Peer Exchange

Nihar Desai, MD, MPH; Kenny J. Cole, MD, MS; Jacinda Mawson Nicklas, MD, MPH, MA; Esra Karslioglu French, MD, MBA, and Goutham Rao, MD, discuss how recent advances in GLP-1 receptor agonists and other therapies are transforming the treatment of type 2 diabetes and obesity by enabling a paradigm shift from reactive glucose management to proactive weight-focused care that addresses the root causes of cardiometabolic disease, while emphasizing the critical need for multidisciplinary teams, bias-free patient communication, and systematic healthcare delivery changes to overcome barriers like provider time constraints, medication access, and weight stigma.

Panelists discuss how the clinical and economic burden of idiopathic and progressive pulmonary fibrosis (IPF and PPF) underscores the need for earlier diagnosis, improved care coordination, and emerging therapies that may close treatment gaps while balancing efficacy with health care resource utilization.

Julie A. Parsons, MD; John Brandsema, MD; and Tina Duong, MPT, PhD, discuss how management approaches for older patients with spinal muscular atrophy (SMA) differ from those for infants, highlighting the importance of individualized treatment goals focused on independence, fatigue management, quality of life, and the challenges of measuring outcomes with currently available assessment tools, while also exploring current and emerging therapies, including splice modifiers and potential intrathecal gene therapy options.

Experts cover key updates in the management of patients with Neurofibromatosis Type 1 with Plexiform Neurofibromas, or NF1-PN, while also exploring the pathophysiology of NF1-PN, the management of it and potential treatment options

Ryan Haumschild, PharmD, MS, MBA, CPEL; Elizabeth Castronovo, NP; Martin Dietrich, MD, PhD; Mary Grizzard, MSN, FNP; and Christine M. Lovly, MD, PhD, FASCO, discuss how advances in ALK-positive non–small cell lung cancer (ALK+ NSCLC) treatment, including 5-year CROWN trial data for lorlatinib, recent ensartinib approval, comparative efficacy against brain metastases, toxicity management strategies, and sequencing approaches following progression are reshaping clinical decision-making to optimize long-term patient outcomes.

Experts provide an overview of third-line treatment options for metastatic colorectal cancer (mCRC), assess the evolving role of pharmacists in treatment optimization and patient education, and analyze access challenges to mCRC therapies, proposing strategies to improve patient access.

Nihar Desai, MD, MPH, leads a panel of experts in a discussion surrounding lipoprotein(a) (Lp[a]) as a causal risk factor for atherosclerotic cardiovascular disease and aortic stenosis, exploring the clinical utility and guidelines for Lp(a) measurement, and addressing barriers and strategies for optimizing the management of Lp(a)-associated risk.

Panelists discuss how the latest data from the 66th American Society of Hematology Annual Meeting and Exposition (ASH 2024) on bispecific therapies for B-cell lymphomas, including epcoritamab, mosunetuzumab, and odronextamab, influence treatment strategies, address toxicity management, and highlight the challenges and opportunities in expanding access to these therapies across academic and community settings.

Ryan Haumschild, PharmD, MS, MBA, CPEL; Gerald Appel, MD; Andrew S. Bomback, MD; and Jared Hassler, MD, discuss IgA nephropathy, a progressive kidney disease characterized by IgA antibody deposits in the mesangium, examining its 4-hit pathogenesis cascade, clinical presentation, diagnostic challenges, treatment evolution from supportive care to targeted therapies addressing specific disease mechanisms, economic impact across disease stages, and the importance of early intervention to delay progression to end-stage kidney disease while improving patient outcomes and quality of life.

Ryan Haumschild, PharmD, MS, MBA; Thomas M. Hooton, MD; Wendy Cheng, PhD, MPH; Debra Fromer, MD; and Katie S. Murray, DO, discuss how uncomplicated urinary tract infection (UTI) management is evolving through new antibiotics such as pivmecillinam, sulopenem etzadroxil/probenecid, and gepotidacin to address growing resistance issues while emphasizing personalized approaches, prevention strategies, antimicrobial stewardship, and the socioeconomic impact of treatment failures across diverse patient populations.

Experts discuss recent bispecific antibody approvals and clinical applications, address operational challenges in implementation—including barriers in community practice and the management of cytokine release syndrome—and consider the potential of these therapies in expanding treatment options and improving patient access.

Kavita V. Nair, PhD; B. Joy Snider, MD, PhD; Cynthia Lawlor, MD, MPH; and Rhonna Shatz, DO, discuss how Alzheimer disease management is evolving through improved screening, specialized care pathways, emerging amyloid-targeting therapies, standardized monitoring approaches, and strategies to address financial barriers while maintaining optimism for future treatment advances.

A discussion exploring how bronchiectasis involves a vicious cycle of airway damage, where neutrophilic inflammation leads to bronchial wall destruction and dilation, while explaining that diagnosis relies primarily on high-resolution CT imaging showing bronchial wall thickening and dilated airways, distinguishing it from COPD's emphysematous changes.

Melody Chang, MBA, RPh, BCOP; Andre D. Harvin, PharmD, MS, MBA; Kirollos S. Hanna, PharmD, BCPS, BCOP, FACCC, FAPO; Brian Mulherin, MD; and Ashley Hall, PharmD, discuss comprehensive approaches to iron deficiency anemia (IDA), from its pathophysiology and diagnosis through various treatment options such as oral and intravenous iron formulations, while addressing challenges such as hypophosphatemia, treatment adherence, insurance barriers, and future directions in patient care, emphasizing the importance of individualized treatment strategies and monitoring protocols to optimize outcomes.

Panelists discuss how recent advancements, particularly the introduction of Janus kinase JAK inhibitors, are reshaping the treatment landscape for Aalopecia Aareata, offering new therapeutic options and addressing unmet needs in both efficacy and patient care.

Callie Coombs, MD; Matthew Davids, MD, MMSc; Seema Bhat, MD; and Lori Leslie, MD, discuss venetoclax-obinutuzumab therapy, pirtobrutinib’s progression-free survival data from the BRUIN CLL-321 trial at ASH 2024, Bruton tyrosine kinase (BTK) inhibitor safety profiles, cost considerations under the Inflation Reduction Act, and clinical strategies for managing BTK inhibitor toxicity.

Panelists discuss how innovative neurokinin-targeted therapies for vasomotor symptoms can reshape menopause management and address unmet needs and improving patient outcomes while highlighting the importance of equity in treatment access.

Experts examine the evolving landscape of HER2-directed therapies in non–small cell lung cancer (NSCLC), discussing their efficacy, safety, and integration into clinical practice, while considering emerging treatments, patient selection criteria, real-world outcomes, and strategies to balance access, cost, and value in managed care settings.

Ryan Haumschild, PharmD, MS, MBA; Anne Chiang, MD, PhD; Afshin Dowlati, MD; Jacob Sands, MD; and Wade Iams, MD, explore recent advances in small cell lung cancer (SCLC) management, discussing staging, treatment options across disease stages, emerging therapies, biomarker testing, and strategies to overcome challenges in diagnosis and care delivery.

Biosimilar utilization considerations in the current health care landscape are explored by an esteemed panel of medical professionals.

A panel of experts discusses the evolving treatment landscape for chronic spontaneous urticaria.

A panel of experts discuss chronic lymphocytic leukemia, focusing on the integration of Bruton tyrosine kinase inhibitors into the treatment landscape, the economic and access considerations of BTK inhibitor therapy, and future directions and ongoing research opportunities in the management of CLL.

Key opinion leaders discuss treatment for patients diagnosed with metastatic NSCLC without driver mutations.

Kirollos Hanna, PharmD, BCPS, BCOP, FACCC, leads an expert panel in a discussion highlighting recent updates for use of CDK4/6 inhibitors in high-risk early breast cancer.

Expert perspectives surrounding the management of patients diagnosed with advancing myelodysplastic syndrome.

Expert perspectives surrounding the management of patients diagnosed with advancing myelodysplastic syndrome.

A panel of experts have a comprehensive discussion on RSV, highlighting risk factors, complications, and the benefits of vaccination.

In this AJMC peer exchange program, Dr. Ryan Haumschild and a panel of experts, including Dr. Jamie Koprivnikar, Dr. Brian Mulherin, and Dr. David Dingli, discuss Paroxysmal Nocturnal Hemoglobinuria (PNH), focusing on its pathophysiology, complement inhibitors, treatment strategies, and the challenges of managing this rare, life-threatening disorder.

Robert O'Brien, RPh; Diana Brixner, PhD; Ashley Peterson, MHA; and Paul Jeffrey, PharmD, discuss the current state of prescription digital therapeutics (PDTs) adoption and explore strategies for increasing payer approval and widespread coverage of PDTs.