🕗 Navigating the Future of Drug Delivery Systems Ep 129

Ready to unravel the truth behind drug administration methods in medical research? Dr. Michael Koren and Kevin Geddings of WSOS St. Augustine Radio discuss the pros and cons of different methods of drug administration, particularly for cholesterol treatment and diabetes. Dr. Koren highlights the incredible progress in this area, explaining how these treatments function, from obstructing enzymes in the liver to blocking proteins in the circulation. We also explore the range of options available, from a daily pill to a twice-yearly shot, and speculate about the potential of oral forms of PCSK9 drugs. Whether you're a healthcare professional or just curious about the mysteries of medicine, this conversation will provide riveting insights.

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Music: Storyblocks - Corporate Inspired

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Transcript

Narrator 0:00

Welcome to the MedEvidence Monday Minute Radio Show hosted by Kevin Gettings of WSOS St Augustine Radio and powered by ENCORE Research Group. Each Monday morning, Dr. Michael Koren calls in to bring you the latest medical updates with insightful discussions. Medevidence is where we help you navigate the real truth behind medical research, with both a clinical and research perspective. So sit back, relax and get ready to learn about the truth behind the data in medicine and health care. This is MedEvidence.

Kevin Geddings 0:32

Dr. Michael Koren is with me live on the studio line on this Monday morning, as he usually is. He, of course, is a medical doctor, cardiologist, research scientist and a big part of our family here at WSOS. You can learn more about him and, of course, ENCORE docs and medical research going on right here in St. John's County by going to ENCOREdocscom. That song from Grand Funk Railroad, the Local Motion, a favorite at skating rinks around the country, at least back when I was growing up how about you? Did you ever go to a roller skating rink, Dr. Koren?

Dr. Michael Koren 1:03

I certainly did, but actually growing up up north we did ice skating. That was the big junior high school hangout.

Kevin Geddings 1:13

So were you a pretty good ice skater, were you that? There was always the one guy that had all the hair and all the girls were just oo and all because he was a great skater.

Dr. Michael Koren 1:23

No, actually, but you know what I'm talking about, right?

Kevin Geddings 1:27

You know about that guy. I mean, every town had that guy.

Dr. Michael Koren 1:32

Yeah, it was a different type of time. I grew up in the 70s and, first of all, it's kind of rough. I grew up in New York and I had the good wits to make best friends with the toughest guy in my school. The only reason I could skate around with any degree of confidence is that I had backup. It was kind of rough but it was definitely a different time. I think going into all the psychology of that, is more than a five minute discussion. Yeah, I could imagine.

Kevin Geddings 2:07

So it might not be labor the point, but in New York we always think of well, everybody goes ice skating at Rockefeller Center, but that's kind of a touristy thing. It's kind of like hanging out in. St Augustine. On St George Street, you would have gone ice skating, growing up in New York. Where?

Dr. Michael Koren 2:22

Yeah, it was a big rink, sort of a hockey rink style in Staten Island where I grew up. It was a place I think it was called Clove Lakes Ice Skating Rink, and that's where we used to go for about four or five months out of the year on Friday or end of Saturday night. It was actually a ride of passage, because we had to drink Boone's Farm Wine before we took the ice skating rink.

Kevin Geddings 2:47

It's even hard to find that stuff Boone's Farm. Wow, apple wine.

Dr. Michael Koren 2:53

Yeah, I think it was like 3% alcohol content, so you had to drink about four bottles before you got a buzz.

Kevin Geddings 3:01

And get some insulin in your system from all the sugar. Hey, Dr Michael Koren is here.

Dr. Michael Koren 3:05

But it's funny. I know we're off track.

Kevin Geddings 3:08

No, we're fine.

Dr. Michael Koren 3:08

It's funny how you get insights into things. So I was just listening to the local motion song and I realized it's actually a plan words that I never realized until just this second. So loco means crazy in Spanish, so I think really what they meant is that it's just crazy motion. It has nothing to do with a train. So, or maybe just a pun that talks about both things, because wasn't that a song where you held a hipsterly person in front of you and you may believe you're a train?

Kevin Geddings 3:35

I think, I would it had a dance associated with it, and the actual on the 45, because I have an image of it when it comes up is loco hyphen motion. So that would be the title of the song on the 45. It wasn't one word, just. It speaks to what you're saying.

Dr. Michael Koren 3:49

Yeah, yeah, exactly, and I never realized that literally into the second that it just meant crazy movement.

Kevin Geddings 3:55

So if you live and learn, and we continue to teach, don't we? So if it's not song history, rock and roll history, we can talk a little bit about medicine. One of the issues we wanted to talk with Dr. Koren about is a lot of folks, a lot of us, just hate taking pills, the whole notion of how you get a drug. I know a lot of folks have a little hesitation over the rage over Wagovy and some of these weight loss drugs because they're only you can only get an injection. A lot of folks just can't get into the routine of taking a blood pressure or a statin pill every day without forgetting it three days out of four. But there may be some solutions for that right, dr.

Dr. Michael Koren 4:32

Yeah, as a matter of fact, it's a huge area of medical research right now, particularly in certain areas. It's very important in diabetes and it's very important in cholesterol treatment and we've talked about this before.

Dr. Michael Koren 4:44

But we have a huge number of options right now in terms of how to take your cholesterol medicine. It's everything from multiple drugs per day to a shot that you take once every six months and that's it. So you know there's pluses and minuses to each thing, and that's what we study. So some people are very comfortable just taking a routine pill once a day before they go to sleep, and that's sort of how you take statins and some people are horrible at remembering taking their medication, so they prefer something that is less frequent. So we have shots that you can give once a month or shots that you can actually give twice a year, and there's pluses and minuses in terms of how effective they are and what the side effect profile is. But that's the research we're doing now, so we do, in fact, offer choices for our patients.

Kevin Geddings 5:32

Wow, so in theory you could that statin pill that you have to take. You know you're supposed to take, I guess, at night. For best benefit, you would just be able to get an injection once every six months and that would be it. You wouldn't have to worry about that every night.

Dr. Michael Koren 5:44

Yeah, now it gets a little more complex than that because the mechanism of action of the different treatments is different. So statins work in one way. For example, statins work by blocking the enzyme in the liver and it's important that you take them, and actually the type of statin determines whether or not you can take it at night or can take it during the day. But some of the newer drugs block a protein called PCSK9, and it's a different mechanism for treating cholesterol problems. Now some of those drugs work in the liver and some of those other drugs work in the circulation using a monoclonal antibody mechanism.

Dr. Michael Koren 6:23

So just in the mechanism alone, there's a lot of variability in terms of how we can treat people. And how does that break down for the average person? Well, I can tell you that, hey, we have a drug that can actually give you twice a year and that all can be good. But once we give it to you, we can't take it away. So you're comfortable using a drug that can give you a system for six months.

Dr. Michael Koren 6:47

A flip side is that we have a drug that is in your one-manipulate Be there. It'll have a surveillance function, actually, and as soon as you make this bad protein, it'll suck it up and take it out of your circulation. That's another approach, and then we actually now have all form of that monoclonal antibody type drug that we're studying right now as we speak that works to block PCSK9, but it's something you can just take once a day like a statin, so literally we have an option for everybody.

Kevin Geddings 7:18

So obviously, if somebody would like to participate in that, you have ongoing studies for that too. So there are opportunities for people to be sort of on the leading edge of that right.

Dr. Michael Koren 7:28

Exactly So, the PCSK9 drugs are particularly interesting. We've been working on those drugs for over 10 years now and they're considered a huge breakthrough in drugs like Rapatha or Praluent, and one of the objections for some people is that you had to take a shot at least every two weeks. Sometimes you'll take three shots once a month.

Dr. Michael Koren 7:50

And now we actually have oral forms of that particular type of medication, and the thing that's exciting about that, Kevin, is it's the most effective cholesterol drug statins can lower your LDL cholesterol 40%, 45%, maybe even 50%, but PCSK9 drugs will actually lower it by 60%, sometimes more. So in the last class, the medication is actually the most effective class.

Kevin Geddings 8:11

Yeah, and we probably have listeners who have persistent problems with high cholesterol and they haven't had the best success at dealing with that right, Absolutely.

Dr. Michael Koren 8:21

Absolutely, and a lot of people these days are concerned about the side effects of statins. I always like to tell people statins are incredibly safe. The number one side effect of a statin drug is that you will live longer. But having said that, there's still people that have trouble with them, and we do have alternatives for those folks.

Kevin Geddings 8:38

Well, if you have any interest in that, or you know someone, a friend, family member and they're struggling with high cholesterol maybe they're struggling with how they take a statin drug or the statin drug isn't as effective as their doctor would like, Get in touch with ENCORE Docs here in Greater St Augustine and St John's County. They have offices all around Northeast Florida, including right here near Flagler Hospital. Go to ENCOREdocs. com. Also a great website to check out that Dr. Koren is very involved with. It has a lot of good information about just good, accurate, you know, health data you can believe in. Go to MedEvidence. com. They'll find all kinds of good stuff there, right, Dr. Koren?

Dr. Michael Koren 9:16

Absolutely, I look at it every day. Yeah, good stuff.

Kevin Geddings 9:19

Dr. Koren, thank you very much for all your time this morning and we hope you have a great week.

Dr. Michael Koren 9:22

okay Sounds great Kevin, have a great week.

Narrator 9:25

Thanks for joining the MedEvidence podcast. To learn more, head over to MedEvidence. com or subscribe to our podcast on your favorite podcast platform.