Dr Jorge Plutzky: New Advances in Science, Medicine Need to Move Into Practice Quicker

The acceleration of science and medicine is exciting, but these new advances are not always moving into practice, said Jorge Plutzky, MD, director of the Vascular Disease Prevention Program and director of Preventive Cardiology at Brigham and Women’s Hospital, and associate professor of medicine at Harvard Medical School.

Transcript

How well are we taking scientific discoveries or trial findings and translating them into real-world care that improves the health of the population?

We live in really exciting times. The acceleration in the ability to identify a target, see that translate into a therapy and see that move into trials in humans, and ultimately, clinical trials that show benefit in humans is really astonishing.

If we look at examples, like the PCSK9 inhibitors from the time in which the gene was identified that contributed people having low LDL [low-density lipoprotein] levels and conferring protection against cardiovascular disease to when we had a drug available, that actually had clinical trial efficacy in reducing cardiovascular events is, you know, on the order of 10 years, that's really amazing. And so, we see that continuing to play out through different kinds of models, different kinds of strategies, really unparalleled kinds of resources that we now have, looking very broadly at the human genome, at the transcriptome, the metabolome, at genetics, and so I think those targets will continue to come out and to move into clinical trials and proof of efficacy and safety. And recognizing that the bar keeps rising because the control population has never been so well treated, you know, you're going up against a group of patients that are well treated.

I think the one thing that also gives us pause is the extent to which new advances are not moving into practice, to the extent that they should. Even therapies that we know have proven benefits and are now even generic, like statins. The underutilization of statins, of either patients not being prescribed, not staying on them, or not being treated to appropriate levels, with statins and adjunctive LDL-lowering medicines is unfortunate. And it is forcing us to also think about new strategies of how do we change that curve? Get people on therapies that they need to support them to stay on those therapies? To make sure that they're being used?

[It] is really almost like the other side of the balance of all this new progress and new targets, you know, very exciting progress that we're seeing and then not seeing implementation. And I think hand in hand with that are rethinking how do we accelerate implementation? How do we bring specialists and primary care physicians up to speed so they feel comfortable in knowing when and how to use these drugs and how to get them approved?