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**Apabetalone (RVX-208) Currently Being Tested in a Phase 3 BETonMACE Cardiovascular Outcomes Trial and Will Soon Begin Phase 2a Kidney Dialysis and Phase 1 Fabry Disease Trials**

Message: A comment about market penetration


For starters I am not wired for business acumen nor have much experience with the dealings of market investments, as such I am "addicted" to this board, SH and IV. As a result I am not a frequent poster for I have nothing intelligent to offer on the business side of things. I enjoy your "ramblings" and others offering different angles on viewing the state of affairs surrounding this amazing company. My experience is with being bedside with the infirmed in an ICU as a Critical Care Physician Assistant. For those who dont know what this entails I am able to practice medicine under the supervision of a physician. I have 15 years experience with inpatient hospital medicine with the last 11 being in a 28 bed medical/surgical ICU. At my institution there is not a CCU (Coronary Care Unit), so these type of patients are admitted to the ICU under the service of a cardiologist usually if there is not other systems decompensated (ie: Sepsis, SIRS, COPD Exacerbation, Respiratory Failure, Acute Kidney Injury, and a host of other organ system dysfunction).

I stumbled on RVX via the internet 2 years ago researching investment sites with the thought of opening an IRA in addition to my 403B. I was instantly taken by the science and potential and have been accumulating shares since.

As I mentioned in response to bfw, protocols are used to ensure a patient gets consistant standard of care. Some my older attendings snicker at these for they feel it "dumbs down" the practice of medicine and removes the "art of medicine". None the less, they are here to stay.

An example of one order set is the ACS (Acute Coronary Syndrom) pathway. Say a patient comes to the an ER with crushing chest pain. There are protocols that Emergency Rooms have in place to deal with this senerio. This patient most likely arrived to the ER via EMS and has been treated in the field. IV acsess obtained given aspirin, nitrogycerin, morphine, anti-nausea medicine if indicated, IV fluids started, placed on oxygen and an EKG performed. Once in triage, this patient will get immediate attention and labled as a level 1 (this identifies severity of signs and symptoms and the required resources to deal with the condition, a level 5 would be someone who wants his morphine perscription refilled).There are other parameters in a protocol designed for discharge and follow up care that I am not familiar with (most people are transfered/downgraded out of the ICU to another floor in the hospital prior to being discharged).

Heart attacks are further catergorized by EKG findings. Some patients require immediate attention and cannot be treated solely with medications while the myocardio infarction evolves thru completion. Those that require immediate intervention are place on a protocol that a study (named CPORT) in the early 2000's found produced better outcomes when compared to treating with fibrolytics, (clot buster drugs). A patient with a STEMI (ST segment elevation MI, an EKG finding that is an ominous sign and requires immediate action or an unacceptable loss of myocardio tissue will certainly ensue and likely a loss of life), will go to the heart catheterization lab (protocol driven time restraints require "door to ballon time" of 90 minutes) and have, more than likely, a stent placed to allow the reperfusion of blood flow. This patient will come to the ICU/CCU for further management on the ACS protocol.

Now there are a host of options to choose from an order set based on the clinical situation. Most will be placed on Beta blockers, statins, ACE inhibitors, Plavix/aspirin; some require lasix, Integrilin, symptomatic medications, etc.

If RVX 208 pans out and becomes standard of care it could find its way on any number of protocols. If the modifying effects to inflammation prove out, maybe there is place for RVX on a sepsis protocol to quell SIRS, systemic inflammatory respose syndrome, or CVA protocol (stroke or "brain attack").

The potential stratospheric. Not only the enormous potential from a personally finacial way, but enormous in regards to alleviating human suffering.

In medicine, therapeutics are offered on a risk/benefit spectrum. Do the benefits of a procedure/medication out weigh the risk of a possible deleterious outcome. In this company I have such a strong belief in the science that I am willing to take the risk.

Hope this helps from a clinical stand point (sorry for my rambling to those that know this stuff already).



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