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Robert S. Rosenson, MD

Robert Rosenson, MD

Professor of Medicine (Cardiology)

Mount Sinai Icahn School of Medicine

Director, Cardiometabolics Unit

Mount Sinai Heart Institute

New York, NY

From a medical cardiologist’s perspective, which patient subgroups in your practice do you feel represent ideal candidates for deployment of PCSK9 inhibitors to lower LDL-C levels, based on the results of the ODYSSEY Outcomes and FOURIER Trials?

From a medical cardiologist’s perspective, which patient subgroups in your practice do you feel represent ideal candidates for deployment of PCSK9 inhibitors to lower LDL-C levels, based on the results of the ODYSSEY Outcomes and FOURIER Trials?

Robert Rosenson, MD

Based on the ODYSSEY Outcomes Trial, specifically the low LDL-C levels achieved without adverse consequences, what target level of LDL-C do you recommend in medically managed patients with moderate-to-high risk features of ASCVD?

Based on the ODYSSEY Outcomes Trial, specifically the low LDL-C levels achieved without adverse consequences, what target level of LDL-C do you recommend in medically managed patients with moderate-to-high risk features of ASCVD?

Robert Rosenson, MD

Within the context of a medical cardiology practice, especially navigating among patients with inadequate responses to ezetimibe and/or statin intolerance or resistance, how do you sequence PCSK9 inhibitors in your LDL-C lowering treatment plans?

Within the context of a medical cardiology practice, especially navigating among patients with inadequate responses to ezetimibe and/or statin intolerance or resistance, how do you sequence PCSK9 inhibitors in your LDL-C lowering treatment plans?

Robert Rosenson, MD

How do you interpret the reduction in associated overall mortality seen with alirocumab in the ODYSSEY Outcome Trial as compared to the lack of such findings—at least prior to results for the extension phase in FOURIER —for the evolocumab trial?

How do you interpret the reduction in associated overall mortality seen with alirocumab in the ODYSSEY Outcome Trial as compared to the lack of such findings—at least prior to results for the extension phase in FOURIER —for the evolocumab trial?

Robert Rosenson, MD

Assuming optimization of patient outcomes, rather than cost, is the primary driver governing use of PCSK9 inhibitors, which patients in a medical cardiology practice would you single out for this therapy, and to achieve what LDL-C target levels?

Assuming optimization of patient outcomes, rather than cost, is the primary driver governing use of PCSK9 inhibitors, which patients in a medical cardiology practice would you single out for this therapy, and to achieve what LDL-C target levels?

Robert Rosenson, MD

As shown in the ODYSSEY Outcomes Trial, alirocumab lowers Lp(a). FOURIER also demonstrated similar results with evolocumab. What are the implications of these findings and how do you translate the results into medical cardiology practice?

As shown in the ODYSSEY Outcomes Trial, alirocumab lowers Lp(a). FOURIER also demonstrated similar results with evolocumab. What are the implications of these findings and how do you translate the results into medical cardiology practice?

Robert Rosenson, MD

Assuming the community cardiologist is able to obtain reimbursement for PCSK9 inhibitors, in what segment of your patient population do you think this therapy is most under-utilized? How do price reductions for these agents affect your approach?

Assuming the community cardiologist is able to obtain reimbursement for PCSK9 inhibitors, in what segment of your patient population do you think this therapy is most under-utilized? How do price reductions for these agents affect your approach?

Robert Rosenson, MD

How do you recommend managing the patient who has a major CV/thrombotic event—a recent MI—who is on a statin and has an LDL-C level of 60-70 mg/dL? How does the ODYSSEY Outcome Trial and/or IVUS studies help you assess the role of a PCSK9 inhibitor?

How do you recommend managing the patient who has a major CV/thrombotic event—a recent MI—who is on a statin and has an LDL-C level of 60-70 mg/dL? How does the ODYSSEY Outcome Trial and/or IVUS studies help you assess the role of a PCSK9 inhibitor?

Robert Rosenson, MD

In the setting of a medical cardiology practice, to what extent is statin-induced muscle intolerance an important cause of poor statin adherence, increased healthcare costs, and increased cardiac event rates?

In the setting of a medical cardiology practice, to what extent is statin-induced muscle intolerance an important cause of poor statin adherence, increased healthcare costs, and increased cardiac event rates?

Robert Rosenson, MD

What percentage of patients have statin muscle intolerance based on the criteria you and your colleagues have developed? Why is there a disconnect between the prevalence of statin muscle intolerance vs the results reported in major trials?

What percentage of patients have statin muscle intolerance based on the criteria you and your colleagues have developed? Why is there a disconnect between the prevalence of statin muscle intolerance vs the results reported in major trials?

Robert Rosenson, MD

Why is down-titration from a high-intensity statin dose potentially problematic, and what are the pragmatic implications as they relate to PCSK9 inhibitor use in patients who cannot achieve optimal CV reduction with statin therapy?

Why is down-titration from a high-intensity statin dose potentially problematic, and what are the pragmatic implications as they relate to PCSK9 inhibitor use in patients who cannot achieve optimal CV reduction with statin therapy?

Robert Rosenson, MD