, held August 29-30 in Newport Beach, California, Lisa Swanson, MD, a board-certified pediatric dermatologist at Ada West Dermatology in Meridian, Idaho, who is on staff at St. Luke's Children's Hospital in Boise, presented a talk titled ‘Failure Is the Stepping Stone to Success.’

Swanson spoke in an on-site interview with

’s editorial team on the topic of how she pushed dermatologists and other clinicians to treat setbacks as a source of direction rather than something to avoid. 

How Failure Is the Stepping Stone to Success, With Lisa Swanson, MD

 this was her first LEADderm conference, and she plans to attend every year going forward. She said the location and content combined to make her feel like a better leader already, even before delivering her own talk. She said the blend of leadership content and destination setting was unlike other dermatology meetings she attends.

The idea had sat in a notes app on Swanson's phone for years before Jennifer Soung, MD, the founder of LEADderm, invited her to bring it to the conference after hearing her describe it informally. Swanson said the invitation moved the concept from something she had been quietly workshopping into content she actually had to build and deliver. Once committed, she prepared by reading extensively about failure while traveling to conferences, an unusual sight she said drew curious looks from fellow travelers.

"We all fail. Everyone fails. But we need to be able to look at it positively, learn from the experience, let it empower us to keep going, and gain some resilience and grit," Swanson said.

Swanson said her talk uses examples of well-known successful people who experienced failure in their own careers, framing setbacks as universal rather than exceptional. She said dermatologists should expect moments of stumbling and treat them as material for growth instead of evidence of inadequacy.

Swanson said failure can point in two directions: it can build curiosity and new skills, fueling a desire to keep pursuing a given path, or it can signal a path is not the right fit and a new direction is needed. Either way, she said the setback becomes a tool for self-improvement rather than a reason to stop. She described failure as the experience most likely to teach dermatologists the most over the course of a career.

Editor's Note: This transcript has been edited for grammar and clarity using artificial intelligence tools. Swanson had no relevant disclosures of note.

LEADderm. About LEADderm: the missing curriculum. leadderm.org.

Conference Preview: 2026 LEADderm Conference in Newport Beach, CA. HCPLive. 

https://www.hcplive.com/view/conference-preview-2026-leadderm-conference-newport-beach-ca

Videos

Lisa Swanson, MD, on treating professional failure as a source of direction and resilience in her LEADderm 2026 talk.

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 conference coverage page features articles, videos, and expert-led live coverage from major medical meetings throughout the year.

Adam Friedman, MD, professor and chair of 

 at the George Washington University School of Medicine & Health Sciences in Washington, DC, traces dermatology's yes-first culture back to residency competition, before trainees ever start their careers.

, held August 29-30 in Newport Beach, California, Friedman said the pressure to say yes takes root long before a dermatologist has any leadership responsibilities to manage.

Competition, Burnout, and the Cost of Always Saying 'Yes' as a Clinician

Friedman said dermatology's match rate has tightened since he entered the field, citing a rate of about 46% last year compared with roughly 60% when he applied. He said the competitive pressure conditions applicants, and later residents, to say yes to nearly everything just to be seen as part of the field's inner circle.

The mindset does not stop once residency begins. Friedman said residents who already hold an MD and a training license, and who are already seeing patients, still operate as though they need to prove they belong.

"Even where I am in my career, sometimes I think of myself still in that position of trying to get to that cool club, so to speak. It gives you a little bit of anxiety that pushes you to say yes, even when you probably shouldn't," Friedman said.

Friedman said no one ever hands trainees a green flag for when it becomes acceptable to slow down, since the message throughout training is simply to keep saying yes. He said the alternative is not always an outright no, but sometimes telling someone he would love to help, just not right now.

Friedman previewed a LEADderm 2026 product theater session built around the same skill: he will present alongside a faculty member he has never met, delegating slides to each other in real time with no advance rehearsal. He said the format mirrors real-world negotiation dermatologists face with medical assistants, practice managers, residents, and even C-suite executives, all without the luxury of preparation time. Friedman said the outcome is not scripted, calling the unpredictability part of what makes the exercise a genuine test of adaptability rather than a rehearsed showcase.

Editor's Note: This transcript has been edited for grammar and clarity using artificial intelligence tools. Friedman had no relevant disclosures of note.

Friedman A. Tips on Saying 'No' as a Dermatology Leader, With Adam Friedman, MD. HCPLive. August 29, 2026. 

https://www.hcplive.com/view/tips-saying-no-as-dermatology-leader-adam-friedman-md

Adam Friedman, MD, traces dermatology's yes-first culture to residency competition, previewing an unrehearsed LEADderm 2026 negotiation exercise.

, held August 29-30 in Newport Beach, California, Adam Friedman, MD, FAAD, professor and chair of 

 at the George Washington University School of Medicine & Health Sciences in Washington, DC, led a table discussion on a skill he says gets little attention in clinical training: saying no.

 at the meeting, Friedman spoke on how he built the session around what he calls the power of yes, and even more so, the power of no. He said the topic doubles as a chance for self-reflection, since he considers himself terrible at saying no himself.

Tips on Saying 'No' as a Dermatology Leader, With Adam Friedman, MD

LEADderm, founded by Jennifer Soung, MD, was designed to address what organizers call dermatology's missing curriculum, skills such as mentorship, negotiation, and practice management rarely covered in clinical training. Friedman built his table discussion around his own struggle with overcommitment as its starting point, framing career growth as a series of choices about where limited time goes.

"The biggest issue for any of us full-on yes responders is we're afraid if we say no, the opportunities disappear. I can tell you that is absolutely not true, unless you say no in the wrong way, which is also very possible," Friedman said.

Friedman said early-career dermatologists should say yes to nearly everything, since even small opportunities can open unexpected doors. As responsibilities and leadership roles accumulate, he said the same habit dilutes a person's attention across too many commitments and starts undermining their reputation. He added this is not multitasking, since real multitasking does not exist, only a gradual erosion of focus.

His first tip for saying no: never answer on the spot. Friedman recommends buying time to weigh whether an opportunity serves a career or personal goal, and whether it would energize rather than drain. His second approach borrows from shared decision-making in patient care, looping the person who made the request back into the decision instead of delivering an outright no.

Friedman said the approach shifts the burden of refusing away from the dermatologist alone, since the person asking often reaches the same conclusion independently. He added the payoff is being better respected for giving fewer commitments full attention, rather than spreading effort across too many and showing the request was considered seriously rather than dismissed.

Adam Friedman, MD, discusses saying no strategically as a career skill in a LEADderm 2026 table talk on managing opportunities.

Patrick Campbell is the editorial director of HCPLive. Patrick has spent years spearheading coverage surrounding cardiometabolic health and rheumatic disease for MJH Life Sciences. Before joining MJH Life Sciences in 2019, he spent time as a beat reporter and/or multimedia specialist with the Pocono Record, Star News Group, and NJ Advance Media. He is the executive producer for multiple HCPLive podcasts, including Diabetes Dialogue, Don't Miss a Beat, Kidney Compass, Medical Ethics Unpacked, The Medical Sisterhood, and Skin of Color Savvy. 


Follow him on Twitter @RealPatCampbell or reach him via email at PCampbell@mjhlifesciences.com.

One year of bempedoic acid-based therapy was associated with a 17.1% relative reduction and a 4.8% absolute reduction in predicted 10-year 

, according to new analyses from the real-world MILOS study presented at the 

European Society of Cardiology (ESC) Congress 2026

, according to an announcement from Daiichi Sankyo.

What did the MILOS study find about bempedoic acid and cardiovascular risk?

An analysis of 960 at-risk patients estimated that 1 year of bempedoic acid-based therapy translated into a 17.1% relative reduction and a 4.8% absolute reduction in predicted 10-year cardiovascular risk.

Does bempedoic acid work similarly in women and men?

Yes, real-world data showed bempedoic acid or its fixed-dose combination with ezetimibe produced relative LDL-C reductions of 31% in women and 25% in men, with similar rates of treatment-related adverse events between sexes.

Is bempedoic acid effective in patients with diabetes?

Yes, MILOS data showed mean relative LDL-C reductions of at least 24.9% regardless of glycemic status, with comparable increases in goal attainment across patients with diabetes, prediabetes, and normoglycemia.

According to the company, the new MILOS analyses extend prior randomized-trial evidence for bempedoic acid, including CLEAR Outcomes, into multinational routine-care populations, quantifying how real-world LDL-C reductions translate into projected long-term cardiovascular benefit across patient subgroups including sex and glycemic status.

“The clinical relevance of this new data is clear,” said Klaus G. Parhofer, MD, professor of endocrinology and metabolism, University of Munich. “These results reinforce physicians’ confidence in using bempedoic acid and its combination with ezetimibe in real-world clinical practice, across a broad range of patient types, including in people with diabetes. The confirmation from real-world data gives us confidence to use bempedoic acid, so that we can better manage our at-risk patients.”

MILOS study design and predicted cardiovascular risk reduction

MILOS is an ongoing, multinational, European observational study (NCT04579367) evaluating the real-world effectiveness and safety of bempedoic acid, administered alone or as a fixed-dose combination with ezetimibe, in adults with primary hypercholesterolemia or mixed dyslipidemia, with sites in Austria, Belgium, Germany, Italy, the Netherlands, Spain, Switzerland, and the UK.

 In an analysis of 960 at-risk patients with a mean age of 66.8 years, most classified at high or very high cardiovascular risk with established atherosclerotic cardiovascular disease, mean predicted 10-year cardiovascular risk was 28.9% before treatment initiation, estimated using SCORE2, SCORE2-OP, or the REACH equation depending on ASCVD status.

Mean LDL-C reduction from baseline to 1-year follow-up was 0.88 mmol/L, translating to an estimated absolute risk reduction of 4.8% (SD, 6.7) and a relative risk reduction of 17.1% (SD, 20.5) in predicted 10-year cardiovascular risk, with directionally consistent findings across countries (relative risk reduction range, 14%-24%).

Patients at higher baseline cardiovascular risk were predicted to derive greater absolute risk reduction with treatment.

 Investigators applied Cholesterol Treatment Trialists’ methodology to translate individual LDL-C changes into relative risk reductions per mmol/L decrease, with probabilistic sampling used to account for estimate uncertainty.

LDL-C reductions by sex and glycemic status in MILOS

In a pooled analysis of 3138 patients across 5 countries, bempedoic acid or the fixed-dose combination was associated with a 31% relative LDL-C reduction in women and 25% in men, with women more often treated for primary prevention and classified at lower cardiovascular risk than men at baseline.

Among 2071 patients with LDL-C data available before treatment and at 1 year, absolute goal attainment increased by approximately 31% in both sexes, and adverse drug reactions considered treatment-related occurred in 10.3% of women and 8.3% of men, most commonly myalgia, with no new safety signals identified.

A separate analysis stratifying the same pooled cohort by glycemic status found bempedoic acid-based therapy delivered a mean relative LDL-C reduction of at least 24.9% regardless of diabetes status, with reductions of 24.9% in patients with diabetes, 28.7% in prediabetes, and 28.2% in normoglycemia.

LDL-C goal attainment increased from approximately 7% at baseline to 37.9%-39.4% at 1 year across all 3 glycemic subgroups, and no new safety signals were observed.

“At Daiichi Sankyo, our ongoing investment in cardiovascular research is driven by our desire to care for every heartbeat,” said Stefan Seyfried, MD, vice president and head of medical affairs, Specialty Medicines, Daiichi Sankyo Europe. “We are committed to supporting better outcomes in CVD, and our latest real-world results continue to demonstrate the impact of bempedoic acid alone or as a fixed-dose combination tablet with ezetimibe in CVD management across a broad range of patient types, so that no patient will be left behind.”

Daiichi Sankyo. New Daiichi Sankyo data underscore the effect of bempedoic acid in the real-world management of dyslipidemia and cardiovascular risk. Published August 28, 2026. Accessed August 29, 2026. 

Parhofer KG, et al. Predicted change in 10-year cardiovascular risk one year after initiation of bempedoic acid-based therapy in the MILOS study. Presented at: European Society of Cardiology (ESC) Congress 2026; August 28-31, 2026; Munich, Germany.

Gouni-Berthold I, et al. Real-world use of bempedoic acid in women and men: pooled 1-year follow-up data from the observational, prospective, real-world MILOS study in Austria, Belgium, Germany, Italy, and the United Kingdom. Presented at: European Society of Cardiology (ESC) Congress 2026; August 28-31, 2026; Munich, Germany.

Stulnig T, et al. Bempedoic acid for LDL-cholesterol management in patients with and without diabetes: insights from the MILOS study. Presented at: European Society of Cardiology (ESC) Congress 2026; August 28-31, 2026; Munich, Germany.

Articles

New MILOS data show bempedoic acid-based therapy translated to meaningful reductions in predicted 10-year cardiovascular risk.

Cardiology

Cardiology condition center page is a comprehensive resource for clinical news and insights on cardiovascular and cardiometabolic diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for heart disease and cardiovascular events, as well as associated diabetes, renal failure, and more...

Dyslipidemia

Bempedoic Acid Cuts 10-year CV Risk 17% in MILOS Real-World Data

Anjali Vaidya, MD, is the director of the Advanced Pulmonary Hypertension, Right Heart Failure & CTEPH Program and the Pulmonary Hypertension Fellowship at Temple University Hospital and a professor of medicine at Temple University

Sotatercept, an activin signaling inhibitor approved for pulmonary arterial hypertension (PAH), continues to build an evidence base spanning exercise capacity, hemodynamics, and hard clinical outcomes. Anjali Vaidya, MD, of Temple University, discussed a 3-pronged framework for understanding the drug's effect on the right ventricle (RV), covering afterload, RV structure, and RV function, in an interview with 

How Sotatercept Reshapes the Right Ventricle in PAH, With Anjali Vaidya, MD

Sotatercept's efficacy is grounded in a pair of pivotal phase 3 trials. The STELLAR trial demonstrated significant improvement in 6-minute walk distance and 8 of 9 secondary end points, supporting US Food and Drug Administration (FDA) approval in 2024, and the more recent ZENITH trial in high-risk patients with PAH found a 76% reduction in the risk of death, lung transplantation, or PAH-related hospitalization, halting enrollment early for efficacy.¹²

Sotatercept's Distinct Effect on RV Afterload in PAH

Vaidya described sotatercept as a fundamentally different mechanism than existing PAH therapies: "It works as an anti-proliferative and really getting to the basis of the pathophysiology of pulmonary arterial hypertension," she said. "We're seeing dramatic improvements and reversals in pulmonary vascular resistance, the load on the right heart... but we are seeing dramatic improvements in all of the clinical markers of pulmonary pressures, right ventricular structure, size, function, biomarkers, and and really so many of the metrics that we have known for many years now that correlate with prognosis and risk assessment."

Asked what changes in pulmonary vascular resistance and other hemodynamic parameters were most informative, Vaidya said the drug's effect is specific to afterload itself, including impedance to flow, vascular resistance, and pulmonary arterial compliance, rather than pressure reduction alone. She noted these parameters are not always measured directly in standard clinical care, despite being central to the hemodynamic abnormalities driving downstream structural and functional changes in the right heart.

Vaidya said the magnitude of this afterload effect distinguishes sotatercept from prior pulmonary vasodilator classes, describing the pattern as fundamentally different and greater in scale than what other PAH therapies have achieved. Despite multiple effective agents across several classes and pathways developed over recent years, she said the activin signaling inhibitor produces a markedly larger reduction in afterload and pulmonary vascular resistance in many patients.

RV Function, Structure, and the Case for Reverse Remodeling

On evidence for RV function improvement specifically, rather than simply reduced workload, Vaidya pointed to a broad set of metrics. "We're seeing improvements in RV work, the magnitude of energy generated by the right ventricle in... every heartbeat of... stroke volume into the pulmonary artery. We're seeing improvements in RV size. We're seeing improvements in RV to LV relationships in size. We're seeing improvements in RV fractional area change. We're seeing improvements in biomarkers of NT-proBNP and BNP. We're seeing dramatic improvements as well in tricuspid regurgitation, another marker of overall right heart performance," she explained.

On RV structure specifically, Vaidya said reverse remodeling encompasses right ventricular size, right ventricle-to-left ventricle relationships, and end-diastolic and end-systolic volumes. She acknowledged some of these changes are likely related to the drop in afterload, but noted the durability of the improvements raises the possibility of an intrinsic effect on the right ventricle beyond load reduction alone, an area she said warrants further study.²

Asked which of the 3 domains, afterload, structure, or function, is the primary driver of clinical benefit, Vaidya described them as inseparable. "The pathogenesis begins in the afterload, in the pulmonary arterial circulation, but the disease manifests in the structure and performance of the right side of the heart," she said. "You look at the right heart to see what's happening in the pulmonary circulation, and the coupling of the two together is really what... manifests in the greatest long-term benefit for our patients."

Editors’ note: Vaidya reports relevant disclosures with Johnson & Johnson, Merck, and United Therapeutics.

Hoeper MM, Badesch DB, Ghofrani HA, et al; STELLAR Trial Investigators. Phase 3 trial of sotatercept for treatment of pulmonary arterial hypertension. N Engl J Med. 2023;388(16):1478-1490. doi:10.1056/NEJMoa2213558

Humbert M, McLaughlin VV, Badesch DB, et al. Sotatercept in patients with pulmonary arterial hypertension at high risk for death. N Engl J Med. 2025;392(20):1987-2000.

Anjali Vaidya, MD, breaks down sotatercept's distinct effects on RV afterload, structure, and function in pulmonary arterial hypertension.

Pulmonology

Infectious Disease condition center page is a comprehensive resource for clinical news and insights on respiratory health. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for asthma, COPD, interstitial lung disease, COVID-19, and more.

Sotatercept's 3-Pronged Effect on the Right Ventricle in PAH, With Anjali Vaidya, MD

Abigail Brooks is a strategic content lead overseeing 

She joined MJH Life Sciences in August 2023 shortly after graduating from Monmouth University where she earned her BA in Communication with a concentration in Public Relations/Journalism and later an MA in Interactive Digital Media. She enjoys traveling, running, and reading books. She can be reached at abrooks@mjhlifesciences.com.

The REACT study found silent atherosclerosis in 57.1% of adults without known cardiovascular disease, a burden largely missed by the SCORE2 risk tool.

Atherosclerotic Cardiovascular Disease

REACT: Silent Atherosclerosis Widespread, Missed By Standard Risk Tools

Steven Nissen, MD, shares key takeaways on AAV8, CTX310, and Kylo-11 gene and molecular therapies presented at ESC Congress 2026.

Spotlight on Gene and Molecular Therapies at ESC 2026, With Steven Nissen, MD

A longitudinal survey found PSVT disrupts patients' daily activities, sleep, and emotions between episodes.

Arrhythmia

PSVT Burden Persists Between Episodes, Milestone Survey Data Show

Ryan Livingston joined the MJH Life Sciences team in March of 2025, shortly after graduating from TCNJ with a bachelor’s degree in English. He enjoys creative writing, reading, and scuba diving. He can be reached at rlivingston@mjhlifesciences.com.

Despite failing to display a clinically significant reduction in all-cause death or hospitalization for cardiovascular events, the trial did highlight evolocumab’s LDL-C-lowering capacity.

AMUNDSEN: Evolocumab Immediately After MI Improves LDL-C Goal Achievement

CTX310, a CRISPR-Cas9 therapy targeting ANGPTL3, sustained deep LDL and triglyceride reductions at 1 year after a single infusion, per ESC 2026 data.

CTX310 Gene Editing Sustains ANGPTL3, LDL Reductions at 1 Year

Erin Michos, MD, MHS, explains why hypertension risk rises earlier in women and how aldosterone and menopause drive that risk. 

Hypertension

The HCPLive hypertension page is a resource for medical news and expert insights on high blood pressure. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for hypertension, and more.

Sex Hormones, Aldosterone, and Hypertension Risk in Women, With Erin Michos, MD

POET-II found tailored antibiotics cut treatment duration by a third in left-sided infective endocarditis without compromising safety, per ESC 2026 data.

Structural Heart Disease

POET-II: Tailored Antibiotics Could Cut Duration in Endocarditis

Gaetano De Ferrari, MD, is a professor and the Head of Cardiology at the University of Turin.

Gaetano De Ferrari, MD, breaks down VESALIUS-CV findings on evolocumab and first MI prevention across major infarct subtypes.

VESALIUS-CV: Evolocumab Cuts First MI Risk by 36%, With Gaetano De Ferrari, MD

PREMIUM found prasugrel monotherapy before primary PCI raised ischemic risk vs DAPT in STEMI despite less major bleeding, per ESC Congress 2026 data.

PREMIUM Trial: Prasugrel Monotherapy Fails Noninferiority to DAPT in STEMI 

Philippe Gabriel Steg, MD, is a professor of cardiology at the Université Paris and the chief of the department of cardiology and director of the coronary care unit at Hôpital Bichat.

Philippe Gabriel Steg, MD, discusses the full results of the terminated trial, reflecting on their impact on the ongoing LIBREXIA-AF and LIBREXIA-Stroke trials.

Stroke

On the HCPLive stroke page, resources on the topics of medical news and expert insight into CVA can be found. Content includes articles, interviews, videos, podcasts, and breaking news on stroke medicine, and more.

Latest News

How Failure Is the Stepping Stone to Success, With Lisa Swanson, MD

Competition, Burnout, and the Cost of Always Saying 'Yes' as a Clinician

Tips on Saying 'No' as a Dermatology Leader, With Adam Friedman, MD

Bempedoic Acid Cuts 10-year CV Risk 17% in MILOS Real-World Data

Sotatercept's 3-Pronged Effect on the Right Ventricle in PAH, With Anjali Vaidya, MD