Yes, pitavastatin is neutral with respect to insulin sensitivity, but could it still cause gut dysbiosis? Although I agree that most likely it doesn’t act on the Clostridium-UDCA-GLP1 axis mentioned in the paper as this axis seems to be the cause of statin-induced glucose intolerance.
Well, I posted before studies showing pitavastatin preventing LPS movement out of the gut and into the brain, and pita increasing the integrity of the BBB. As to gut dysbiosis I can’t find anything specific to pitavastatin, but in general the findings for statins are mixed:
Cholesterol Gallstones and Long-Term Use of Statins: Is Gut Microbiota Dysbiosis Bridging over Uncertainties?
https://www.mdpi.com/2075-4418/14/12/1234
Statin therapy is associated with lower prevalence of gut microbiota dysbiosis
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Pitavastatin Ameliorates Lipopolysaccharide-Induced Blood-Brain Barrier Dysfunction
Effect of pitavastatin on glucose, HbA1c and incident diabetes: A meta-analysis of randomized controlled clinical trials in individuals without diabetes
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Third-generation PCSK9 inhibitor approved for high cholesterol
The FDA approved lerodalcibep (Lerochol) injections for the treatment of elevated LDL cholesterol in adults, maker LIB Therapeutics announced.
A third-generation PCSK9 inhibitor, lerodalcibep is indicated as an adjunct to diet and exercise to reduce LDL cholesterol in adults with hypercholesterolemia, including heterozygous familial hypercholesterolemia.
Lerodalcibep is a recombinant fusion protein that offers more convenient dosing than the current PCSK9 inhibitors. As such, the drug marks a new pharmacological option that may help more individuals reach their guideline-recommended cholesterol targets. …
Unlike monoclonal antibodies, lerodalcibep is a smaller molecule that binds to PCSK9. Its high solubility allows for a much lower injection volume, and it has a plasma half-life of 12 to 15 days. …
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Thanks for this!
I’m on repatha, so I just looked to see how they compare. IF AI is correct, it seems Lerodalcibep is once per month vs 2x per month for repatha
Similar LCL C lowering, but it appears Lerodalcibep might lower Lp(a) more
33% vs 20-30%
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This might have been covered before (and I missed it) but what’s the benefit of using Repatha (or any of the PCSK9) compared to other cholesterol lowering meds, i.e. statins, ezetimibe etc…?
@Kelman
I believe repatha is often more powerful than statins, but I’m sure the experts will chime in.
I’m on it because I don’t feel well on statins. I am also taking BA and EZ
Most people would use the others and only go to pcsk9 if they don’t tolerate them or if they don’t bring their numbers down low enough. If it were cheaper, then perhaps there would be advantages to make it first line, but I’m not sure?
I do know statins have demonstrated they can stabilize plaques. I don’t know that repatha has shown this.
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Forgive me if this was covered further up top, but is your insurance covering the repatha? I’d like to get my hands on an economical pcsk9 inhibitor… Is there a cheap solution overseas yet? Maybe there are independent longevity doctors in the US who can now prescribe this loosely?
Fortunately, I can pop high dose statins like pez, have never noticed any side effect at all from simvastatin 40 (high dose)/ezetimibe10/bempedoic 180… Would love to add pcsk9 to this tho and shoot for as low as possible ldl
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You don’t need a special doctor for a repatha rx.
I can’t speak to your particular doc, but I’ve never had a doctor deny me anything I’ve asked for (I have good docs, I’m very assertive, and don’t ask for anything that is not appropriate for me, so my experience could of course be different)
My insurance sorta kinda covers it, but I have an 8k deductible, so I’m paying mostly out of pocket, unfortunately.
I do get a coupon from them, so for a few months per year I only pay aprox $15.
I’d see if you are eligible for the coupon and consider what some others have done… just use it on occasion to make it last?
Or perhaps your insurance is better, so it’s worth looking into .
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Since it’s a monoclonal antibody it’s unlikely costs can be much lower.
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I meant from purchasing from a generic manufacturer or India if they were available there.
I wasn’t aware of this graph. How reliable is it, and what about in the most recent years? Just curious.
Manufacturing costs might also differ depending on the mAb.
Effect of Omega-3 Dosage on Cardiovascular Outcomes
An Updated Meta-Analysis and Meta-Regression of Interventional Trials
Open access paper: https://www.mayoclinicproceedings.org/article/S0025-6196(20)30985-X/fulltext
Gemini AI Summary
Objective: To resolve the historical inconsistency regarding the cardiovascular benefits of Omega-3 fatty acids (EPA and DHA) by conducting a meta-analysis that specifically evaluates the relationship between dosage and cardiovascular outcomes.
Methods: The authors performed a systematic review and meta-regression of **40 randomized controlled trials (RCTs)**involving a combined total of 135,267 participants. They analyzed the effects of EPA and DHA supplementation on myocardial infarction (MI), coronary heart disease (CHD) events, CVD events, and mortality.
Key Findings:
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supplementation was associated with a statistically significant reduced risk of:
- Fatal Myocardial Infarction: 35% reduction (RR 0.65)
- Myocardial Infarction: 13% reduction (RR 0.87)
- CHD Events: 10% reduction (RR 0.90)
- CHD Mortality: 9% reduction (RR 0.91)
- Dose-Response: The study identified a linear dose-response relationship. An additional 1000 mg/day of EPA/DHA was associated with an additional 9% reduction in the risk of myocardial infarction (P < .001) and a 5.8% reduction in total CVD events (P < .001).
- Conclusion: Omega-3 supplementation is an effective preventive strategy for CVD, with benefits that increase with dosage. Previous conflicting studies likely failed to show benefit due to insufficient dosing.
Full analysis here: https://gemini.google.com/share/38109d243b8f
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I’m more impressed by this study:
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Midlife Mediterranean diet is associated with subclinical carotid atherosclerosis in late midlife
Conclusion
Findings underscore associations of midlife Mediterranean-style diet and lower presence of subclinical carotid atherosclerosis at Age 60 and confirm the significance of dietary interventions as potential means for cardiovascular disease prevention. The study enhances understanding of long-term dietary patterns and their link to subclinical atherosclerosis, supporting future interventions and further research.
Open Paper: https://academic.oup.com/eurjpc/article/32/16/1614/8084907?login=false
Key Findings
- MDS & Plaque: High or midrange cumulative MDS across midlife was significantly associated with a reduced prevalence of carotid plaque at age 60 (OR ~0.72–0.74) compared to low adherence.
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Sex-Specific Divergence:
- Women: The association between higher MDS and reduced plaque was strongly driven by women (OR: 0.41).
- Men: A significant association between MDS and CIMT (wall thickness) was observed only in men.
- Null Result for HDS: The generic “Healthy Diet Score” showed no significant association with either plaque or CIMT, suggesting that specific components of the Mediterranean diet (e.g., lipid profile modulation, anti-inflammatory properties) are superior to general “healthy eating” guidelines for this specific vascular outcome.
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I believe so. Whenever I’ve taken it, I have noticed zero side effects (besides dark stools) and it reliably increased my ferritin quickly. It can be taken with or without food and still be well absorbed.
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I think a good sleep mask is critical. I wear one every night and bring it on every trip I go on.
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Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality worldwide, and LDL-cholesterol (LDL-C) plays a fundamental causal role. The classic INTERHEART study showed that dyslipidemia, characterized by an elevated apolipoprotein B/apolipoprotein AI ratio, was the risk factor with the highest population-attributable risk (PAR) for myocardial infarction (MI) (PAR 49.2% for the top four quintiles vs. the lowest quintile).
Despite strong evidence supporting the benefits of statins in reducing ASCVD, misinformation about this therapy continues to spread widely on social media, potentially increasing the risk of clinical events for the population. A Danish study showed that early statin discontinuation was more common after exposure to negative media coverage and was linked to a higher risk of MI and ASCVD death. Misinformation is a threat that needs to be fought because it causes delays in starting lipid-lowering treatment, denying many patients its benefits.
LDL-cholesterol lowering, the earlier the better: lessons from the real world
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AI and Genetics Reveal Early Risk Signals for Aortic Stenosis
Aortic stenosis is one of the most common and deadly forms of heart valve disease, affecting millions worldwide. The condition develops gradually as the aortic valve narrows, eventually limiting blood flow from the heart. Yet despite its prevalence, medicine still lacks drugs that can prevent or slow its progression. Once the disease becomes severe, patients are left with only one option: valve replacement through surgery or catheter-based procedures.
A new study from researchers at UC San Francisco and the Broad Institute of MIT and Harvard suggests that this reactive approach may not be inevitable. By combining artificial intelligence–based imaging analysis with large-scale human genetics, the team has uncovered early genetic signals that shape aortic valve function long before clinical disease develops. The findings, published in Nature Genetics, point toward a future in which aortic stenosis could be detected, and potentially intercepted, years earlier.
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