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Ray Kausik Part 4, PCSK9 and SGLT2 Combination Therapy

Jan 23, 2018
 

In part 4 of this Exclusive Interview, Dr. Ray Kausik talks with Diabetes in Control Publisher Steve Freed during the ADA 2017 convention in San Diego, CA about the joint effects of SGLT-2 and PCSK9 inhibitors.

Ray Kausik, MB, ChB, MD, is Professor of Public Health in the Department of Public Health and Primary Care at Imperial College London as well as Honorary Consultant Cardiologist at the Imperial College NHS Trust.

Transcript of this video segment:

Freed: You know what’s interesting about this drug is it helps to prevent cardiovascular disease and it helps to prevent death. Now what happens, and I don’t even know if you have any literature on it, but I would think that if you add an SGLT-2 to this product, that would be a huge benefit and now you’ve got two things working for you. What do we know about that?

Kausik: So that hasn’t been tested, but you are absolutely right. What we know from the SGLT-2s is that they seem to alter different types of events, so what they’re altering is heart failure death, sudden cardiac death, and they’re reducing hospitalization for heart failure in people with diabetes and established cardiovascular disease. What these drugs do is by lowering LDL cholesterol, they alter atherosclorotic cardiovascular events; they reduce strokes, they reduce non-fatal myocardial infarctions and they’ll reduce fatal myocardial infarctions. So those are events that are particularly altered by the SGLT-2 inhibitors, but you’re absolutely right. In the patient with diabetes, they’re at risk of a range of events, and you may need more than one treatment. So the patient who has left ventricular dysfunction and heart failure, who’s a diabetic, whose renal function EGFR is about 45, an SGLT-2 inhibitor (with one in particular, empagliflozin) should give you big reductions in events. But that won’t prevent your risk of having a heart attack or a stroke or a coronary death. For that, you need a drug that lowers atheroscerotic risk and that’s where PCSK9 inhibitors then would give you.

To view other segments in this video series:

Part 1: PCSK9 Inhibitor Treatment For Diabetes

Part 2: PCSK9 Effect On HDL Goal Levels

Part 3: PCSK9 Effect On Lowering Cardiovascular Death