about 20% of thepopulation that either needs
(02:16):
more cholesterol lowering thanthat which is provided by the
statin, or they're intolerant ofstatins, or they have a
specific type of condition thatdoesn't respond to statins as
well.
So, for example, if you have,like, a protein delay problem,
you actually don't get anybenefit from the statins for
that particular problem.
So it's a little bit morecomplicated.
(02:38):
But, to your point, 80% ofpeople just fine with their
statins and it's that 20% thatwe're really working for.
Kevin Geddings (02:46):
If there are folks out there listening to us
right now and they've hadperhaps little to no success
with their current statins, orthey know they have a
cholesterol issue that hasn'tbeen addressed with diet or what
have you, I would imagine thereare ways they can participate
in clinical trials with EncoreDocs, right?
Dr. Michael Koren (03:01):
Absolutely.
So we're really focused onthose areas in which are a
little bit more complicated.
So, for example, if you knowyou have an LPA problem that
will not respond to statins andwe're right now doing studies
that enroll people that have LPAproblems so we've talked about
that, but that's that really,really, really, really bad
cholesterol that causes moreatherosclerotic complications,
(03:23):
such as heart attacks andstrokes, compared to just
regular cholesterol.
And we're also looking atpeople that have genetic
predisposition.
So if you have a conditioncalled familial
hypercholesterolemia, you'regoing to need something more
than just being on a statin.
And then we're also looking atpeople that have inflammatory
risk.
I think you and I have talkedabout this, but we also will
(03:44):
check people for somethingcalled HSCRP, so people that may
have their cholesterol controlsstill may have inflammation in
their bloodstream, and thatinflammation is also something
we can target these days.
So a lot of really excitingthings to help people prevent
heart attacks and strokes.
Kevin Geddings (03:59):
Yeah, so many of you out there listening, of
course have some of these issues, whether it's cholesterol or
cardiac health issues.
We encourage you to learn aboutall the amazing studies that
are ongoing that you canpotentially participate in.
Go to the website EncoreDocscom, and know that you can do that
from the comfort and convenienceof life right here in St John's
County.
Encore Docs with offices rightnext door to UF Flagler Hospital
(04:21):
in the Whetstone Building.
Go to EncoreDocs, e-n-c-o-r-edocscom to learn more.
And also you can call Let megive you this phone number that
you can punch into your cellphone 904-730-0166.
So the American College ofCardiology meeting in Chicago.
That's a big deal, right, doc?
Dr. Michael Koren (04:42):
It is.
That is one of our bigprofessional conferences and it
was an honor actually to beasked to do what's called a late
breaking clinical trial session.
And I get into what they callthe main tent, a big
amphitheater that can fit up to3,000 people, and just present
(05:02):
the latest and greatest inscientific results and then
typically they'll have an expertask me a series of questions
about my results, which we did.
So it's a neat process.
It's the way we share scienceand, keep in mind, this is very
international.
There are people all over theworld that are watching this
conference and attending theconference, and as soon as I
finished my presentation I had anumber of media discussions,
(05:27):
different media outlets that areprojected around the world,
including China.
I mentioned to you right beforewe got on the call that I had
an interesting conversation withChinese TV, and a little funny
part about it is that theyhooked me up with this really
high-tech microphone and thenthey gave me a fake microphone
with the station's logo on it tospeak into.
(05:48):
That's hilarious.
It was pretty interesting, butthe more important point is that
these results are projected tocardiologists and other
physicians around the world.
Kevin Geddings (05:58):
Yeah, so I'm always wondering so you go to a
place like Chicago, which Ithink is one of my favorite
cities in the world for eatinggreat food, right yeah?
Dr. Michael Koren (06:06):
Oh, it was fabulous yeah.
Kevin Geddings (06:07):
So you have to be heart.
You know cardiac.
Friendly food though, right, noPortellos hot dogs, nothing
like that.
Dr. Michael Koren (06:13):
Well, you can , you can branch out a little
bit, but you have to be careful.
So I did go to Michael Jordan'sSteakhouse in Chicago.
Kevin Geddings (06:19):
Was that any good?
Dr. Michael Koren (06:21):
It was actually pretty good.
Kevin Geddings (06:22):
Okay.
Dr. Michael Koren (06:23):
You know I wouldn't put it in the top tier,
but it's pretty good.
And, but I but it's pretty good.
Yeah and uh, but I I did ordera filet mignon, but I ordered it
without butter.
So I was, with a heart,friendly other people and when
it came out, everybody's steakwas dripping with butter except
mine.
I felt, I felt proud of myself.
Yeah, absolutely.
Kevin Geddings (06:43):
Well, the one thing I've learned from dr corn
over the years and I share witheverybody, is everything in
moderation right.
Dr corn, you know everythingabout nothing wrong with it, you
know, that's, I'd say dr cornworld is everything in
moderation, right, dr Coren?
Exactly, you know.
Everything in moderation,nothing wrong with it.
I'd say Dr Coren, world-classcardiologist, will tell you go
ahead and enjoy that steak, justdon't enjoy it every day of the
week.
Dr. Michael Koren (06:59):
There you go.
Yeah, overindulgence is whatkills people.
Kevin Geddings (07:02):
Right.
Well, data like what you sharedwith the world in Chicago on
Monday and data that otherscientists and research experts
from around the world shared onMonday, along with all sorts of
other information that's beenwell filtered, if you will, is
available on the MedEvidencewebsite, right MedEvidencecom.
Give us a quick sense of whatthat's all about, doctor.
Dr. Michael Koren (07:21):
It is, and it's actually getting a lot of
momentum.
More and more people arewatching these podcasts and
other things where we havegroups of doctors or two doctors
talk to each other and reallybreak down different issues.
So we've had some reallyfascinating recent discussions,
for example, talking aboutwhether or not alcohol is a net
(07:43):
positive or negative from ahealth perspective.
We've had discussions aroundthe lipoprotein little, a
problem, which is this problemthat we have not been able to
deal with at all until very,very recently and multiple other
discussions.
We had a great discussion onchronic cough.
There are people out there thathave a cough that they just
(08:03):
can't get rid of.
We had a discussion about whatthat could mean and hopefully
help people.
We have clinical trials, forexample, enrolling in that as we
speak.
So MedEvidence talks about alot of things that people are
interested in, but instead oftrying to sell you something, we
have a discussion around it andthen people can glean important
insights based on theirindividual circumstances.
Kevin Geddings (08:24):
Well, it's a great resource and, of course,
totally free of charge, which isalso phenomenal and much more
reliable than just going to DrGoogle.
Check out the information atmedevidencecom and, if you can
help, share that website withother people that are exploring
various health topics.
Medevidencecom that'smedevidencecom the truth behind
the data.
(08:45):
Dr Koren, thank you very muchfor your time this morning.
We're glad that you're backsafely from Chicago and we'll
talk with you again on Monday,okay.
Dr. Michael Koren (08:52):
Sounds great.
Have a great week.
Bye-bye.
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