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  1. Article ; Online: Lipid lowering therapy: implications of recent clinical trials.

    Backes, James M / Hilleman, Daniel E

    Future cardiology

    2024  Volume 20, Issue 2, Page(s) 89–98

    Abstract: Recent lipid lowering therapy trials have provided important insights on certain agents while also continuing to expand our understanding of atherosclerotic cardiovascular disease (ASCVD) risk. Findings from current trials include the impact of statin ... ...

    Abstract Recent lipid lowering therapy trials have provided important insights on certain agents while also continuing to expand our understanding of atherosclerotic cardiovascular disease (ASCVD) risk. Findings from current trials include the impact of statin therapy on ASCVD among populations with HIV, the benefit of lowering low-density lipoprotein cholesterol with bempedoic acid among patients considered statin intolerant, the safety and efficacy of inclisiran over a 4-year period, another failed attempt for fibrates to reduce ASCVD risk, which omega-3 fatty to utilize for lowering cardiovascular events, 'n-of-1' trials evaluating statin intolerance, and how low-dose rosuvastatin compared with commonly utilized supplements for lowering lipid parameters. Such data help inform so clinicians can optimize lipid lowering therapy and improve ASCVD outcomes.
    MeSH term(s) Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Cholesterol, LDL ; Atherosclerosis/drug therapy ; Rosuvastatin Calcium/therapeutic use ; Fatty Acids, Omega-3/therapeutic use ; Cardiovascular Diseases/drug therapy ; Anticholesteremic Agents/therapeutic use
    Chemical Substances Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Cholesterol, LDL ; Rosuvastatin Calcium (83MVU38M7Q) ; Fatty Acids, Omega-3 ; Anticholesteremic Agents
    Language English
    Publishing date 2024-01-16
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2274267-0
    ISSN 1744-8298 ; 1479-6678
    ISSN (online) 1744-8298
    ISSN 1479-6678
    DOI 10.2217/fca-2023-0132
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6836: Show issues Location:
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  2. Article ; Online: Elevated Lp(a): Guidance for Identifying and Managing Patients.

    Hilleman, Daniel E / Vacek, James L / Backes, James M

    Southern medical journal

    2024  Volume 117, Issue 4, Page(s) 208–213

    Abstract: Lipoprotein(a) (Lp(a)) is a unique low-density lipoprotein-like lipoprotein that is considered an independent and causal risk factor for atherosclerotic cardiovascular disease (ASCVD) and calcific aortic valve stenosis. The Lp(a) molecule also contains ... ...

    Abstract Lipoprotein(a) (Lp(a)) is a unique low-density lipoprotein-like lipoprotein that is considered an independent and causal risk factor for atherosclerotic cardiovascular disease (ASCVD) and calcific aortic valve stenosis. The Lp(a) molecule also contains apolipoprotein A and apolipoprotein B, which collectively promote atherosclerosis, thrombosis, and inflammation. Lp(a) is highly genetic and minimally responsive to nonpharmacological measures. Lp(a) serum levels ≥125 nmol/L are associated with increased ASCVD risk, but this threshold has not been accepted universally. Elevated Lp(a) is the most common genetic dyslipidemia affecting approximately 20% of the general population. Certain currently available lipid-lowering drugs, including the proprotein convertase subtilisin/kexin type 9 therapies, produce moderate reductions in Lp(a); however, none are indicated for the treatment of elevated Lp(a). There are currently four investigational RNA-based therapeutic agents that reduce Lp(a) by 70% to 100%. Two of these agents are being evaluated for ASCVD risk reduction in adequately powered outcomes trials, with results expected in 2 to 3 years. Until such therapies become available and demonstrate favorable clinical outcomes, strategies for elevated Lp(a) primarily involve early and intensive ASCVD risk factor management.
    MeSH term(s) Humans ; Aortic Valve Stenosis/diagnosis ; Aortic Valve Stenosis/therapy ; Lipoprotein(a) ; Aortic Valve ; Calcinosis/therapy ; Risk Factors ; Apolipoproteins ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/prevention & control
    Chemical Substances Lipoprotein(a) ; Apolipoproteins
    Language English
    Publishing date 2024-04-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 185329-6
    ISSN 1541-8243 ; 0038-4348
    ISSN (online) 1541-8243
    ISSN 0038-4348
    DOI 10.14423/SMJ.0000000000001675
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  3. Article ; Online: New and emerging lipid-lowering therapy.

    Backes, James M / Hilleman, Daniel E

    Future cardiology

    2021  Volume 17, Issue 8, Page(s) 1407–1420

    Abstract: Statins remain the drugs of choice in patients at risk of or with atherosclerotic cardiovascular disease (ASCVD). Statins have limitations that drive the development of investigational agents to manage dyslipidemias and/or reduce ASCVD risk. There are a ... ...

    Abstract Statins remain the drugs of choice in patients at risk of or with atherosclerotic cardiovascular disease (ASCVD). Statins have limitations that drive the development of investigational agents to manage dyslipidemias and/or reduce ASCVD risk. There are a few small-molecule drugs that have the potential to mitigate ASCVD risk either alone or in combination with statins. Most lipid-modifying drugs in clinical development are biologic agents that target specific enzymes or genetic-based protein synthesis. Limitations of the biologic agents include complex mechanisms of action and manufacturing processes with indications in select patients with genetic dyslipidemia or who have failed traditional therapies. The ultimate clinical utility of the new and investigational agents will become established over the next several years.
    MeSH term(s) Atherosclerosis/drug therapy ; Atherosclerosis/prevention & control ; Cardiovascular Diseases/drug therapy ; Cardiovascular Diseases/prevention & control ; Dyslipidemias/drug therapy ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Lipids
    Chemical Substances Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Lipids
    Language English
    Publishing date 2021-03-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 2274267-0
    ISSN 1744-8298 ; 1479-6678
    ISSN (online) 1744-8298
    ISSN 1479-6678
    DOI 10.2217/fca-2020-0217
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  4. Article ; Online: Management of patients with fibrosing interstitial lung diseases.

    Morrow, Lee E / Hilleman, Daniel / Malesker, Mark A

    American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists

    2021  Volume 79, Issue 3, Page(s) 129–139

    Abstract: Purpose: This article summarizes the appropriate use and pharmacology of treatments for fibrosing interstitial lung diseases, with a specific focus on the antifibrotic agents nintedanib and pirfenidone.: Summary: The interstitial lung diseases are a ... ...

    Abstract Purpose: This article summarizes the appropriate use and pharmacology of treatments for fibrosing interstitial lung diseases, with a specific focus on the antifibrotic agents nintedanib and pirfenidone.
    Summary: The interstitial lung diseases are a heterogenous group of parenchymal lung disorders with a common feature-infiltration of the interstitial space with derangement of the normal capillary-alveolar anatomy. Diseases characterized by fibrosis of the interstitial space are referred to as the fibrosing interstitial lung diseases and often show progression over time: idiopathic pulmonary fibrosis is the most common fibrotic interstitial lung disease. Historically, therapies for fibrosing lung diseases have been limited in number, questionable in efficacy, and associated with potential harms. Food and Drug Administration (FDA) approval of the antifibrotic agents nintedanib and pirfenidone for idiopathic pulmonary fibrosis in 2014 heralded an era of reorganization of therapy for the fibrotic interstitial lung diseases. Subsequent investigations have led to FDA approval of nintedanib for systemic sclerosis-associated interstitial lung disease and interstitial lung diseases with a progressive phenotype. Although supportive care and pulmonary rehabilitation should be provided to all patients, the role(s) of immunomodulators and/or immune suppressing agents vary by the underlying disease state. Several agents previously used to treat fibrotic lung diseases (N-acetylcysteine, anticoagulation, and pulmonary vasodilators) lack efficacy or cause harm.
    Conclusion: With the introduction of effective pharmacotherapy for fibrosing interstitial lung disease, pharmacists have an increasingly important role in the interdisciplinary team managing these patients.
    MeSH term(s) Disease Progression ; Fibrosis ; Humans ; Idiopathic Pulmonary Fibrosis/diagnosis ; Idiopathic Pulmonary Fibrosis/drug therapy ; Lung Diseases, Interstitial/diagnosis ; Lung Diseases, Interstitial/drug therapy ; Protein Kinase Inhibitors ; Pyridones/therapeutic use
    Chemical Substances Protein Kinase Inhibitors ; Pyridones
    Language English
    Publishing date 2021-10-04
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1224627-x
    ISSN 1535-2900 ; 1079-2082
    ISSN (online) 1535-2900
    ISSN 1079-2082
    DOI 10.1093/ajhp/zxab375
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    Zs.A 419: Show issues Location:
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  5. Article ; Online: A Response to: Letter to the Editor Regarding "Critical Differences Between Dietary Supplement and Prescription Omega-3 Fatty Acids: a Narrative Review".

    Hilleman, Daniel E / Wiggins, Barbara S / Bottorff, Michael B

    Advances in therapy

    2020  Volume 37, Issue 9, Page(s) 4046–4048

    MeSH term(s) Dietary Supplements ; Fatty Acids, Omega-3 ; Humans ; Hypertriglyceridemia
    Chemical Substances Fatty Acids, Omega-3
    Language English
    Publishing date 2020-07-09
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 632651-1
    ISSN 1865-8652 ; 0741-238X
    ISSN (online) 1865-8652
    ISSN 0741-238X
    DOI 10.1007/s12325-020-01420-z
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    Zs.A 2101: Show issues Location:
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  6. Article ; Online: Critical Differences Between Dietary Supplement and Prescription Omega-3 Fatty Acids: A Narrative Review.

    Hilleman, Daniel E / Wiggins, Barbara S / Bottorff, Michael B

    Advances in therapy

    2020  Volume 37, Issue 2, Page(s) 656–670

    Abstract: ... either nonprescription dietary supplements (e.g., fish oils) or prescription (Rx) medications. As such, we aimed ...

    Abstract Introduction: Currently available omega-3 (OM-3) fatty acid products in the US are either nonprescription dietary supplements (e.g., fish oils) or prescription (Rx) medications. As such, we aimed to describe critical therapeutic differences among the OM-3 fatty acids, focusing on differences between fish oil supplements and Rx OM-3s.
    Methods: A narrative review of known papers salient to this topic was conducted.
    Results: Despite the multiple purported clinical benefits, the published evidence for OM-3 dietary supplements is generally insufficient, inconsistent, or negative. Rx OM-3 products are indicated as an adjunct to diet to reduce triglycerides (TG) in adults with severe hypertriglyceridemia (TG ≥ 500 mg/dl). Recently, the Rx eicosapentaenoic acid (EPA)-only OM-3, icosapent ethyl, demonstrated cardiovascular (CV) risk reduction among statin-treated patients at high risk of CV disease in a large CV outcomes trial (CVOT), and is now also indicated as an adjunct to maximally tolerated statin therapy to reduce the risk of myocardial infarction, stroke, coronary revascularization, and unstable angina requiring hospitalization in adult patients with elevated TG (≥ 150 mg/dL) and established CVD or diabetes mellitus and ≥ 2 additional risk factors for CVD. In contrast to the rigorous regulatory standards for safety, efficacy, and manufacturing of medications (whether Rx or over the counter), the Food and Drug Administration manages dietary supplements as food. Issues specific to OM-3 dietary supplements include variable content, labeling inconsistencies, and poor product quality/impurity. Given these issues, OM-3 dietary supplements should not be substituted for Rx OM-3 products. The efficacy of the EPA-only Rx OM-3 product in a large CVOT cannot be extrapolated to other OM-3 products.
    Conclusion: Consumers and health care providers need to recognize critical differences between Rx and OM-3 dietary supplements to ensure appropriate use of each OM-3 product.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Cardiovascular Diseases/drug therapy ; Dietary Supplements ; Eicosapentaenoic Acid/therapeutic use ; Fatty Acids, Omega-3/therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Nonprescription Drugs/therapeutic use ; Prescription Drugs/therapeutic use ; United States
    Chemical Substances Fatty Acids, Omega-3 ; Nonprescription Drugs ; Prescription Drugs ; Eicosapentaenoic Acid (AAN7QOV9EA)
    Language English
    Publishing date 2020-01-09
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 632651-1
    ISSN 1865-8652 ; 0741-238X
    ISSN (online) 1865-8652
    ISSN 0741-238X
    DOI 10.1007/s12325-019-01211-1
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  7. Article ; Online: Adherence and health care costs with single-pill fixed-dose combinations in hypertension management.

    Hilleman, Daniel E

    Journal of managed care pharmacy : JMCP

    2013  Volume 20, Issue 1, Page(s) 93–100

    MeSH term(s) Antihypertensive Agents/economics ; Antihypertensive Agents/therapeutic use ; Disease Management ; Drug Therapy, Combination/economics ; Drug Therapy, Combination/methods ; Health Care Costs ; Humans ; Hypertension/drug therapy ; Hypertension/economics ; Medication Adherence
    Chemical Substances Antihypertensive Agents
    Language English
    Publishing date 2013-05-17
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2022394-8
    ISSN 1944-706X ; 1083-4087
    ISSN (online) 1944-706X
    ISSN 1083-4087
    DOI 10.18553/jmcp.2014.20.1.93
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    Zs.A 5450: Show issues Location:
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  8. Article ; Online: Comparative antiplatelet effects of chlorthalidone and hydrochlorothiazide.

    Bashir, Khalid / Burns, Tammy / Pirruccello, Samuel J / Aurit, Sarah J / Hilleman, Daniel E

    Journal of clinical hypertension (Greenwich, Conn.)

    2022  Volume 24, Issue 10, Page(s) 1310–1315

    Abstract: Chlorthalidone (CTD) may be superior to hydrochlorothiazide (HCTZ) in the reduction of adverse cardiovascular events in hypertensive patients. The mechanism of the potential benefit of CTD could be related to antiplatelet effects. The objective of this ... ...

    Abstract Chlorthalidone (CTD) may be superior to hydrochlorothiazide (HCTZ) in the reduction of adverse cardiovascular events in hypertensive patients. The mechanism of the potential benefit of CTD could be related to antiplatelet effects. The objective of this study was to determine if CTD or HCTZ have antiplatelet effects. This study was a prospective, double-blind, randomized, three-way crossover comparison evaluating the antiplatelet effects of CTD, HCTZ, and aspirin (ASA) in healthy volunteers. The effects of these treatments on platelet activation and aggregation were assessed using a well-established method with five standard platelet agonists. Thirty-four patients completed the three-way crossover comparing pre- and post-treatment changes in platelet activation and aggregation studies. There were statistically significant antiplatelet effects with ASA but not with CTD or HCTZ. Hypokalemia occurred in 0 (0%), 10 (30%), and 6 (18%) of the ASA, CTD, and HCTZ patients, respectively. The results of our study suggest that the benefits of CTD and HCTZ in reducing adverse cardiovascular events in patients with hypertension is not a result of an antiplatelet effect. In our study, hypokalemia with CTD was more prevalent than that reported in a large outcome trial in patients with hypertension. The clinical relevance of this finding is uncertain.
    MeSH term(s) Humans ; Chlorthalidone/adverse effects ; Hydrochlorothiazide/adverse effects ; Hypertension ; Hypokalemia/chemically induced ; Hypokalemia/epidemiology ; Prospective Studies ; Antihypertensive Agents/adverse effects ; Blood Pressure ; Diuretics/therapeutic use ; Double-Blind Method ; Aspirin/pharmacology ; Aspirin/therapeutic use ; Drug Therapy, Combination
    Chemical Substances Chlorthalidone (Q0MQD1073Q) ; Hydrochlorothiazide (0J48LPH2TH) ; Antihypertensive Agents ; Diuretics ; Aspirin (R16CO5Y76E)
    Language English
    Publishing date 2022-09-06
    Publishing country United States
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 2077222-1
    ISSN 1751-7176 ; 1524-6175
    ISSN (online) 1751-7176
    ISSN 1524-6175
    DOI 10.1111/jch.14564
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    Zs.A 5723: Show issues Location:
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  9. Book: New concepts to improve health outcomes for patients with chronic obstructive pulmonary disease

    Minkoff, Neil B. / Leff, Richard D. / Hilleman, Daniel E.

    (Journal of managed care pharmacy ; 11,6,S-a = Suppl.)

    2005  

    Author's details Neil B. Minkoff ; Richard D. Leff ; Daniel E. Hilleman
    Series title Journal of managed care pharmacy ; 11,6,S-a = Suppl.
    Collection
    Language English
    Size S22 S. : Ill., graph. Darst.
    Publisher Acad. of Managed Care Pharmacy
    Publishing place Alexandria, VA
    Publishing country United States
    Document type Book
    HBZ-ID HT014468355
    Database Catalogue ZB MED Medicine, Health

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    Shelf markLoan statusLocation
    Zs A 5450 -11,6,Suppl.A- not available for loan Zeitschriften-Lesesaal

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  10. Article ; Online: Knowledge, Perceptions, and Patterns of Fish Oil Use in Cardiac Patients.

    Hilleman, Daniel E / Teply, Robyn / Packard, Kathleen A

    Journal of pharmacy practice

    2019  Volume 33, Issue 5, Page(s) 580–585

    Abstract: Background: Fish oils are the most widely used nonvitamin, nonmineral dietary supplements in the United States. They are not over-the-counter medications and are neither approved nor indicated for treating disease. Patient knowledge and patterns of fish ...

    Abstract Background: Fish oils are the most widely used nonvitamin, nonmineral dietary supplements in the United States. They are not over-the-counter medications and are neither approved nor indicated for treating disease. Patient knowledge and patterns of fish oil use are not well defined.
    Objective: To determine cardiac patients' knowledge and patterns of fish oil use.
    Methods: One thousand consecutive patients admitted to an in-patient cardiology service (2015-2017) taking fish oil dietary supplements or prescription omega-3 fatty acids were asked to complete an anonymous questionnaire concerning product knowledge and use.
    Results: A total of 711 (71%) patients completed the questionnaire. Primary reasons for use included general health (34%), heart health (28%), arthritis (9%), and lipid disorders (8%). Few patients (14%) were advised to take fish oil products by a health-care provider. Only 2.5% were taking prescription omega-3 fatty acids. Only 26% knew the active ingredient in their fish oil product. Supplements were purchased through a nonpharmacy retail seller by 81% of respondents.
    Conclusions: Most cardiac patients consuming fish oil dietary supplements do so without medical supervision and without knowledge of the active ingredients. As most patients obtain supplements outside of a pharmacy, opportunities to monitor and educate patients remain a major challenge.
    MeSH term(s) Dietary Supplements ; Docosahexaenoic Acids ; Eicosapentaenoic Acid ; Fatty Acids, Omega-3 ; Fish Oils ; Humans ; Perception ; United States
    Chemical Substances Fatty Acids, Omega-3 ; Fish Oils ; Docosahexaenoic Acids (25167-62-8) ; Eicosapentaenoic Acid (AAN7QOV9EA)
    Language English
    Publishing date 2019-01-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1027474-1
    ISSN 1531-1937 ; 0897-1900
    ISSN (online) 1531-1937
    ISSN 0897-1900
    DOI 10.1177/0897190018824485
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