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 is live, offering a concise roundup of 5 leading clinical updates for primary care physicians. Below, the episode begins with a nationwide analysis showing that individuals newly diagnosed with a chronic medical condition face more than twice the risk of developing major depressive disorder compared with those without such conditions, with the highest risk occurring in the first month following diagnosis.

The discussion then turns to data from a large case-control study finding that vaginal estradiol use was not associated with an increased risk of recurrent ischemic stroke in women with a history of stroke, providing reassurance for symptom management in this population.

Also included is the US approval and launch of the first generic version of liraglutide injection for weight loss, expanding access to GLP-1 therapy for adults and adolescents with obesity. Additional evidence links GLP-1 receptor agonist use to a lower overall incidence of cancer, particularly endometrial, ovarian, and meningioma cancers.

The episode concludes with results from the STEER real-world study, which found that semaglutide was associated with lower rates of major adverse cardiovascular events compared with tirzepatide among adults with obesity and established cardiovascular disease.

The stories featured in this week's Weekly Dose podcast are further detailed here:

New Data Shows Risk of Major Depressive Disorder Spikes After a Medical Diagnosis

Vaginal Estradiol Shows No Added Risk of Repeat Stroke in Women

First Generic GLP-1 RA Approved for Weight Management in the US

GLP-1 RAs May Reduce Risk for Cancer in Adults with Obesity

Semaglutide Shows Greater CVD Risk Reduction Than Tirzepatide in Adults With Obesity

 to subscribe to the Weekly Dose podcast for more updates and news. Be sure to leave a rating and review for the show. Thanks for listening! 

Hoping to listen on your favorite podcast app? See below:

Podcasts

Today's episode covers depression risk after chronic illness, vaginal estradiol safety, GLP-1 updates, cancer risk, and cardiovascular outcomes.

Weekly Dose Podcast: Depression Risk After Chronic Illness, Vaginal Estradiol Safety, GLP-1 Updates, Cancer Risk Reduction, and Cardiovascular Outcomes

® highlights key updates for clinicians, spanning colorectal cancer (CRC) prevention, obesity management, cardiovascular health, and nutrition. This week’s discussion covers new data on rising CRC screening rates in younger adults, the scope of GLP-1 eligibility among adolescents and young adults, long-term cardiovascular outcomes in midlife women, the most effective population health outreach strategy for CRC screening, and the impact of ultraprocessed foods on cardiometabolic risk.

Editor's note: Episode timestamps produced using AI tools.

Colorectal Cancer Screening Uptake Rises (00:00:11)


Screening rates increased among adults aged 45-49 after lowering the recommended starting age from 50 to 45.

GLP-1 Therapy Eligibility and Coverage in Youth (00:01:24)


Millions of US adolescents and young adults are eligible for GLP-1 therapy, but insurance coverage and comorbidities present barriers.

Midlife Cardiovascular Health in Women (00:02:48)


Tracking women’s cardiovascular health using Life’s Essential Eight; glucose, blood pressure, and nicotine avoidance are key predictors.

Colorectal Cancer Screening Outreach Strategies (00:03:38)


Mailing FIT kits directly to patients significantly increases screening participation among adults aged 45-49.

Ultra-Processed Foods and Cardiometabolic Risk (00:04:09)


Ultra-processed foods raise cardiometabolic risk; public health measures and dietary counseling thresholds are recommended.

This week’s podcast episode covers CRC screening, GLP-1 eligibility in youth, women’s heart health, FIT outreach, and ultraprocessed food risks.

Weekly Dose Podcast: CRC Screening Uptake, GLP-1 Eligibility in Youth, Women’s Heart Health, and Ultraprocessed Food Risks

, we cover a wide range of important clinical findings. We discuss the feasibility of digital cognitive assessments for Alzheimer screening in primary care, patient preferences for atopic dermatitis treatments, and the impact of social determinants of health on hormonal therapy use among midlife women. Additionally, we explore the FDA's Breakthrough Device designation for a multi-cancer detection test and new findings linking the quality of low-carb and low-fat diets to coronary heart disease prevention. Tune in for these key insights that are shaping clinical practice.

Discover essential clinical insights on Alzheimer disease screening in primary care, eczema treatments, and the latest in cancer detection and diet impacts on CHD risk.

The Weekly Dose: Clinical Updates on Cancer Detection, Cognitive Screening, CVD Prevention, Atopic Dermatitis Treatment

, obesity medicine specialist Alina Elperin, MD, discusses preventive cardiology and obesity, including 2 cardiovascular disease risk factors to screen patients with obesity for, the top 3 cardiovascular complications seen in patients with obesity, the importance of checking a patients' current medication list, and how clinicians can start a conversation around nutrition plans with their patients. 

Dr Elperin is an internist and a Clinical Assistant Professor at the University of Chicago Pritzker School of Medicine. 

 podcast features informative conversations with health care experts, opinion leaders, and practicing physicians, about what impacts primary care medicine today. 

 to subscribe on your favorite streaming service.

Listen to our latest podcast episode for details on top CVD risk factors to screen patients with obesity for, medications to help prevent CVD, and more.

Navigating Cardiovascular Complications of Obesity: Expert Insights for Primary Care

The following transcript has been edited for clarity and length.

, a website for primary care physicians. Today I'm speaking with Dr. Patrick Moriarty about cardiovascular risk and risk assessment. More specifically, we're going to talk about the evidence for the role of lipoprotein A, which I will call Lp(a) here on, as an independent risk factor for atherosclerotic cardiovascular disease (ASCVD) and as a target for therapy. Dr Moriarty is a professor in the Department of Internal Medicine at the University of Kansas Medical Center in Kansas City, where he is also the Director of Clinical Pharmacology and the Atherosclerosis/Lipoprotein-Apheresis Center. He'll be speaking on this topic that we're talking about today, next week at the 2020 virtual Cardiometabolic Health Congress. Welcome Dr. Moriarty. 

 Thank you Grace for inviting me. Good afternoon to you.

 Thank you. So, you're involved in the most current research on the role of Lp(a) in the development of ASCVD and also in some promising research on a potential treatment to reduce levels in patients at high risk. Could you just give us a little bit of background on how Lp(a) became identified as one of the more important markers of residual cardiovascular risk?

 Sure. It goes back all the way to 1963. A Dr. Berg from Norway - he was a physician but also a researcher - was trying to investigate if there were new blood types. In his investigation, he immunized rabbits with a human beta lipoprotein from a single donor. The antibodies that he found that developed from this procedure, were found in one-third of the population. And eventually he found out that these patients that had this protein, had an increased risk of cardiovascular disease and he called it lipoprotein A, and that's where it originated from. So, we're going all the way back there, and it's progressing and progressing up until now. If you want, I can give you a quick overview of what this lipoprotein is.

 It contains an LDL-like moiety 100 in size, like a typical LDL. It has this apolipoprotein A bound to it and this apolipoprotein A looks somewhat like plasminogen, except it doesn't have an active protease domain. The protease domain of plasminogen is what causes clots to break up because our blood is constantly clotting or unclotting, daily, if not we would bleed to death or we'd clot to death. So, this plasminogen goes to where a clot is and breaks it up. Well, Lp(a) goes where it is, binds to it, but does not increase the fibrinolytic cascade. The clot sustains a longer duration, which in places like cardiac and brain, could be very detrimental. Third, it’s a major carrier of inflammatory molecules, including, more importantly, oxidized phospholipids. About 80% of our oxidized phospholipids in the blood are carried on this lipoprotein. And oxidized phospholipids are major players in the plaque foam cell deposition and degradation of plaque causing rupture, which is a major etiology of a cardiovascular event is a ruptured plaque. So, it's a triple whammy because it has LDL too. It's LDL, inflammation, and coagulation. About a third—20% to 30%—of the world’s population have this lipoprotein, and you're born with it. It's an autosomal dominant gene that dictates it. So, if you have it, 50% chance your children might have it. And you can't change it by lifestyle, diet, exercise has no effect on it. Actually, statins might raise it a certain percentage. Well, the good thing about that, even though statins do raise it, the statins still give clinical benefit. There was a study called JUPITER where they used rosuvastatin—if you remember that—and it was a primary prevention study and they showed a reduction in cardiovascular events and reduction of LDLs quite dramatically, but then they looked back and said "okay, what about the patients in that trial that had a high Lp(a)?" Well, they showed that they still got benefit with the statin, but it was attenuated. It was weakened by the high Lp(a), so you never stop a statin therapy in a patient based on their Lp(a) level.

 This new molecule, I believe it's an antisense oligonucleotide, is what you were looking at in your research that was published in the beginning of the year. What is it? And how does it work?

 We published a paper in January of this year in the 

. It was a phase 2 trial where we had different levels of this drug dosing in patients, about 85% got some dose and 15% got placebo; and it's an antisense oligonucleotide, as you mentioned. Present day monoclonal antibodies, such as the PCSK9 inhibitors, inhibit the protein as produced in the blood to prevent it from being active, with whatever its mechanism of action is. For antisense, this drug causes a missense reading of the messenger RNA to prevent the protein from being read out and made. It inhibits the protein being made itself and the drug has a special addition to it, which makes it liver specific, so it goes directly to the liver only because it can't go out other tissues. So, this is a new version, we had one that didn't have that. This one is 100-times more potent, so the dose is much lower. And we found that the drug could lower LDL, Lp(a) by about 80%.

 The results were quite remarkable, if you just look at raw numbers.

 Incredibly powerful. And now we're moving into so-called phase 3 trial, which hard endpoint is looking at reduction of cardiovascular events, and dose is going to be 80 mL once a month, compared to placebo. It'd be 50/50. We're talking about thousands of patients worldwide, it started already late last year, and COVID-19 has slowed down the process of it, as you would expect, but it's moving ahead. We're one of the sites and it looks in 5 years, hopefully, we'll be able to show that this drug not only lowers Lp(a), which we know it does, but lowers cardiovascular events on top of that. We have a paper coming out in 

JACC (Journal of the American College of Cardiology)

Patrick Moriarty, MD, from the University of Kansas Medical Center, discusses the role of Lp(a) as a risk factor for cardiovascular disease and the phase 3 trials of a potential treatment.

Cardiology

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