In the Weeks Since ACC.23/WCC, We Asked Practicing Cardiologists About the Data

The American College of Cardiology held its 2023 scientific session together with the World Heart Federation’s World Congress of Cardiology (ACC.23/WCC) on March 4th through 6th in New Orleans. In the weeks since, the study data disseminated at the event has made its way into the medical community. 

This has paved the way for Stream by AlphaSense to publish reactions from twelve cardiologists to key ACC.23/WCC presentations on high blood cholesterol, hypertrophic cardiomyopathy, mitral regurgitation and pulmonary arterial hypertension. 

Notably, these are practicing physicians who did not participate in any of the studies presented at ACC.23/WCC, so this is a great boots-on-the-ground read on some of the most important cardiology data presented this year.

High Blood Cholesterol

Three cardiologists had favorable reactions to data presented at ACC.23/WCC on Esperion Therapeutics’ Nexletol (bempedoic acid) because it fills a niche for patients with high blood cholesterol who are statin-intolerant. These physicians believe that in the statin-intolerant population, Nexletol and Nexlizet (a fixed dose combination of bempedoic acid and Merck & Co.’s Zetia cholesterol medication) will likely take share from injectable PCSK9 inhibitors because Nextelol and Nexlizet are administered orally. Amgen Inc.’s Repatha, Novartis Inc.’s Leqvio and Regeneron Pharmaceuticals Inc.’s Praluent are the approved injectable PCSK9 inhibitors on the market.

Primary Ticker: Esperion Therapeutics Inc. (ESPR)

Other Companies Mentioned: Amgen Inc. (AMGN), AstraZeneca PLC (AZN), Merck & Co. (MRK), Viatris Inc. (VTRS)

“I would go toward Nexlizet [over PCSK9 injectables] because it’s a tablet and easy to give.” Cardiologist at the Cardiology Center

Primary Ticker: ESPR

Other Companies Mentioned: Novartis Inc. (NVS), MRK

“The issue [with using bempedoic acid] was not having the CLEAR Outcomes data to justify using it over a PCSK9 inhibitor. Now that we have the CLEAR Outcomes data, at least for patients who are statin-intolerant, bempedoic acid offers a reasonable alternative.”  – Cardiologist at Harbor-UCLA Medical Center

Primary Ticker: ESPR

Other Companies Mentioned: MRK, NVS

“The overall impression of the agent changed dramatically for me [after the CLEAR Outcomes data]…The reduction in MACE [Major Adverse Cardiovascular Events], for me, was a bit of a home run.” Cardiologist at Bassett Medical Center

Meanwhile, three other cardiologists had favorable reactions to trial data presented on Merck & Co.’s MK-0616 PCSK9 inhibitor for high cholesterol and expect MK-0616, which is orally-administered, to take share from injectable PCSK9s. 

Primary Ticker: MRK

Other Companies Mentioned: AMGN, ESPR, Regeneron Pharmaceuticals (REGN)

“Any time you come out with another route of administration that may… be more acceptable for the patient, it is going to be a big thing because compliance is a big issue with medical therapy in general.” Cardiologist in private practice

Primary Ticker: MRK

Other Companies Mentioned: ESPR

“[MK-0616] would be exciting [to have on the market] because here we have an oral PCSK9, which, really, we’ve been hoping for since the day the injectable PCSK9s came about.”Cardiologist in private practice

Primary Ticker: MRK

Other Companies Mentioned: AMGN, ESPR, NVS, REGN

[MK-0616] is a good option. It’s viable. I don’t know the percentage of [patients] who would want to take [a PCSK9 injectable] versus the oral, but I’m sure there’s a good portion who would prefer the orals.”Cardiologist at Coastal Cardiovascular Consultants

Hypertrophic Cardiomyopathy (HCM)  

Three cardiologists had positive reactions to trial data on Cytokinetics Inc.’s aficamten for HCM, particularly non-obstructive HCM, which has scant treatment options. In addition, these physicians believe aficamten may offer advantages over Bristol-Myer Squibb’s Camzyos (mavacamten). 

Primary Ticker: Cytokinetics Inc. (CYTK) 

Other Companies Mentioned: Bristol-Myers Squibb Co. (BMY)

“I’m actually waiting for [aficamten} to come out because, right now, we only have Camzyos… but it’s complicated to use… I would say nine or 10 [out of 10 is my level of excitement about aficamten]… Until now, I really haven’t had any medication to help these [non-obstructive HCM] patients.” Cardiologist in private practice

Primary Ticker: CYTK

Other Companies Mentioned: BMY

“Mavacamten may have been the first kid in the block, but aficamten has come along nicely.” Cardiologist at Bay Area Hospital

Primary Ticker: CYTK

Other Companies Mentioned: BMY 

“[With the aficamten data], I’m seeing a benefit even in people in whom I would not have, at the outset, thought would benefit. [Aficamten] would be very compelling to me to either take the place of or use in addition to my standard [treatment], non-dihydropyridine calcium blocker.”Cardiologist at Lakeview Healthcare System

Mitral Regurgitation (MR)

One cardiologist reacted positively to five-year data on Abbott Laboratories’ MitraClip device for patients with severe secondary MR despite concerns the trial results were obscured by the number of participants who died, crossed over from the control group and/or did not receive heart medications.

Primary Ticker: Abbott Laboratories (ABT)

Other companies mentioned: NVS

“The fact of the matter is this is a positive trial. There does seem to be a benefit to the [MitraClip] device… especially because it’s not a very risky procedure overall and… it’s not really that expensive compared to [open-heart] surgery.” Cardiologist at North Shore Heart and Vascular

Pulmonary Arterial Hypertension (PAH)

Two cardiologists were impressed by Merck’s sotatercept phase-3 trial results and were enthusiastic about the drug’s unique approach to treating PAH.

Primary Ticker: MRK

Other Companies Mentioned: Eli Lilly & Co. (LLY), Pfizer Inc. (PFE)

[Sotatercept] is a different category of drug entirely. It’s not another me-too or alternate formulation of something that we had already in some version or another… It definitely grabbed our attention.” Cardiologist at MedStar Health

Primary Ticker: MRK

“[Sotatercept] is an out-of-the-box idea… and could open up a whole new paradigm as to how PAH could be treated with targeting the underlying pathophysiology.”Cardiologist at Baylor College of Medicine

Want more boots on the ground reads of healthcare conferences? Read our previous blog posts on the American Academy of Orthopaedic Surgeons (AAOS) 2023 and American Society of Hematology (ASH) 2022 conferences to learn what physicians had to say about the information shared at these meetings. You can also explore the entire Stream expert transcript library to stay on top of the latest developments in the healthcare sector and beyond.

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Alyees Qureshi, Content Marketing Specialist and Healthcare Lead

Sara Mallatt Stahl
Sara Mallatt Stahl
Vice President and Sector Head, Healthcare at Stream by AlphaSense

Sara has more than 16 years of experience generating sell-side research content across a variety of industries, including healthcare, which is her focus at Stream by AlphaSense. Sara has a passion for developing content that helps clients pursue their ideas and sparks new ways of thinking.

Read all posts written by Sara Mallatt Stahl