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Fipco

@fipco.bsky.social
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Fipco @fipco.bsky.social · 13h
About the CMS survey www.cms.gov/newsroom/fac... Detailed price files here - click CY27 information then preliminary medians for summary info www.cms.gov/medicare/pay... c: @ceed.bsky.social
cms.gov
Preliminary Calendar Year (CY) 2027 Medicare Clinical Laboratory Fee Schedule Payment Rates
Preliminary Calendar Year (CY) 2027 Medicare Clinical Laboratory Fee Schedule Payment Rates
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Fipco @fipco.bsky.social · 13h
CMS surveyed almost all private party transactions for the period Jan-Jun 2025. They found a weighted median price for apoB of $14.59 compared to $10.85 for calculated LDL-C, a difference of $3.74. This is based on 370k apoB tests and 26m lipid panels.
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Matthew Herper @matthewherper.bsky.social · 19/08/2026
Moderna and Merck say mRNA cancer vaccine succeeded in late-stage melanoma trial www.statnews.com/2026/08/19/m... via @statnews.com
statnews.com
Moderna and Merck say mRNA cancer vaccine succeeded in late-stage melanoma trial
A personalized mRNA cancer vaccine succeeded in a late-stage melanoma study, results that could herald a new, powerful approach in oncology.
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Fipco @fipco.bsky.social · 23/07/2026
TRIUMPH-3 had about half the total MACE-3 events of SURPASS-4. Clarity on CV benefit from TRIUMPH-OUTCOMES 10k patient trial. Primary completion date 2029. /2 clinicaltrials.gov/study/NCT063...
clinicaltrials.gov
ClinicalTrials.gov
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Fipco @fipco.bsky.social · 23/07/2026
Top line retatrutide results in TRIUMPH-2 and TRIUMPH-3. Top dose shows 20.8% per protocol weight loss in T2DM. (few % > tirzepatide) In contrast with tirze's SURPASS-4, uncertainty on CV effects of adding glucagon agonism. /1 investor.lilly.com/news-release...
x.com
fipco (@fipco) on X
Reassuring for GIP agonism. This seems to meet previous FDA CV safety standard ahead of CV outcomes trial. #tirzepatide https://t.co/cBo21QZmiy https://t.co/SRvuoPegE6
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Fipco @fipco.bsky.social · 23/07/2026
Both trials included T2DM. Weight loss attenuated in diabetics. SURMOUNT-2 (diabetics) weight loss 15.7% tirzepatide 15mg vs 3.3% pbo, net 12.4%. TRIUMPH-2 20.8% retatrutide 12mg vs pbo 4%, net 16.8% (all non-ITT). CV safety of adding glucagon agonism uncertain. TRIUMPH-OUTCOMES readout 2029.
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Fipco @fipco.bsky.social · 21/07/2026
Of the ~35m eligible under '26 guidelines, 13.7m plus some part of 5.3m (overlap with LDL-C>=160) added based on 30-yr PREVENT risk. /2 bsky.app/profile/fipc...
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Fipco @fipco.bsky.social · 21/07/2026
Anderson, et al. show major expansion of statin eligible individuals 30-59 years old under the new 2026 ACC/AHA/+ lipid guidelines ~18% --> 36% of individuals. A large factor is the 30-year PREVENT-ASCVD risk criteria.👍 /1 jamanetwork.com/journals/jam...
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Fipco @fipco.bsky.social · 07/06/2026
Bari and tofa cancer KM. Late separation at ~2y seen in both trials. Bari HR CIs include 1. 2nd chart from www.nejm.org/doi/full/10....
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Fipco @fipco.bsky.social · 07/06/2026
Re-assuring on mortality after tofa trial. Tofa trial had ~70% more MACE events in the control/TNFi arm and was enriched for higher events.
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Fipco @fipco.bsky.social · 07/06/2026
Baricitinib safety data presented at #EULAR2026 for pooled RA-BRIDGE and RA-BRANCH scientific.sparx-ip.net/archiveeular... abstract search link. Arguably VTE and cancer signals persist. Tofa safety trial Rx dropouts 35% for TNF arm, 57% in bari trials. #Jak bsky.app/profile/fipc...
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Fipco @fipco.bsky.social · 05/05/2026
NCT03915964 and NCT04086745 have yet to report. Primary completion date of trial was May 2025. Nearly 4k randomized patients followed multiple years assessing JAKi safety. Potential release this month. #baricitinib bsky.app/profile/fipc...
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Ignacio GHOULlup-Diaz @igallupd.bsky.social · 19/04/2026
"Pancreatic cancer mRNA vaccine shows lasting results in an early trial: Scientists caution that more research is needed, but nearly all of the patients who responded to the personalized vaccine are still alive six years later."
nbcnews.com
Pancreatic cancer mRNA vaccine shows lasting results in an early trial
Scientists caution that more research is needed, but nearly all of the patients who responded to the personalized vaccine are still alive six years later.
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JAMA @jama.com · 08/04/2026
💬 Editorial: Simulation modeling demonstrates #ApoB-guided statin intensification is cost-effective, identifies more clinically meaningful risk, and aligns with 2026 ACC/AHA guidelines. ja.ma/4cxddfa
JAMA editorial published online April 8, 2026, titled "ApoB and Resilient Cost-Effectiveness of Statin Intensity" by Ankur Pandya, PhD, and Jinyi Zhu, PhD. The article discusses statin therapy and ASCVD prevention.
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JAMA @jama.com · 08/04/2026
A computer simulation found #ApoB-guided intensification of lipid-lowering therapy provides the most QALYs and is highly cost-effective compared to #LDL-C or #nonHDL-C targets. ja.ma/4cxfzKX
Line graph titled 'Cost-Effectiveness of text@1, Non-HDL-C, and LDL-C Goals for Primary Prevention Lipid-Lowering Therapy'. The graph shows cost-effectiveness acceptability curve with 'Optimal probability strategy, %' on the Y-axis and 'Cost-effectiveness threshold (2025 $/QALY gained)' on the X-axis. Lines represent ApoB goal, Non-HDL-C goal, and LDL-C goal.
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Dr Lipid @drlipid.bsky.social · 30/03/2026
New mega-analysis showing statin therapy is associated with reduced risk of AD and related out comes, pubmed.ncbi.nlm.nih.gov/41761642/ @nationallipid.bsky.social @aspcardio.bsky.social @fabyollaveras.bsky.social @menopausesociety.bsky.social @eassociety.bsky.social
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American College of Cardiology @accintouch.bsky.social · 30/03/2026
Essence-CTA: Does Olezarsen Reduce Noncalcified Coronary Plaque Volume? Check out the results of the 🆕 #ACC26 late-breaking clinical trial: bit.ly/4tc0UKH #cvLipids #CardioSky
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Fipco @fipco.bsky.social · 14/03/2026
If you buy into the concept that statin benefit is tied to lipid lowering, traditional epidemiology shows the impact of elevated lipids varies by duration of exposure (Navar study linked above). In 30-year Framingham data, each decade of exposure to elevated lipids doubles risk. (adj'd HR ~1.5)
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James Pirruccello 🎃🦇🧹 @jamespirruccello.com · 13/03/2026
Ann Marie Navar has more to say on this topic: youtu.be/DRO5kHfcnz0?...
youtu.be
New Lipid Guidelines, Baby!
YouTube video by Ann Marie Navar
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Fipco @fipco.bsky.social · 14/03/2026
2. Individuals with one of 2 PTV mutations (PCSK9 or APOB) associated with lower lipids... Lifelong 50mg/dL lower LDL-C vs non-carriers associated with 50% lower CV risk. Consistent in 2 datasets. Risk reduction per unit of LDL lowering ~2x that of short RCTs. jamanetwork.com/journals/jam...
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Fipco @fipco.bsky.social · 14/03/2026
1. Across multiple mechanisms, RCT benefit tracks with level of lipid lowering. And magnitude of benefit much greater with life long lower lipids as seen in MR/genetic studies compared to RCTs.
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Fipco @fipco.bsky.social · 14/03/2026
Me trying to convince Mike of statin legacy effects. bsky.app/profile/fipc...
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Fipco @fipco.bsky.social · 14/03/2026
AHA/ACC/+ Lipid Guidelines - another notable and welcome change: use of long term risk to guide lipid lowering therapy. 30-year PREVENT-ASCVD risk >=10% support use of lipid lowering therapy. (this adds a large number of 30-59yr olds over prior PCE 5%) x.com/fipco/status...
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Fipco @fipco.bsky.social · 14/03/2026
How do statins work? It's largely about reducing atherogenic lipoproteins (LDL and other apoB LPs). The literature for cumulative effects of LDL-C/apoB is pretty extensive. 3 good links... pubmed.ncbi.nlm.nih.gov/29122815/ corserahealth.com/assets/pdfs/... www.ahajournals.org/doi/10.1161/...
pubmed.ncbi.nlm.nih.gov
Evaluation of the Pleiotropic Effects of Statins: A Reanalysis of the Randomized Trial Evidence Using Egger Regression-Brief Report - PubMed
Our reanalysis of the randomized control trial data using Egger regression adds to the existing evidence that the cardiovascular benefits of statins and their association with incident diabetes mellitus are mediated primarily, if not entirely, via their LDL-C lowering properties rather than by any p …
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Fipco @fipco.bsky.social · 13/03/2026
AHA/ACC/+ Guidelines recommend one time Lp(a) test in all adults. /2
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Fipco @fipco.bsky.social · 13/03/2026
ApoB recommendations from the 2026 AHA/ACC/+ lipid guidelines. "reasonable to measure" Yay! /1 www.jacc.org/doi/full/10....
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Fipco @fipco.bsky.social · 23/02/2026
In Novo's head to head trial of Cagrisema 2.4/2.4mg compared to Tirzepatide 15mg, Cagrisema did not show non-inferiority on the primary endpoint of weight loss at 84 weeks. ITT weight loss 20.2% v 23.6%, PP 23.0% v 25.5% for C-S v T. REDEFINE-4 www.novonordisk.com/news-and-med...
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Fipco @fipco.bsky.social · 08/02/2026
Note: apoB price can be close to that of a standard lipid panel. 2 options <=$20 with national labs. CMS zip file link - www.cms.gov/Medicare/Med...
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Fipco @fipco.bsky.social · 08/02/2026
"Recent research suggests that more people should be screened for a protein called apoB. A growing number of doctors agree." #cardiosky www.nbcnews.com/health/heart...
nbcnews.com
Is this blood test a better predictor of heart disease than LDL cholesterol?
Recent research suggests that more people should be screened for a protein called apoB. A growing number of doctors agree.
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Fipco @fipco.bsky.social · 24/01/2026
The formula weights apoB on TRL at 4.5 vs 1 for LDL. There's some uncertainty on the risk of TRLs compared to LDL particles. The PROMINENT trial of pemafibrate implies a 4.2mg/dL lower RW-apoB for the fibrate arm, while the MACE-4 HR was 1.03 (using median values & assuming no Lp(a) difference). /2
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Fipco @fipco.bsky.social · 24/01/2026
Rehman, et al. propose a single risk measure to reflect risk from apoB generally, Lp(a), and TG rich-lipoproteins. "RW-apoB" for "risk weighted". The scale is comparable to current apoB levels. #cardiosky /1 academic.oup.com/eurheartj/ad...
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Nature Reviews Cardiology @natrevcardiol.nature.com · 24/01/2026
New online! Residual cardiovascular risk in coronary artery disease: from pathophysiology to established and novel therapies #CardioSky
dlvr.it
Residual cardiovascular risk in coronary artery disease: from pathophysiology to established and novel therapies
Nature Reviews Cardiology, Published online: 23 January 2026; doi:10.1038/s41569-026-01249-zIn this Review, Galli and colleagues discuss the mechanisms and associated biomarkers of traditional and emerging factors responsible for the residual risk of recurrent adverse cardiovascular events in patients with coronary artery disease, with a focus on new pathophysiological insights and the therapeutic implications.
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Daniel Drucker @danieljdrucker.bsky.social · 11/12/2025
A TRIUMPH for the GCGR-GLP1R-GIPR triple agonist Retatrutide in P3. Participants with #obesity and knee osteoarthritis taking retatrutide 12 mg lost an average of 28.7% of their body weight at 68 weeks. Mild dysesthesias noted #weightloss #arthritis investor.lilly.com/news-release...
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Fipco @fipco.bsky.social · 02/12/2025
... since patients in trial have likely lower achieved EPA vs STRENGTH. However, dialysis patients are different and have different drivers of CV disease. Mechanisms are uncertain. We should be open to using medicines with convincing RCTs (as with SGLT2s) despite this uncertainty. /2-fin
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Fipco @fipco.bsky.social · 02/12/2025
Open to views of others. I'm hooked based on RCT + supportive trial + limited alternatives. I'm also a supporter of high dose EPA for secondary CV prevention. That's based in part on theory that high achieved EPA drives benefit. That doesn't apply to PISCES... /1 bsky.app/profile/neph...
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Fipco @fipco.bsky.social · 01/12/2025
Some are reassured by observational epidemiology. But the recent semaglutide Alzheimer's trials did not recapitulate real world simulations. Links via Gregg Fonarow. Corrected jamanetwork.com/journals/jam... alz-journals.onlinelibrary.wiley.com/doi/10.1002/... diabetesjournals.org/care/article...
jamanetwork.com
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Fipco @fipco.bsky.social · 30/11/2025
According to clinicaltrials.gov the baricitinib CV safety trials completed 6 months ago. Perhaps more t's to cross and i's to dot. This EULAR consensus review pointed to these studies as important in assessing JAKi safety. pubmed.ncbi.nlm.nih.gov/36357155/ bsky.app/profile/fipc...
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Fipco @fipco.bsky.social · 26/11/2025
The Economist on apoB. ApoB is inexpensive and more accurate than LDL-C. The measures disagree in 30-40% of individuals. www.economist.com/science-and-... #cardiosky
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Fipco @fipco.bsky.social · 08/11/2025
Just saw this. Good review on uses of apoB testing. In my view, apoB testing has a broader role than envisioned here. jamesstein18.substack.com/p/when-lipop...
jamesstein18.substack.com
When Lipoprotein Tests Can Be Helpful, Part I: Apolipoprotein B-100
In my first blog, I expressed skepticism about using additional blood tests for cardiovascular disease (CVD) risk prediction beyond traditional risk factors.
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Fipco @fipco.bsky.social · 08/11/2025
Also believe 10 year risk paradigm of current guidelines misses opportunity for early prevention for those with elevated longer term risk.
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Fipco @fipco.bsky.social · 08/11/2025
Thoughtful, provocative editorial. Some fair points. Respectfully disagree with apoB/CAC examples. IMO evidence base (including health economics) for these support broader use and are incorporated in some guidelines (apoB: EAS/ESC, CCS, NLA statement) #cardiosky bsky.app/profile/jame...
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JAMA @jama.com · 07/11/2025
Among more than 800 000 CKD-PC participants, discordance between cystatin C and creatinine eGFR values was associated with increased risk of death, cardiovascular events, and kidney failure. #KidneyWK @asnkidney.bsky.social ja.ma/4oV4DtU
JAMA graph shows association of eGFR difference with risks of long-term adverse outcomes. Hazard ratio vs. difference between eGFRcys & eGFRcr (%). Lines for death, CVD death, heart failure, ASCVD, KFRT are plotted. Declining risk as difference approaches zero.
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Nayan Arora @captainchloride.bsky.social · 07/11/2025
Shocking first high impact trial of the day. Fish oil reduces CV events in dialysis patients! #Pisces #kidneywk Simultaneous pub in NEJM www.nejm.org/doi/full/10....
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 21/10/2025
The latest empadata dump: @nephroseeker.medsky.social writes up a #NephJC short on the meta analysis www.nephjc.com/news/2025/10...
nephjc.com
Empagliflozin, the kidney, and what we still don’t understand — NephJC
NephJC short on an empagliflozin meta-analysis
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Fipco @fipco.bsky.social · 18/09/2025
Probably yes, for example lixisenatide - short half-life GLP-1ra dosed once a day was not superior to placebo on MACE (ELIXA). Real world data has some value, but results are all over the place. IMO CVOTs suggest both semaglutide and tirzepatide are good options for secondary prevention.
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Fipco @fipco.bsky.social · 09/09/2025
• start prevention earlier (than current guidelines suggest) • measure apoB Editorial by Angela Pirillo and Alberico Catapano #cardiosky academic.oup.com/eurheartj/ad...
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Fipco @fipco.bsky.social · 09/09/2025
ICER organization draft: Semaglutide and tirzepatide for obesity are cost effective. For context, a 2014 ACC/AHA task force suggested a less than $50k per QALY threshold as "high value". #cardiosky icer.org/assessment/o...
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Fipco @fipco.bsky.social · 08/09/2025
Key take home: current risk models understate clinical & economic benefit of long term bp/lipid lowering. Link to slides corserahealth.com/assets/pdfs/...
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Fipco @fipco.bsky.social · 08/09/2025
NATURE-Legacy study compares MR/genetically modeled life long LDL-C and blood pressure lowering (HR 0.32) to short term effects in the HOPE-3 trial (HR 0.71). By Brian Ference, et al. /1 #ESCCongress2025 #cardiosky
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Fipco @fipco.bsky.social · 02/09/2025
"This study suggests that ApoB is a more accurate marker for cardiovascular risk than LDL-P when discordant, as marked by ApoB levels in excess of LDL-P." Analysis of UK Biobank data by Elizabeth Epstein, et al. #cardiosky pubmed.ncbi.nlm.nih.gov/40887080/
pubmed.ncbi.nlm.nih.gov
Apolipoprotein B outperforms low density lipoprotein particle number as a marker of cardiovascular risk in the UK Biobank - PubMed
This study suggests that ApoB is a more accurate marker for cardiovascular risk than LDL-P when discordant, as marked by ApoB levels in excess of LDL-P. Notably, risk was already elevated at as little...
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