Barry A. Borlaug, MD is a cardiologist in Rochester, Minnesota, affiliated with the Mayo Clinic.

Barry A. Borlaug, MD: Impact of Tirzepatide on Cardiorenal End-Organ Damage in HFpEF 

Tirzepatide lowered circulatory pressure-volume overload and reduced end-organ damage in the kidney and heart in patients with 

heart failure with preserved ejection fraction (HFpEF)

, according to data from the SUMMIT trial.

American Heart Association (AHA) Scientific Sessions 2024

, these data build upon the known benefit of tirzepatide, a long-acting glucose-dependent insulinotropic polypeptide receptor and glucagon-like peptide-1 receptor agonist (GLP-1 RA), for the treatment of obesity-related HFpEF.

“I think it ties together a lot of the pathophysiologic components that we think are very important in obesity-related HFpEF, and tirzepatide seems to be working through many of these different pathways, some of them hemodynamic and volume-loading and [others] related to inflammation,” presenting investigator Barry A. Borlaug, MD, Mayo Clinic, told 

The double-blind SUMMIT trial randomized 731 individuals with NYHA Class II-IV heart failure, an EF of ≥50%, and body mass index (BMI) ≥30 kg/m2 to tirzepatide (n = 364) or placebo (n = 367). Tirzepatide was titrated to a maximum weekly tolerated dose of up to 15 mg subcutaneously.

For the analysis, Borlaug and colleagues collected data on blood pressure, anthropometrics, estimated plasma volume, and blood samples at baseline and 52 weeks, to determine biomarkers of cardiorenal function in all patients. Primary results from SUMMIT showed tirzepatide lowered the risk of cardiovascular death or worsening heart failure (hazard ratio [HR], 0.62; 95% CI, 0.41–0.95; 

Trial participants exhibited borderline hypertension (systolic blood pressure [SBP], ~128 mmHg), volume expansion (estimated plasma volume, ~3.3 L), chronic kidney disease (urine albumin/creatinine ratio [UACR], ~2.8 g/mol), and subclinical myocardial injury (troponin T, ~11 ng/L).

Compared with placebo, tirzepatide treatment reduced SBP by ~6 mmHg (95% CI, –8 to –4; 

<.001) at 24 weeks and by –5 mmHg (95% CI, –7 to –3; 

 <.001) at 52 weeks, respectively. Tirzepatide also decreased the estimated plasma volume by ~0.32 L (95% CI, –0.36 to –0.27; 

At the same time, tirzepatide achieved an increase in eGFR at 52 weeks (~1.85 ml/min/1.73 m2; 95% CI, 0.19–3.51; 

 = .029), decreases in microalbuminuria at 24 weeks (–25.0%; 95% CI, –36 to –13; 

 <.001) and 52 weeks (–15%; 95% CI, –28 to 0.1; 

 = .051), and a reduction in troponin T at 24 weeks (–9.8%; 95% CI, –16.0 to –3.3; 

 = .004) and 52 weeks (–10.4%; 95% CI, –16.7 to –3.6; 

“I think we need to be looking to use these drugs, these incretin-based drugs, more frequently, including tirzepatide, for the treatment of people with obesity-related HFpEF,” Borlaug told 

Disclosures: Borlaug reports relevant disclosures with Amgen, Boehringer Ingelheim, Eli Lilly, Novo Nordisk, and others.

Borlaug BA. Effects of Tirzepatide on Cardiorenal End-Organ Damage in Heart Failure and Preserved Ejection Fraction: Insights from the SUMMIT trial. Presented at the American Heart Association (AHA) Scientific Sessions 2024. Chicago, Illinois. November 16-18, 2024.

Tirzepatide, a GLP-1 RA, demonstrated significant benefits in reducing circulatory pressure-volume overload and end-organ damage in patients with HFpEF and obesity, as shown in the SUMMIT trial. The trial, presented at the AHA Scientific Sessions 2024, involved 731 participants and revealed that tirzepatide lowered cardiovascular death risk and improved cardiorenal biomarkers. Notable improvements included reductions in systolic blood pressure, plasma volume, microalbuminuria, and troponin T levels, alongside an increase in eGFR. These findings suggest tirzepatide's potential in managing obesity-related HFpEF.

Barry A. Borlaug, MD describes the beneficial effect of tirzepatide on circulatory pressure-volume overload and end-organ damage in patients with HFpEF and obesity.

Barry A. Borlaug, MD

Associate Professor, Jane Anne Nohl Division of Hematology, Keck School of Medicine, University of Southern California

Piatek discussed findings from a healthcare resource utilization study and a sentiment analysis study presented at ASH 2024.

Caroline Piatek, MD: High HCRU, Patient Concerns Highlight Great Unmet Need in wAIHA

New research has revealed high unmet needs in people with warm autoimmune hemolytic anemia (wAIHA), as evidenced by high healthcare resource utilization (HCRU) and prevalent concerns about adverse events (AEs) and a lack of treatment efficacy.

These findings are from 2 studies, data from which were presented at the

 66th American Society of Hematology (ASH) Annual Meeting and Exposition

, held December 7-10, 2024, in San Diego, California.

® spoke with Caroline Piatek, MD, Associate Professor, Jane Anne Nohl Division of Hematology, Keck School of Medicine, University of Southern California, who served as an investigator on both studies.

In a retrospective, HCRU study, Piatek and colleagues found that HCRU remained high in both 12-month periods preceding and following initial wAIHA diagnosis in people with both primary and secondary wAIHA.

 In a sentiment analysis study powered by artificial intelligence (AI), they found a dearth of positive sentiments about rituximab treatment or transfusion therapy, notable concerns about AEs and a lack of treatment efficacy, and a prevalence of information seeking, highlighting the importance of healthcare provider support and involvement in implementing a successful treatment strategy.

During the discussion, Piatek emphasized the high unmet need that these studies revealed and the need for better treatment strategies for people with wAIHA.

“There just isn't much [out there for wAIHA]. And so, anything is helpful, but ultimately, we need better therapeutic agents in this setting… Characterizing the disease burden is important, but we kind of have to move forward from that and do something about it,” Piatek said.

Jackson LA, Pesa J, Choudhry Z, et al. A Retrospective Database Analysis of Healthcare Resource Utilization in Patients with Warm Autoimmune Hemolytic Anemia in the United States. Presented at: ASH Annual meeting; December 7-10; San Diego, California. Abstract 2324

Piatek C, Jackson LA, Brethenoux C, et al. Sentiment Analysis Applied to Digital Conversations Among Warm Autoimmune Hemolytic Anemia (wAIHA) Patients Receiving Rituximab and/or Blood Transfusion. Presented at: ASH Annual meeting; December 7-10; San Diego, California. Abstract 3705

Caroline Piatek, MD

A panel of expert cardiologists share their clinical pearls for managing patients with hyperlipidemia.

Clinical Pearls on Lipid Management

Keith C. Ferdinand, MD, FACC, FAHA, FNLA:

 I’m going to give each of you about a minute or so to give what we call a take-home message: a clinical pearl for the physicians, nurse practitioners, physician assistants, [and] pharmacists who may be listening, something that will motivate them to do better. We’ve heard from the Family Heart Foundation that we’re not recognizing these patients early enough and that those patients at high risk are not getting high-intensity statin. We heard from Dr Michos that there is a whole world of alternatives. Christie, you suggested [that] we combine these agents [to] reach lower [lipid] levels vs pushing [the dose of] a drug to toxicity level. Dr Kohli, you’ve been very persistent that education, culturally appropriate [and] literacy-appropriate education, is one of the linchpins to success.

 We’ve talked about education, but it starts with [this]: “You can prevent heart attacks and strokes.” Patients need to know their numbers; that’s an education process. We help them get there. We’re their guides to get there. One thing that is a frustration, a practical point in terms of when you use some of the nonstatin therapies, [is] the approval process. It turns out—we have fellows coming [in] every year—if you say this patient has a family history of very high cholesterol [level] and premature heart disease, [you’re] denied. You [have] to say heterozygous familial hypercholesterolemia [FH]. There’s an 

International Classification of Diseases, Tenth Revision

] code for that. Put those words in there. If you say [the patient] “has heart disease or ASCVD [atherosclerotic cardiovascular disease] with MI [myocardial infarction]”…put the right information. Have a lipid measurement within a month, [provide] the LDL [low-density lipoprotein] cholesterol [level], [and state], “It was unacceptably high; therefore, [I’m] using this agent.” Some pragmatic steps will reduce the frustration for both [patient and provider], because if the patient doesn’t get it and you don’t get it, it’s frustrating. But you can do it. It’s easier.

 Dr McGowan, thank you for your great work with the Family Heart Foundation. Can you give us some clinical pearls to help our clinicians out there do better?

 When you screen patients, and hopefully you’ll screen all your patients, [but] when you screen patients with a lipid profile, if it’s an adult person and you see an LDL [level] greater than 190 mg/dL, you want to think familial hypercholesterolemia. With that in mind, you want to have a conversation with the patient [that] this is unlikely to be chance. This is your genetics, and, therefore, your children need to be screened, your siblings need to be screened, and it’s important. People who hear that it might [affect] their children are more likely to take action. So take action. The other big thing, [because] I’m coming from the Family Heart Foundation, [is] don’t forget to measure lipoprotein(a) [Lp(a)] [level]. Don’t think it’s unactionable. I’m going to tell you one quick story about a patient of ours who’s an advocate for Lp(a). This young woman was 44 years old [with a] completely normal lipid profile. [She] did have a history of cardiac disease [and] attributed her father’s early cardiac disease to his type A behavior. She waited 18 hours with chest pain before going in and finding that she was having a cardiovascular event: a myocardial infarction. What she said to us was, “If I had known I had such a high Lp(a) [level], I would have gone in earlier.” That was important information to me. So even if you feel like there aren’t agents currently [available], as everybody else has said, you can reduce other risk factors. Measure that Lp(a) [level] and then take action. And educate your patients about it.

 There’s so much burnout in medicine. It is so hard, what we do on a day-to-day basis. But the thing that keeps me most engaged is knowing that I made an impact on somebody’s life. If you could take 2 or 3 minutes at the end of every visit, no matter what it’s for (eg, knee pain, urinary tract infection, back pain), to look at those lipid [levels and] focus on prevention, [then] you are going to have a tremendous impact on [a] number of lives out there that you won’t even realize. That will give you the highest degree of engagement: knowing their numbers, not just knowing your numbers, but knowing your patients’ numbers and phenotyping at every visit so [that] you’re delivering a personalized care plan. You’re not lumping every secondary prevention to less than 70 mg/dL or less than 55 mg/dL. You’re using your risk modifiers to reclassify that risk in an iterative fashion at every visit for your primary and secondary prevention. So if Mrs Jones had a stroke since the last time you saw her, her risk just changed. You bump her down to the next level, δ LDL of 50%, and get [her level] below those thresholds. If you can work it into your busy practice, just spend 2 minutes at the end of each visit looking at those lipid [levels] and making a little plan. It’ll be tremendous how many lives you’ve changed and how many trajectories of atherosclerosis you’ve modified.

 That’s a wonderful message. Dr Michos, you have the last take-home [message].

 I want to circle back to something that Dr Kohli said at the beginning about cholesterol years. This is something that might resonate with patients and other clinicians when they’re familiar with pack-years of smoking. It’s not only the magnitude of elevation; it’s the duration [that] one’s [had] that value. There’s been some modeling thinking that the theoretical onset of clinical ASCVD may be around 5000 mg/dL-years. Individuals who have had high cholesterol [level] since birth—our patients with FH—if left untreated, they’ll cross that threshold of clinical ASCVD very young in life. Whereas individuals who have favorable genetics, healthy lifestyle, or early treatment may never cross that threshold for clinical ASCVD. [And] don’t forget about those with mild to moderate hyperlipidemia. The LDL [level] is [in the] 130s mg/dL [or] 160s mg/dL. A lot of these patients are ignored. But [if] left untreated for a sufficient number of years, those individuals will have earlier onset ASCVD than their counterparts who have had lifelong low LDL [levels]. The message is [that] we want to get LDL [levels] lower for longer and get there faster.

 Wonderful message. Thanks to you all for this rich and informative discussion. And thank you for watching this 

. If you enjoyed this content, please subscribe to our e-newsletters to receive upcoming 

 [videos] and other great content right in your inbox.

Christie Ballantyne, MD

This interview in the latest issue of The Respiratory Report features Divay Chandra, MD, MSc, discussing lithium's potential enhancement of alveolar repair after injury.

Exploring Lithium: A Potential Disease-Modifying Therapy for Emphysema

While chronic obstructive pulmonary disease (COPD) remains a leading cause of death worldwide, there is still no treatment that reverses or halts its progression.  Recent research is exploring the potential of lithium, a drug commonly used for bipolar disorder, as a candidate to repair lung damage by targeting a key regenerative signaling pathway in the lung.

This study is being led by Divay Chandra, MD, MSc, an associate professor in the Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, at University of Pittsburgh in Pennsylvania. Chandra spoke in the third issue of 

 that is powered by the American Lung Association Research Institute, on his team’s current research in this area.

Chandra and his team analyzed data from large population cohorts to assess whether individuals taking lithium for other conditions had less lung disease and then measured environmental lithium exposure in people not on the drug. They found that both therapeutic and naturally occurring lithium levels were associated with reduced COPD severity, supporting its potential as a disease-modifying agent. The next step in Chandra's research is scaling up their studies to look at longitudinal progression and is enabled by an American Lung Association grant.

"Despite decades of research and multiple clinical trials, as yet, we have not been able to identify a disease modifying agent in COPD. And that is really the frustrating part. We have drugs that can treat symptoms. You know, we have drugs which can treat eosinophilia, which can reduce exacerbations, but we have no drug that can get at the fundamental disease process that drives this lung disease. That is exactly where lithium could play a role," Chandra said.

To learn more about Chandra's research, view the interview above or read his contribution to the third issue of The Respiratory Report here:

Exploring Lithium as a Potential Disease-Modifying Therapy for Emphysema

This interview in the latest issue of The Respiratory Report features Divay Chandra, MD, MSc, discussing lithium's potential enhancement of alveolar repair after injury.



Divay Chandra, MD, MSc

Leandro Boer, MD, PhD, vice president of general medicines at Amgen

Preliminary results from the VESALIUS-REAL study highlight a significant burden of 

 in real-world settings, revealing gaps in lipid-lowering management among more than 277,000 individuals in the U.S. with elevated low-density lipoprotein cholesterol (LDL-C).

The analysis found that most high-risk patients aged ≥50 years with atherosclerotic cardiovascular disease (ASCVD)—including coronary artery disease (CAD), peripheral artery disease (PAD), cerebrovascular disease (CeVD), or high-risk diabetes—who had no prior history of myocardial infarction or stroke were neither adequately tested for LDL-C nor treated with lipid-lowering therapy (LLT).

Among 277,808 patients, only 37.6% received statin therapy, while more than half (62.4%) had no background LLT. One year after the index date, 87.6% of patients had an LDL-C level above 70 mg/dL, yet only 22.4% intensified their treatment, and fewer than 2% initiated a nonstatin LLT.

American College of Cardiology (ACC) 2025 Annual Scientific Sessions

, Leandro Boer, MD, PhD, vice president of general medicines at Amgen, discussed the study’s findings, emphasizing the urgent need for improved LDL-C management strategies to reduce cardiovascular risk in high-risk patient populations.

This transcript has been edited for clarity.

: What do these results inform about the current state of cardiovascular disease risk management in US patients?

These results are part of a whole cohort of patients in the VESALIUS-REAL study, comprising 277,000 patients in the US, alongside 11 other countries. This just focuses on the presentation of the US data. Who are these patients? These patients are patients with a very high risk of cardiovascular events. They have CVD, but have never had a stroke or myocardial infarction before. We are focused on what happened with them once they are in that situation.

We found very startling findings in the US, which may not be different from the rest of the world, showing 70% of these patients are not starting any therapy for LDL reduction, which is the most modifiable risk factor. In 88% of patients, if they start on a medication, they don’t have their medication intensified to the next level so they can achieve their goals. The level of patients not achieving this goal is high and that’s what we show in this poster.

: When we consider this issue, do we see it more as a provider-driven issue, a patient adherence challenge, or a systemic health care obstacle?

It’s a systemic health care gap. I like to say there is no silver bullet for this problem, but we also should not be looking at the gap and say ‘it is what it is.’ Since I started practicing, I prescribed my first statin prescription more than 20 years ago. We haven’t seen much happening and have seen a lot of inertia. These results and outcomes in the US population are not acceptable.

I believe there is a problem that we need to tackle. We need to be together, hand in hand, with insurers; they need to do their part. The manufacturers need to do their part and the patient needs to do their part. And the HCP needs to do their part. I think it’s missing the element of empowerment of the patient and the HCP binary, we need to help them take control of their destiny and their treatments.

: Despite the need for more intensive therapy, these data indicate <2% of patients initiated a nonstatin lipid-lowering therapy (LLT). What are the barriers that might be impacting the greater adoption of those agents?

In the US, we have some statistics. For example, one-third of the population does not have any insurance or is poorly insured. The second thing, a lot of cardiologists often come from cities, but 50% of counties in the country do not have a single cardiologist. We have a compounding effect of many things happening culminating with a patient not being intensified or therapy not achieving their goals. So, we have systemic barriers.

Even the possibility of a patient talking about their disease with their doctor, given the short duration of time, it often feels like patients spend more time asking questions with ChatGPT than their doctors. Is this the ideal thing? Maybe it’s an indication of how to use technology in the future, but we need to put the trust back in the relationship. Approximately three out of four patients in the US trust their primary care, so I think it’s an untapped opportunity.

We should not only focus on cardiology, we need to go to primary care, so they can also achieve their goals. This is not rocket science. We talk about lipids, the most modifiable risk factor. It’s accessible and really for everyone. It’s not complicated, so I think all primary care should have these goals and help their patients achieve those goals.

: How can recent guideline recommendations from organizations like the ACC and the American Heart Association (AHA) help address this issue?

Every time they go with the guidelines in a simple way, they can make it clear that what they’re recommending can be translated into clinical practice. Even when the guideline is not clear, we have a gap of 17 years between what is published and actual clinical practice. That’s why we need implementation science that’s been around with the National Institutes of Health (NIH) for the last 20 years. They help, by not only being a beacon and source of knowledge, but also helping us be partners for implementation initiatives. What works best to have those patients achieve their goals?

HCPLive: Do you have any final thoughts on these treatment

I would say just the importance of testing. In the country right now, we’re seeing dramatically low levels of testing. People are not testing for LDL, and when they do test, they don’t initiate the treatment. Something is going on there that we need to crack the code of, particularly what’s going on between the testing not being performed and why testing is not generating the urgency to do something.

It’s accessible to everyone and affordable, so why is someone not doing it? Testing is very important, because that’s the best way to put someone on a patient care pathway, so they can achieve their goals. The second thing is to continue mass education of both patients and also HCPs so they know the goal, know your number, and understand getting there is not so complicated.

Disclosures: Boer is an employee of Amgen.

Sakhuja S, Chan Q, Ochs A et al. Lipid Lowering Therapy Use in High-Risk ASCVD Patients Without Prior MI or Stroke - Preliminary Data from VESALIUS-Real, US. Presented at: American College of Cardiology (ACC.25) Annual Scientific Session. March 29 – 31, 2025. Chicago, Il.

The VESALIUS-REAL study reveals significant gaps in lipid-lowering management among over 277,000 U.S. patients with elevated LDL-C, highlighting a systemic healthcare issue. Despite being at high risk for cardiovascular events, many patients with ASCVD are inadequately tested and treated for LDL-C. Only 37.6% received statin therapy, and a mere 22.4% intensified treatment after a year. Barriers include lack of insurance, limited access to cardiologists, and insufficient patient-provider communication. Recent guidelines and implementation science are crucial for improving LDL-C management and reducing cardiovascular risk.

At ACC.25, Boer highlights treatment gaps in the US for lipid control in a high-risk ASCVD population.

VESALIUS-REAL Reveals Lipid Control Gaps in US with Leandro Boer, MD, PhD

Leandro Boer, MD, PhD

Matthew J. Budoff, MD: Examining the Interplay of Coronary Artery Calcium and Osteoporosis

22nd Annual World Congress Insulin Resistance Diabetes & Cardiovascular Disease (WCIRDC)

, Matthew Budoff, MD, a professor of medicine at the David Geffen School of Medicine at UCLA and an investigator at The Lundquist Institute, discussed the intersection of 

 and osteoporosis, emphasizing how these conditions share overlapping pathophysiology as diseases of aging.

Budoff highlighted findings from studies, including the Multi-Ethnic Study of Atherosclerosis, showing that elevated CAC scores not only predicted cardiovascular events but also correlated with lower bone density and increased fracture risk. Importantly, this relationship is bidirectional—osteoporosis independently increases the risk of atherosclerosis, myocardial infarction, stroke, and cardiovascular mortality. Leveraging advanced imaging techniques, clinicians have developed algorithms to measure bone density from coronary calcium scans or routine CT imaging, allowing simultaneous diagnosis of atherosclerosis and osteoporosis. Budoff indicated this approach could bridge the diagnostic gap, as only 8% of Medicare beneficiaries currently receive bone density testing despite the high osteoporosis prevalence.

The conversation also addressed high-risk populations, including older adults, smokers, Caucasians, and those undergoing significant weight loss due to obesity medications, which exacerbate osteoporosis risk. Budoff urged clinicians to prioritize bone density screening for postmenopausal women and men over 65, using existing CT imaging when DEXA scans are unavailable. By recognizing the dual risk of cardiovascular disease and osteoporosis, Budoff suggested healthcare providers can implement earlier interventions to improve patient outcomes.

Relevant disclosures for Budoff include AstraZeneca, Amarin, Merck, Novo Nordisk, Regeneron, and others.

Budoff MJ. CAC in ASCVD Relation to Bone Density & Osteoporosis. Presented at the 22nd Annual World Congress Insulin Resistance Diabetes & Cardiovascular Disease (WCIRDC). Los Angeles, California. December 12-14, 2024.

Matthew J. Budoff, MD describes bridging the gap between atherosclerosis and osteoporosis through advanced Imaging techniques.

Matthew J. Budoff, MD: Examining the Interplay of Coronary Calcium and Osteoporosis

Matthew J. Budoff, MD

This article was originally published on 


A new drug is here to make waves in the menopause symptom treatment landscape with the FDA approval of fezolinetant (Veozah; Astellas Pharma) for the treatment of moderate to severe vasomotor symptoms (VMS) associated with menopause.

This approval makes fezolinetant the first neurokinin 3 receptor antagonist approved by the agency to treat VMS in menopause, according to the FDA.

“Hot flashes as a result of menopause can be a serious physical burden on women and impact their quality of life,” said Janet Maynard, MD, MHS, director of the Office of Rare Diseases, Pediatrics, Urologic, and Reproductive Medicine, in the FDA’s Center for Drug Evaluation and Research.

 “The introduction of a new molecule to treat moderate to severe menopausal hot flashes will provide an additional safe and effective treatment option for women.”

The approval is backed by positive data from the BRIGHT SKY program. This clinical trial program consisted of 3 phase 3 studies that enrolled more than 3,000 individuals from the United States, Canada, and Europe. In 

 (NCT04003155) and SKYLIGHT 2 (NCT04003142), results emphasized the safety and efficacy of the nonhormonal treatment for VMS associated with menopause. Meanwhile, 

 (NCT04003389) demonstrated the long-term safety of fezolinetant.2

"[The] approval of fezolinetant is a significant and, I believe, long-awaited milestone for individuals in the [United States] who experience moderate to severe vasomotor symptoms during the menopausal transition," said Genevieve Neal-Perry, MD, PhD, chair, University of North Carolina School of Medicine Department of Obstetrics and Gynecology.

 "This therapy is based on our understanding of the biology behind hot flashes. I'm excited to know that patients will have the option to choose this nonhormonal treatment."

Patients taking fezolinetant are instructed to take 1, 45 mg pill orally, once per day, with or without food. Additionally, the medication should be taken at the same time every day.

According to the FDA and the prescribing information, the medication includes a warning for elevated hepatic transaminase (liver injury). Prior to using fezolinetant, patients should have blood work completed to test for liver damage. Additionally, while taking fezolinetant, patients should undergo routine bloodwork every 3 months for the first 9 months of usage. If patients experience symptoms such as nausea, vomiting, or yellowing of the skin and eyes, they should contact their physician.

The FDA also notes that fezolinetant cannot be used with CYP1A2 inhibitors, and individuals with cirrhosis, severe renal damage, or end-stage renal disease should avoid taking the medication.

Per the prescribing information, the most common side effects of fezolinetant include abdominal pain, insomnia, back pain, hot flush, diarrhea, and elevated hepatic transaminases.

FDA approves novel drug to treat moderate to severe hot flashes caused by menopause. FDA. May 12, 2023. Accessed May 12, 2023. https://www.fda.gov/news-events/press-announcements/fda-approves-novel-drug-treat-moderate-severe-hot-flashes-caused-menopause

Astellas’ Veozah (fezolinetant) approved by US FDA for treatment of vasomotor symptoms due to menopause. PR Newswire. May 12, 2023. Accessed May 12, 2023. https://www.prnewswire.com/news-releases/astellas-veozah-fezolinetant-approved-by-us-fda-for-treatment-of-vasomotor-symptoms-due-to-menopause-301823639.html

Announced on May 12, 2023, the FDA's approval of fezolinetant (Veozah) marks their first approval for an NK3 receptor antagonist for the treatment of vasomotor symptoms of menopause.

FDA Approves Fezolinetant for Moderate to Severe Hot Flashes in Menopause

Morgan Petronelli

Skin of Color Savvy: The Art and Science of Treating Patients of Color

Skin of Color Savvy: News Update—SOCS Awards, My Best Winter Skin, & TORPEDO Program, with Robert Brodell, MD

Skin of Color Savvy: News Update—SOCS Awards, My Best Winter Skin, & TORPEDO Program

In the inaugural Skin of Color Savvy: News Update, host Robert Brodell, MD, introduces the 

 and its mission to promote excellence in skin of color dermatology. Founded in 2004 by Susan C. Taylor, MD, SOCS is a global leader with members in over 30 countries. Through its pillars of research, education, mentorship, and advocacy, SOCS is committed to advancing dermatologic care, increasing diversity in the field, and addressing the unique needs of patients with skin of color.

SOCS initiatives designed to support innovation and diversity in dermatology

. These include the Sanofi and Regeneron Diversity, Equity, and Inclusion Mid-Career Award, the Institutional Research Fellowship Grant for underrepresented minority physicians, and the Early Career Innovations Award, which fosters creative solutions in the field. SOCS also supports cutting-edge research through its annual Scientific Symposium, where experts present the latest findings in skin of color dermatology.

The episode also introduces SOCS’s “My Best Winter Skin” campaign, launched to promote optimal winter skincare practices and raise awareness about skin health. This initiative includes an international awareness day, volunteer events, educational materials, and product donations sponsored by Clinique. Brodell encourages dermatologists to participate in outreach efforts within their communities to promote skin health and support SOCS’s broader mission.

In the final update, Brodell shares details about TORPEDO (Training Opportunities and Residency Programs to Enhance Diversity and Outcomes), an initiative at the University of Mississippi to foster diversity in dermatology. Through mentoring, away rotations, and research opportunities, TORPEDO supports students from historically Black colleges and universities, addressing gaps in mentorship and training.

The January 15, 2025 SOCS News Update highlights research ongoing/upcoming initiatives and awards, the My Best Winter Skin Campaign, and the TORPEDO program.

Robert Brodell, MD

 Looking forward, how do you envision implementing therapies in a more aggressive fashion? I’m going to go to each of you to share some clinical pearls about how you envision the heart failure world getting its arms around the need to take a chemotherapy-like approach to our patients in getting them on therapy. Since you were the last to speak Muthiah, I’ll ask you to be the next to speak.

I’m going to jump forward, I’m going to look to the future. I think we are looking at an environment in which these drugs are going to be accessible, affordable, easy to administer, and I think we should start to engage our patients and have patients have a more active role in the initiation and titration of these drugs. We can envision a system much like insulin titration, in which at least some patients who are engaged in their care could modulate dosing, could initiate new drug therapy, in their home environments with relatively limited monitoring structures.

We’ve got a cancer analogy, now we have an endocrinology analogy, that’s great. Rob, what do you think? What does the future hold in structuring rapid titration and getting patients to target?

I’m really hopeful on a couple of fronts. One is that we strike this term “consider.”“We’ll consider starting ARNI [angiotensin receptor-neprilysin inhibitor] at follow up.” We’ve got to eliminate that from our vernacular, that can’t be in a discharge summary. We need to start these therapies in the hospital, and I think it’s all as others have highlighted, this multidisciplinary team. We’ve learned about the tremendous success of having a pharmacist who can help a case manager if there’s paperwork and other financial limitations. So the future is multidisciplinary teams, it’s rapid sequence. We’ve got to do better for our patients.

Javed, what do you think? At Baylor Scott and White [Health], how are you thinking about this?

No, I don’t have much to add on top of what Muthiah and Rob said. Let me just take a moment and make a plea to all our listeners. Symptoms should be targets of therapy in heart failure, not a guide for therapy. Things like high blood pressure, diabetes, lipids, these diseases by definition are asymptomatic. We have many cancers that are diagnosed on screening, and that comes as a surprise to patients, they are asymptomatic. We would never leave these patients alone because their symptoms are OK. You treat the biology of the disease. Heart failure is the same thing. Whether you have a lot of symptoms or you have few symptoms, we need to target the underlying biology and treat them aggressively with appropriate indicated therapies. Just because somebody says they’re doing OK is not a reason to not treat them appropriately.

Absolutely, an important take-home message from Dr Javed Butler. At our institution at [Massachusetts General Hospital], we recognize the need for infrastructure for rapid sequence initiation and titration, even before STRONG-HF trial data came out. We have a clinic called the GDMT [guideline-directed medical therapy] clinic, and it is in existence for one job, which is education, initiation, and titration of GDMT. We’ll either start outpatients or we will take patients who have just been discharged in continuity to get them to target. It’s a 12-week process or shorter. We utilize many of the tools Dr Vaduganathan mentioned, not only education, but home-based titration, including virtual care, virtual laboratory testing as well, in order to get patients to target, because by and large that’s really the most important monitoring piece in this process. Blood pressure matters to be sure, but provided patients are not symptomatically hypotensive, we will continue titrating. We get patients in the office periodically, however, we have a nurse practitioner-based approach but we also have a pharmacist, as Dr Mentz mentioned. In our patients in our GDMT clinic, we are achieving quadruple therapy in over 90% of our patients, with nearly 90% on sacubitril/valsartan, and over 60% on target doses of all 4 drugs.

We’ll close with the point, Rob, in the CHAMP-HF Registry, how many patients were at target dose?

 This is striking, you can count it on a couple of hands.

It was single digits. The point is that it can be done. GDMT works for our patients, it reduces morbidity and mortality. We should not wait for initiating and titrating, getting patients feeling better and living longer. Four drugs, 5 pathways, 6 years of extra survival.

Thanks to all of you for this rich and informative discussion, and thank you for watching this peer exchange. If you enjoyed the content, please subscribe to our e-newsletters to receive upcoming peer exchanges and other great content right in your inbox. I’m Jim Januzzi, thanks for watching.

Drs James Januzzi, Javed Butler, Robert Mentz, and Muthiah Vaduganathan share practice pearls for treating patients with heart failure, focusing on the future of treatment.

Clinical Pearls for the Treatment of Heart Failure

Robert J. Mentz, MD

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