Peter Attia· MD
peter knows the billions that probably have to be invested when you're developing a drug of that type of magnitude to reduce something you're not going to do it on every tom dick and harry who has a trivial lp little a you want that first trial to work because if it doesn't that's it detroit the drug is dead it'll never be tested in lesser risk people so the only way you can get into this current apo little a synthesis modulator drug is you have to have had an atherosclerotic clinical event a myocardial infarction stroke blah blah blah stents and you have to have an astronomical like upper quintile concentration of lp little a because mendelian trials suggests if you're going to get benefit by lowering april little a or lp little a it has to be a pretty significant drop in it so you're not going to take somebody with a trivial lp little a elevation and you know if you tested 50 000 maybe it would work but so if they go through this first trial and it'll probably take three four five years to show efficacy and safety then they're going to have to maybe do some sub uh trial analysis and then is anybody even going to fund the primary prevention trial with this drug with the course that that takes i don't know so even if you're somebody who has had a heart attack because of lp little and you're waiting for this drug you've got five ten years to wait and for primary prevention go on to other ways that clinicians are attacking this problem right now because you're not gonna have anything