Preparing for the RNA Therapy Pipeline in Lipid Management

In an interview with Pharmacy Times, On Chen, MD, clinical associate professor in medicine at Stony Brook Medicine, and Tahmid Rahman, MD, associate director of the Center for Advanced Lipid Management at Stony Brook Medicine, explained how specialty and ambulatory care pharmacists can integrate RNA-based lipid therapies such as plozasiran (Redemplo; Arrowhead Pharmaceuticals) into multidisciplinary care models.

Rahman emphasized that pharmacists play a frontline role in identifying patients who may benefit from these therapies by reviewing biomarker trends, particularly elevated triglyceride levels. He noted that clinical trial criteria, such as those used in the PALISADE trial, relied on triglyceride thresholds above 880 mg/dL, providing a clear framework for pharmacists to flag potential familial chylomicronemia syndrome (FCS) cases.

Rahman described how pharmacists can implement electronic alerts tied to lipid panels or diagnoses such as pancreatitis to prompt further evaluation. Once high-risk patients are identified, pharmacists can collaborate with cardiologists, critical care teams, and primary care providers to assess treatment gaps and discuss emerging therapeutic options. Beyond identification, pharmacists are instrumental in educating patients about RNA-based therapies, coordinating prior authorizations, and working closely with case management and nursing teams to ensure timely medication access.

Monitoring remains another critical responsibility. While plozasiran has demonstrated a favorable safety profile, Rahman highlighted the importance of ongoing laboratory surveillance, including glucose and liver function tests, to proactively detect potential safety signals as these therapies expand in practice.

Looking ahead, Chen and Rahman anticipate significant growth in RNA interference therapies across lipid disorders. Chen highlighted inclisiran (Leqvio; Novartis) as an established example in low density lipoprotein cholesterol management, underscoring the platform’s safety and patient-friendly dosing schedules. Rahman pointed to emerging therapies targeting lipoprotein(a), an area with historically limited treatment options, noting promising trial data in cardiovascular risk reduction.

For pharmacists, this evolving pipeline signals a need to stay informed on novel mechanisms, optimize patient identification workflows, and prepare for expanded clinical monitoring roles. As RNA-based therapies continue to reshape cardiovascular care, pharmacists will be central to translating innovation into real-world practice.