
How Low Do You Go?
Clinical Updates in LDL-C Management
Meeting Slides

Guidelines
2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.
Stone NJ, et al. Circulation. 2014;129(25 suppl 2):S1-S45.
National Lipid Association Recommendations For Patient-Centered Management Of Dyslipidemia: Part 1-Full Report.
Jacobson TA, et al. J Clin Lipidol. 2015;9(2):129-169.
2016 ACC Expert Consensus Decision Pathway on the Role of Non-Statin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk.
Lloyd-Jones DM, et al. J Am Coll Cardiol. 2016;pii:S0735-1097(16)32398-1.
Patient Resources
Centers for Disease Control and Prevention
High cholesterol education materials for patients about high cholesterol.
American Heart Association
Resources on managing hyperlipidemia means controlling cholesterol and triglycerides.
The FH Foundation
A patient-centered nonprofit organization dedicated to education, advocacy, and research on familial hypercholesterolemia (FH).
Clinical Assessment Tools
ASCVD Risk Estimator
A companion tool to the 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk and the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults (Goff DC, et al. JACC. 2014;633(25):2935-2959).
Reynolds Risk Score
A framework for calculating heart and stroke risk for women and men (Ridker PM, et al. JAMA. 2007;297:611-619).
Risk Assessment Tool for Estimating 10-year Risk of Having a Heart Attack
A tool developed based on the Framingham Heart Study (Wilson PW, et al. Circulation. 1998;97(18):1837-1847).
Suggested Readings
Familial hypercholesterolemia: screening, diagnosis and management of pediatric and adult patients: clinical guidance from the National Lipid Association Expert Panel on Familial Hypercholesterolemia.
Goldberg AC, et al. J Clin Lipid. 2011;5(3 Suppl):S1-S8
Management of familial hypercholesterolemia: a review of the recommendations from the National Lipid Association Expert Panel on Familial Hypercholesterolemia.
Robinson JG. J Manage Care Pharm. 2013;19(2):139-149.
Understanding Statin Use in America and Gaps in Patient Education (USAGE): an internet-based survey of 10,138 current and former statin users.
Cohen JD, et al. J Clin Lipidol. 2012;6(3):208-215.
An assessment by the Statin Muscle Safety Task Force: 2014 update.
Rosenson RS, et al. J Clin Lipidol. 2014;8(3Suppl):S58-S71.
Anti-PCSK9 antibody effectively lowers cholesterol in patients with statin intolerance: the GAUSS-2 randomized, placebo-controlled phase 3 clinical trial of evolocumab.
Stroes E, et al. Am J Cardiol. 2014;63(23):2541-2548.
Monotherapy with the PCSK9 inhibitor alirocumab versus ezetimibe in patients with hypercholesterolemia: results of a 24 week, double-blind, randomized Phase 3 trial.
Roth EM, et al. Intern J Cardiol. 2014;176(1):55-61.
Anti-PCSK9 monotherapy for hypercholesterolemia: the MENDEL-2 randomized, controlled phase III clinical trial of evolocumab.
Koren MJ, et al. J Am Coll Cardiol. 2014;63(23):2531-2540.
Efficacy and safety of alirocumab in reducing lipids and cardiovascular events.
Robinson JG, et al. N Engl J Med. 2015;372(16):1489-1499.
Efficacy and safety of evolocumab in reducing lipids and cardiovascular events.
Sabatine MS, et al. N Engl J Med. 2015;372(16):1500-1509.
Efficacy and safety of alirocumab vs ezetimibe in statin-intolerant patients, with a statin rechallenge arm: The ODYSSEY ALTERNATIVE randomized trial.
Moriarty PM, et al. J Clin Lipid. 2015;9:758-769.
Efficacy and Tolerability of Evolocumab vs Ezetimibe in Patients With Muscle-Related Statin Intolerance: The GAUSS-3 Randomized Clinical Trial.
Nissen SE, et al. JAMA. 2016;315(15):1580-1590.
ODYSSEY FH I and FH II: 78 week results with alirocumab treatment in 735 patients with heterozygous familial hypercholesterolaemia.
Kastelein JJP, et al. Euro Heart J. 2015;36(43):2996-3003.
PCSK9 inhibition with evolocumab (AMG 145) in heterozygous familial hypercholesterolaemia (RUTHERFORD-2): a randomised, double-blind, placebo-controlled trial.
Raal FJ, et al. Lancet. 2015;385(9965):331-340.
Inhibition of PCSK9 with evolocumab in homozygous familial hypercholesterolaemia (TESLA Part B): a randomised, double-blind, placebo-controlled trial.
Raal FJ, et al. Lancet. 2015;385(9965):341-350.
Alirocumab as Add-On to Atorvastatin Versus Other Lipid Treatment Strategies: ODYSSEY OPTIONS I Randomized Trial.
Bays H, et al. J Clin Endocrinol Metab. 2015;100(8):3140-3148.
Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes.
Cannon CP, et al. N Engl J Med. 2015;372(25):2387-2397.
Achievement of dual low-density lipoprotein cholesterol and high-sensitivity C-reactive protein targets more frequent with the addition of ezetimibe to simvastatin and associated with better outcomes in IMPROVE-IT.
Bohula EA, et al. Circulation. 2015;132(13):1224-1233.
Safety and efficacy of anti-PCSK9 antibodies: a meta-analysis of 25 randomized, controlled trials.
Zhang XL, et al. BMC Medicine. 2015;13(123):1-18.

Scientific Insights Into LDL-C, PCSK9, and CV RISKS
James A. Underberg, MD
Relevant Resources
Mechanism-Based Strategies to Achieve Patient-Centered Care
Patient-Centered Management of Hyperglycemia in Primary Care
Integrating GLP-1 Receptor Agonists Into Multimodal Treatment Regimens
Translating Research Into Practice
Translating Reseach Into Practice
Overcoming Diagnostic Barriers and Optimizing Long-Term Patient Outcomes
Overcoming Pain and Gastrointestinal Distress to Improve Patient Outcomes
Evidence-Based Strategies for Improved Patient Outcomes
Discussions and Debates Around GLP-1 Receptor Agonists
Evolving Roles of GLP-1 Receptor Agonists
Proactive Diagnosis and Targeted Management
Differential Diagnosis and Comprehensive Management Strategies
Individualizing Evidence-Based Care
Optimizing Maintenance Therapy Across Healthcare Settings
Evolving Strategies for Diagnosis and Long-Term Management
Consensus and Controversies for Responsible Opioid Prescribing
Best Practices in Combination Therapy
Evolving Approaches to Insulin Based Therapy
Best Practices in Diagnosis and Management
Improving Outcomes for Patients with COPD
New Strategies for Insulin Replacement Therapy
Consensus and Controversies Around Intensifying Noninsulin Therapy
Improving Comprehensive Patient Care
Identifying Patients and Tailoring Therapy
Collaborative Approaches to Guideline-Concordant Patient Care
New Strategies for Individualizing Long-term Care
A Focus on Patients With Opioid-Induced Constipation
Consensus and Controversies Across the Spectrum of Patient Presentations
Evolving Treatment Algorithms and Expert Perspectives on Biosimilars
Evolving Best Practices to Optimize Outcomes
The PCP’s Role in Timely Recognition and Referral
An Evolving Role for Combinations of Injectable Antihyperglycemic Therapies
Integrating PCSK9 Inhibitors Into Hypercholesterolemia Management
Evolving Roles of GLP-1 Receptor Agonists
Differential Diagnosis, Multidisciplinary Management, and Patient Engagement
Key Issues Impacting OB/GYN Practice
Volume II: Expanding Evidence for the Role of Rapid ART Initiation in HIV Practice
Looking Beyond Hemoglobin A1c
Improving Patient Outcomes Through Shared Clinical Decision Making
What You Need to Know
Mechanistic Insights and Evolving Treatment Options
Clinical Resource Center
Implications for PCSK9 Inhibitors in Clinical Practice
A Case-Based Conversation on Managing Asthma and Chronic Rhinosinusitis With Nasal Polyposis
The Clinical and Utilization Benefits of Exacerbation Prevention
A PrEP Primer
A Foundation for Managed Care
Cardiovascular and Renal Outcomes With SGLT2 Inhibitors
Best Practices for Primary Care
New Paths to Chronic Pain Management
What the Pharmacist Needs to Know about PrEP
Unlocking Novel Paths to Patient Care
The Increasing Role of JAK Inhibitors
Preventing COPD Exacerbations to Improve Outcomes
A Whole Patient Case Series
Getting on the Fast Track to Identify AxSpA
Establishing Clinical Readiness Through Mentored Learning
Interdisciplinary Strategies for Adult and Pediatric Patients
Interdisciplinary Management of Eosinophilic Esophagitis and Hereditary Angioedema
Reducing LDL-C and a Lifetime of Cardiovascular Risk
Updates, Clinical Scenarios, and Future Directions
A Multidisciplinary Look at Early Diagnosis and Management
Best Practices for Diagnosis and Management
An Update on Best Practices
New Avenues to Pre-Exposure Prophylaxis
Are You Aware of New Blood-Based Multi-Cancer Screening Tools
A Look at the Changing HIV Playing Field
A “How To” Series Spanning Policy to Practice
Test Your Mastery!
Building Bridges to Reach People who Inject Drugs with the Goal of Employing PrEP for HIV Prevention
Strengthening Your Knowledge of Blood-Based Screening Tools
Bringing HIV Prevention to a New Level
Optimizing HIV Prevention in Primary Care
What You Need to Know About New Blood-Based Screening Tools
Monoclonal Antibodies for the Prevention and Treatment of COVID-19
Multidimensional Outcomes With SGLT2 Inhibitors
New Avenues to Improve Patient Outcomes
Exploring New Treatment Avenues in Nonadvanced Systemic Mastocytosis
Practical Updates on the 2023 GOLD Guidelines
A Phone-a-Friend CME Series – Volume 2
Incorporating New Data and Updated Guidelines Into Daily Practice
Focus on Psoriasis
Capitalizing on BCMA-Directed Therapies