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Editorial

Introducing Emerging Concepts in Pharmacotherapeutics

Dixon, Dave L. PharmD

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Journal of Cardiovascular Pharmacology: October 2020 - Volume 76 - Issue 4 - p 372-373
doi: 10.1097/FJC.0000000000000904
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This is an exciting time in the field of cardiovascular medicine, which has seen significant progress in the available pharmacological agents to prevent and treat cardiovascular disease. In the past decade, we have seen major therapeutic advancements in anticoagulation, dyslipidemia, and heart failure, among others. Some examples include the identification of the proprotein convertase subtilisin/kexin type 9 (PCSK9) gene, which in only 12 years resulted in the availability of two monoclonal antibodies targeting PCSK9, and renewed interest in the intersection between cardiovascular disease and diabetes because of the success of the sodium glucose co-transporter 2 inhibitors, which not only improve glycemic control but also reduce heart failure hospitalizations and cardiovascular mortality.1,2 Despite this tremendous progress, our work is far from over because cardiovascular disease remains the leading cause of death worldwide.3 This has become even more evident in light of the ongoing coronavirus disease 2019 (COVID-19) pandemic, where those at high cardiovascular risk face a greater risk of severe illness and mortality.4 There is a silver lining in that our urgent need to better understand COVID-19 may also give us clues regarding cardiovascular pathophysiology, especially from an inflammation standpoint, which is a rich area of ongoing research with significant potential.5

The pipeline for novel cardiovascular therapies remains robust as we continue to identify new targets (Fig. 1) and technologies that are driving innovation faster than ever, including gene modification using small interfering RNA and computational modeling to better understand disease as a means to developing more targeted therapies.6,7 In recognition of this evolving landscape, the Journal is dedicating a new section to emerging therapies entitled, “Emerging Concepts in Pharmacotherapeutics,” which aims to recruit the best and brightest clinical pharmacists and pharmacologists to produce high-quality review articles that provide readers with an in-depth understanding of the pharmacology, available and ongoing clinical trial data, and potential clinical role of emerging or recently approved therapies. Furthermore, it is my pleasure to serve as the Section Editor, and I look forward to working with the Editor-in-Chief and Editorial Board. My background includes 15 years of experience as a clinical pharmacist and researcher focused in cardiometabolic disease and heart failure as part of an interdisciplinary team of investigators, including fellow pharmacists, cardiologists, dietitians, exercise physiologists, and basic scientists. Thus, it is my hope to invite authors who are similarly qualified to provide a broad clinical perspective to these emerging therapies and help close the loop by connecting the bench with the bedside.

FIGURE 1.
FIGURE 1.:
Emerging topics in cardiovascular pharmacotherapeutics. ACE, angiotensin-converting enzyme; RAAS, renin–angiotensin–aldosterone system. Images credited to Servier Medical Art (https://smart.servier.com/); Creative Commons License 3.0 (https://creativecommons.org/licenses/by/3.0/).

The inaugural review, “The Role of Bempedoic Acid in Dyslipidemia Management,” highlights a novel lipid-lowering therapy that was recently approved in February by the Food and Drug Administration. Kelly et al8 provide a fair and balanced review of the oral ATP-citrate lyase inhibitor, bempedoic acid, a first-in-class therapy that offers an alternative to high-risk patients unable to achieve desired low-density lipoprotein cholesterol levels on maximally tolerated statin therapy but has not yet been shown to reduce the risk of cardiovascular events. This is just one of many advancements in the available treatment options for dyslipidemia and an example of the type of articles we aim to publish in this section.

In closing, although there are several articles in production, we invite you to reach out with your ideas regarding novel therapies in the pipeline that should be considered. At this time, these articles are by invitation alone, but if you have interest in authoring a review, do not hesitate to contact us. We welcome your feedback and ideas so that this new section will achieve its purpose of keeping our readers at the forefront of cardiovascular pharmacology.

REFERENCES

1. Board C, Kelly MS, Shapiro MD, et al. PCSK9 inhibitors in secondary prevention—an opportunity for personalized therapy. J Cardiovasc Pharmacol. 2020;75:410–420.
2. Bonaventura A, Carbone S, Dixon DL, et al. Pharmacologic strategies to reduce cardiovascular disease in type 2 diabetes mellitus: focus on SGLT-2 inhibitors and GLP-1 receptor agonists. J Intern Med. 2019;286:16–31.
3. Roth GA, Johnson C, Abajobir A, et al. Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. J Am Coll Cardiol. 2017;70:1–25.
4. Dixon DL, Van Tassell BW, Vecchié A, et al. Cardiovascular considerations in treating patients with coronavirus disease 2019 (COVID-19). J Cardiovasc Pharmacol. 2020;75:359–367.
5. Abbate A, Toldo S, Marchetti C, et al. Interleukin-1 and the inflammasome as therapeutic targets in cardiovascular disease. Circ Res. 2020;126:1260–1280.
6. Li P, Fu Y, Ru J, et al. Insights from systems pharmacology into cardiovascular drug discovery and therapy. BMC Syst Biol. 2014;8:141.
7. Niederer SA, Lumens J, Trayanova NA. Computational models in cardiology. Nat Rev Cardiol. 2019;16:100–111.
8. Kelly MS, Sulaica EM, Beavers CJ. Role of bempedoic acid in dyslipidemia management. J Cardiovasc Pharmacol. 2020;16:1.
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