Pharmacists’ Role in Supporting Adherence and Proper Administration of Enlicitide

At the American Heart Association Scientific Sessions 2025 in New Orleans, Ann Marie Navar, MD, PhD, discussed the critical role pharmacists play in optimizing low-density lipoprotein (LDL)-cholesterol management and supporting adherence to emerging therapies such as enlicitide. She highlighted that pharmacist-led lipid management programs are highly effective in getting patients on appropriate treatments and achieving cholesterol goals. Retail pharmacists, in particular, are essential in reinforcing proper administration instructions—taking the medication first thing in the morning after an overnight fast and waiting 30 minutes before eating or drinking, similar to Synthroid. Navar noted that in the CORALreef Lipids trial, 97% of patients demonstrated high adherence to both the medication and fasting instructions, emphasizing that with pharmacy support, patient adherence to enlicitide will be feasible once it reaches the market.

Pharmacy Times: From a clinical and adherence standpoint, what advantages might a once-daily oral PCSK9 inhibitor offer compared with injectable options—particularly for pharmacists supporting patients with medication management or access challenges?

Ann Marie Navar, MD, PhD: Well, I think everybody who treats patients or helps patients with medication adherence is aware that there are different solutions for different individuals. For some individuals, a twice-monthly shot works really well, but others really don't want to use an injectable therapy. I think having a once-daily option allows people to choose the cholesterol-lowering therapy that works best for them, and being able to have a more tailored solution will likely improve adherence overall.

Pharmacy Times: Were there any patient populations in the CORALreef Lipids or HeFH trials that appeared to benefit most from enlicitide, and how might those findings inform pharmacist counseling or follow-up care

Navar: The great news about both CORALreef studies that we're presenting this weekend is that the effect of LDL cholesterol lowering was very consistent across every subgroup we examined. Patients with HeFH, those with ASCVD, individuals at risk for ASCVD, and every subgroup within those categories all experienced robust cholesterol lowering. There really isn’t one group that responds better or worse to enlicitide—it’s ultimately going to come down to what treatment patients prefer to be on.

Pharmacy Times: Given the ongoing challenges in getting patients to LDL-C goal, what role can pharmacists play in optimizing lipid-lowering therapy and educating patients about the importance of sustained LDL-C reduction?

Navar: Pharmacists play such an integral role in our management of LDL cholesterol. We know that pharmacist-led lipid management programs are highly effective in getting patients on the right treatments and helping them reach their goals. We also rely heavily on retail pharmacists, who interact with patients when dispensing medications, to reinforce correct administration instructions for elisocitide. It’s pretty simple, but patients will need to take it first thing in the morning after an overnight fast and then wait 30 minutes before eating or drinking anything—similar to what we tell people taking Synthroid.

The good news is that in the CORALreef Lipids trial, 97% of patients reported high adherence both to the medication and to the fasting instructions. I think this shows that it’s very feasible, especially with the support of our pharmacy colleagues in reinforcing proper administration once this medication becomes available on the market.