Jeanie Misko is the Senior Pharmacist – Medicines Information at Fiona Stanley Hospital, Perth. She has previously worked as a clinical pharmacist and clinical team lead across a number of specialist areas in tertiary and secondary hospitals. Her professional interests include oncology, mental health, smart infusion pump technology and pharmacy education. She also co-ordinates the Fiona Stanley Hospital Foundations of Clinical Pharmacy program to assist pharmacists developing their clinical skills. Jeanie recently completed a Postgraduate Diploma in Oncology with Distinction from Newcastle University, UK and is currently pondering her next direction of study.
Jeanie has lectured at both undergraduate and postgraduate levels for Curtin University and the University of Notre Dame across for pharmacy, nursing and physiotherapy. She has also spoken at continuing education events for pharmacists and other health professionals. Jeanie is currently a reviewer for the Australian Medicines Handbook and SHPA’s Australian Injectable Drug Handbook and Don’t Rush to Crush. She is also treasurer for the SHPA W.A. branch. Outside of pharmacy life, Jeanie enjoys baking, cars and her pet birds. She is an avid reader and has been named as one of the top non-professional book reviewers in Australia.
We all know social media is now a part of daily life. But have you ever wondered how to use it for good in a professional space or connect with others who share your work passions? Join Helen Bevan, Chief of Service Transformation from the NHS (UK) via webinar to learn how to connect with others across the world in 140 characters or less. Twitter is more than just emojis and hashtags, it can be a tool to find people to share ideas and network with. Twitter’s power also will demonstrate how you can create and sustain transformational change and to avoid digital mishaps.
(Please note: Participants should create a Twitter account prior to attending this workshop – see https://support.twitter.com/articles/100990).
Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are a group of new monoclonal antibodies that significantly reduce low density lipoprotein (LDL) cholesterol levels. The PCSK9 inhibitors are currently being studied in relation to reducing cardiovascular risk across a number of patient groups. These include familial hypercholesterolaemia (homozygous and heterozygous) and hyperlipidaemia (including statin intolerant patients). A number of Phase III trials are underway for the three leading PCSK9 inhibitors. Evolocumab and alirocumab are now registered in Australia and evolocumab received a positive PBS recommendation for listing in early 2016. Bococizumab is currently in Phase III trials and several other as yet unnamed PCSK9 inhibitors are in Phase I and II trials.
But what does this mean for the treatment of patients with hyperlipidaemia? PCSK9 inhibitors can be used as monotherapy or in combination with other lipid lowering treatments (e.g. ezetimibe, statins or both) to achieve maximal decline in LDL. While the LDL reductions of up to 70% for PCSK9 inhibitors are impressive, their high cost and need for regular injection may limit their wider use and patient acceptability.
There is also a lack of long term outcome and safety data for PCSK9 inhibitors, although short term clinical data appears to suggest a reduction in cardiovascular risk and all-cause mortality. At present, the reported adverse effect profile seems tolerable but neurocognitive events such as amnesia, memory loss and confusion have been reported. Other unanswered questions include ‘how low is too low’ for LDL levels and whether PCSK9 inhibition has detrimental long term effects.