In part 3 of this Exclusive Interview, Dr. Aaron Vinik talks with Diabetes in Control Publisher Steve Freed during the AACE 2017 convention in Austin, Texas about the hurdle of trying to reverse arteriosclerosis.
Aaron Vinik, MD, PhD, FCP, MACP is the Director of Research and Professor of Medicine, Pathology and Neurobiology at Eastern Virginia Medical School in Norfolk, Virginia. His research and recent discovery of a gene, INGAP, could prove to be a cure for diabetes.
Transcript of this video segment:
Steve Freed: So in the LEADER study, arteriosclerosis, they found that it was able to prevent it in some way, can we reverse it?
Dr. Vinik: Oh, dearie me. You can. I mean, following the LEADER study and following EMPA-REG we’ve now had a new excitement of people who have extreme risk of cardiovascular disease and we’re learning that from there, as you will see in the position statement by AACE, we need to be more aggressive in lowering your LDL level. Most people were satisfied when we came from 130 down to 100, from 100 to 70 and then a question of whether we should be at 54 or even lower. You have to think about that because when you come out of your mother’s womb, your LDL level is around 20. And you’ve got blood vessels that are as smooth as a baby’s bottom and that’s what you want, you want your blood vessels to look like that. And can we go back and get our LDL levels around 20 or very low? We were all terrified of doing that, we thought terrible things would happen to you if we lower your LDL and you don’t get enough cholesterol in your body to synthesize everything you need to synthesize, like steroids for example. So, what transpires from that, is we now have agents like…I think you’ve spoken to a number of other people but, the PSCK-9 drugs. These drugs are monoclonal antibodies and they are enhancing the breakdown of LDL and the breakdown of LDL when it’s coupled with its receptor, so that it is eliminated from the body. The numbers that you can achieve with LDL are unbelievable. You are getting a 70-80% reduction in LDL, but that’s not the key thing. The key thing is if I take serial pictures on you and I look at your carotid internal thickness or your carotid calcification scores and I put you on one of these drugs, I can change that. So in answer to your question can we reverse it? Yes now, we’re beginning to reverse it for the first time and that’s very exciting. It’s a little disappointing that we have to get a drug that you can’t get pre-approval for the darn thing and you fight like hell to get it. I know, I’m on it. I’m now on one of those drugs. Me personally, because I’ve gone through using a statin that interfered with my ballroom dancing and Argentine Tango, because I used to cramp like hell and there was nothing I could do. I did all the usual things but there was nothing I could do that would stop the cramping, so I just stopped the drug and watched my LDL climb to levels I didn’t even want to look at anymore. So with the advent of this new class of drugs, I called my primary care physician and said, “I’ll guarantee you one thing.” He said, “what’s that?” I said, “You’re going to write a prescription for this and you’re going to approve it, and you’re right to do that, but I guarantee you that it’s not going to be approved.” He says, “How’d you know?” I say, “I’ve been granting prescriptions for this and I have been having a huge battle.” So he writes a very nice letter and it comes back saying, “ Well, it appears to us that Dr. Vinik hasn’t had a heart attack yet and when he has a heart attack, then we will consider approving him for the drug.” This is a prevention drug, they want me to have a heart attack and die first. Isn’t that beautiful?
To view other segments in this video series:
Part 1: INGAP Research
Part 2: Heart Failure and Diabetes