The Importance of Early Nonstatin Initiation in Lipid Management: Reducing CV Risk by Achieving LDL-C Targets Beyond Statin Therapy

Audience: This activity is intended for healthcare professionals practicing in managed care environments.

This activity is supported by educational grants from
Merck Sharp & Dohme LLC and Novartis Pharmaceuticals Corporation

Description:
Over 73 million adults in the United States have hypercholesterolemia and are at elevated risk for atherosclerotic cardiovascular disease. Low-density lipoprotein cholesterol (LDL-C) is a primary mediator of the development of heart disease and plays a key role in determining cardiovascular risk and overall health management. Early and aggressive lowering of LDL-C reduces the risk of atherosclerotic cardiovascular disease (ASCVD) events in patients with hypercholesterolemia, and every 1.0 mmol/L reduction in LDL-C is estimated to lead to ~20% reduction in the relative risk of major cardiovascular events. Statins are the mainstay of hypercholesterolemia management, but many patients do not tolerate statin-based treatment, which ultimately leads to medication nonadherence, ASCVD events, and higher healthcare costs. On the other hand, some patients, including those with pre-existing ASCVD or severe hypercholesterolemia, do not reach recommended LDL-C treatment targets despite intensive statin therapy. Non-statin agents can be useful for patients who inadequately respond to or are intolerant of statin therapy. Fortunately for patients with high LDL-C, several new treatments have recently become available as an adjunct or instead of statin therapies. These options, including agents that inhibit production of PCSK9, have shown improved efficacy and safety, offering patients the potential for improved outcomes and quality of life. With so many new options becoming available in recent years that have shown the ability to lower LDL-C and reduce cardiovascular risk in lipid management, it is critical that physician medical directors, payers, cardiologists, pharmacy directors, pharmacists, nurse case managers and other HCPs are updated on the comparisons among safety, efficacy, and administration data on these options, possible strategies for implementing them into the treatment paradigm, and key points that managed care professionals need to know, which will ultimately improve both clinical and economic outcomes.

Upon completion of this activity, participants will be able to:

• Assess current practice patterns and barriers to guideline-directed LDL-C monitoring and treatment escalation for patients with hyperlipidemia and/or ASCVD
• Evaluate nonstatin therapies for lowering persistently elevated LDL-C based on their mechanism of action, administration, efficacy and safety
• Review the latest clinical data on the early addition of nonstatin therapy following maximally tolerated statin therapy, including the role of newer and emerging PCSK9 inhibitors
• Identify patients who may be appropriate candidates for PCSK9 inhibitors based on expert consensus and evidence-based guidelines
• Explore recent long term clinical studies showing long term efficacy and safety of nonstatin therapy following maximally tolerated statin therapy
• Apply multidisciplinary strategies to overcome barriers to timely treatment escalation to nonstatin therapies for appropriate patients, including collaboration with managed care professionals

Faculty:
Michael Miller, MD, FACC, FAHA
Cardiologist and Professor of Medicine
University of Pennsylvania
Chief of Medicine
Corporal Michael J Crescenz VA Medical Center

Disclosure Information:
As accredited providers, NAMCP and AAMCN must ensure balance, independence, objectivity, and scientific rigor in all of their activities. All faculty participating in this activity are required to disclose to NAMCP/AAMCN any financial relationships with ineligible companies. NAMCP/AAMCN in turn discloses all relevant financial conflicts to the learners. NAMCP/AAMCN disclosure policy adheres to The Standards for Integrity and Independence in Accredited Continuing Education. All relevant conflicts of interest have been mitigated prior to the commencement of the activity. See below for conflicts of interest.

Disclosures (Relevant Financial Relationships with Ineligible Companies in the Last 24 Months):
Dr. Miller has no relevant financial relationships with ineligible companies to disclose.

Planning Committee Disclosures (Relevant Financial Relationships with Ineligible Companies in the Last 24 Months):
Bill Williams, MD has no relevant financial relationship with an ineligible company to disclose.
Jeremy Williams has no relevant financial relationship with an ineligible company to disclose.
Jacqueline Cole, RN, MS, CMCN has no relevant financial relationship with an ineligible company to disclose.

NAMCP and/or the presenter has copyright or has received permissions for use of materials provided in this activity.

Accreditation & Designation
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the National Association of Managed Care Physicians (NAMCP) and American Association of Managed Care Nurses (AAMCN). The National Association of Managed Care Physicians is accredited by the ACCME to provide continuing medical education for physicians.

NAMCP designates this enduring material for a maximum of 1 AMA PRA Category 1 credit(s)^TM. Each physician should claim credit commensurate with the extent of their participation in the activity.

The American Association of Managed Care Nurses is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

Nurses who complete this activity and achieve a passing score will receive 1 hour in nursing continuing professional development.

This activity has been approved by the American Board of Managed Care Nursing for 1.0 contact hours toward CMCN recertification requirements.

NAMCP and/or this website do not provide medical advice, diagnosis, or treatment. NAMCP does not endorse or imply endorsement of the content on any linked website. This website is to be used as an informational resource. With any health-related concern, consult with your physician or healthcare professional.

This activity is supported by educational grants from
Merck Sharp & Dohme LLC and Novartis Pharmaceuticals Corporation

NAMCP and/or this website does not provide medical advice, diagnosis or treatment. NAMCP does not endorse or imply endorsement of the content on any linked website. This website is to be used as an informational resource. With any health related concern, consult with your physician or healthcare professional.