Hi {{first name | there}},
Heart disease has shaped my family.
My dad survived a massive heart attack and eventually needed a heart transplant. My grandfather spent the last six years of his life bed-bound after a stroke.
Then my own LDL came back at 192 mg/dL.
A PCSK9 inhibitor changed my trajectory. I take Repatha every two weeks, and my LDL dropped to roughly 40 mg/dL. The injection is manageable. Most people would still rather take a pill, and plenty will never start an injectable for a risk they cannot feel.
My LDL reached 192 mg/dL. PCSK9 inhibition has had the biggest impact on my longevity by far.
On Thursday, the FDA approved Lipfendra, or enlicitide, the first oral PCSK9 inhibitor in the United States. In Phase 3 trials, it lowered LDL by roughly 56–59% versus placebo and ApoB by about 50%.
That is injectable-class LDL lowering in a once-daily tablet.
While not as sexy as GLP-1 inhibitors, I strongly believe this and other effective, well-tolerated lipid-lowering and atherosclerosis-preventing interventions will have such a large impact on healthspan and lifespan that they will transform the field entirely.
So how did we discover such an incredible mechanism of intervention, and why am I so convinced of its safety and efficacy for longevity?
