Oral Arguments: Enlicitide, the first oral PCSK9 inhibitor for dyslipidemia

Cardiovascular disease remains a leading cause of death, while evolving guidelines and increasingly aggressive LDL cholesterol targets are changing how clinicians approach lipid management. Jodi Martinez, Pharmacist Clinical Specialist in Cardiology at the University of Colorado Hospital, part of UCHealth, joins Kerry Schwarz, Senior Clinical Manager for Evidence Based Medicine and Outcomes with the Vizient Center for Pharmacy Practice Excellence, to explore the emerging role of enlicitide in lipid management. They discuss the evidence behind its approval, its potential to expand patient access and where this first oral PCSK9 inhibitor may fit alongside existing therapies.   Guest Speaker: Dr. Jodi Martinez, Pharm.D., BCPS, BCCP, HF-CERT Pharmacist Clinical Specialist in Cardiology University of Colorado Hospital, UCHealth   Host:  Dr. Kerry Schwarz, Pharm.D., MPH Senior Clinical Manager, Evidence-Based Medicine and Outcomes Vizient Center for Pharmacy Practice Excellence    Show Notes:  [01:26] The limitations of current lipid management and why many high-risk patients still struggle to reach increasingly aggressive LDL cholesterol targets. How cost, prior authorization requirements and step therapy can create barriers to accessing injectable PCSK9 therapies. [03:27] The evidence behind enlicitide and findings from the CORALreef clinical trial supporting its FDA approval. How enlicitide performed across LDL cholesterol, non-HDL cholesterol, ApoB and lipoprotein(a) endpoints, and why cardiovascular outcomes remain an important unanswered question. [06:37] An oral PCSK9 inhibitor could expand access by offering an alternative to specialty injectable therapies. Why retail pharmacy availability, cost and greater prescribing flexibility could help more patients receive intensive lipid lowering therapy. [08:11] The potential barriers to enlicitide adoption, including delays in formulary review, insurance coverage and the administrative burden placed on clinicians. The lack of published cardiovascular outcomes could influence payer coverage, formulary placement and early uptake. [10:15] Station remains the cornerstone of lipid management and where enlicitide may ultimately play a role Clinicians may consider the amount of LDL reduction a patient needs when choosing among available therapies.   Links and Resources: 2022 ACC Expert Consensus Decision Pathway on the Role of Nonstatin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk: A Report of the American College of Cardiology Solution Set Oversight Committee 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines   Subscribe Today! Apple Podcasts Spotify YouTube RSS Feed