Last week I experienced a tumultuous interface with the pharmaceutical industry. In the space of a few hours, three representatives came bearing information on the compounds formerly known as S-16257, REGN727, and LCZ696. They've been awarded the clumsy generic names of ivabradine, alirocumab, and sacubitril/valsartan, respectively. After spinning in the marketing bin, they tumbled out as Corlanor (Amgen), for tachycardia, angina, and heart failure; Praluent (Sanofi/Regeneron), an injection for cholesterol lowering; and Entresto (Novartis), a molecule that has been piggybacked onto our familiar and much-beloved valsartan for heart-failure management.
The side effects of these new meds were probed, argued, and discussed long before they could travel along conveyor belts, plop into bottles, and slide onto my sample cabinet. I'm not resistant to new meds, but I'm always suspicious that we don't know everything about side effects or efficacy until they have burst onto the scene of a tell-all American market. Despite adequate trials, wider use of these potentially life-changing drugs directed by healthcare providers is still nothing more than a well-vetted leap of faith. I'm cautiously optimistic, though, about all of them. Here are some specific thoughts I've mulled regarding these three new compounds and how they might affect our office day:/.../
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