.@SaketRKumar is a builder at heart and @rishabhjain1198 engineered Grok at xAI. They met in March 2025 and launched @PrimeMeridianAI four months later—100% on TaxCalcBench, live for tax season. We've known Saket since 2017, when he was at La Famiglia, which became part of General Catalyst's European team in 2024. When he told us about Prime Meridian, backing them from day one was obvious. 150 million Americans overpay their taxes every year. Traditional software uses rigid rules, and CPAs routinely miss credits. Prime Meridian built AI that treats the tax code like a codebase, finding an extra $500-$1,000+ per return. They're offering free filing, and using tax season as their entry point to rebuild consumer finance with AI at the core. More from @jcfurstenberg, @yuris, and @utkbajpai: Source: Forbes

Just a homebody at heart with stories to share 😏 Passionate about flowers 💐, found strength in life's struggles 💪 Looking for someone special who craves connection and finds beauty everywhere 🌟

I'm a cardiologist. Today the FDA approved something I've been waiting two decades for: the first oral PCSK9 inhibitor in history. A once-daily pill — Lipfendra (enlicitide), from Merck — that lowers LDL as powerfully as the injections we've relied on. This is one of those days that quietly changes the trajectory of the disease that kills more people than anything else on earth. Let me tell you exactly why — and who should act on it this week. Start with the biology, because it's elegant. Your liver cells are covered in LDL receptors — molecular catcher's mitts that grab "bad" cholesterol out of your blood and pull it in for disposal. The more receptors you have working, the lower your LDL. But your body makes a protein called PCSK9 whose entire job is to find those receptors and drag them to the incinerator before they can be reused. PCSK9 is the saboteur. Block PCSK9, and the receptors survive. They get recycled back to the surface. They keep clearing LDL, over and over. Cholesterol plummets. It is one of the most powerful mechanisms we have ever discovered in cardiology. And until today, you could only access it through a needle. That needle was a bigger problem than most people realize. The injectables — Repatha, Praluent — are phenomenal drugs. But needle aversion, injection-site reactions, pharmacy logistics, and cost meant that millions of patients who desperately needed them simply said no. I have watched patients stay at heart-attack-level cholesterol for years because they wouldn't inject. The barrier was never the science. It was human. Now the trial data — from a program spanning over 19,000 participants — and it's genuinely impressive. Roughly 60% LDL reduction. A placebo-adjusted 56% in the main lipids trial, 59% in patients with inherited high cholesterol. On top of statins. That matches the injectable class in a daily tablet. But here's the detail that made me sit up as a cardiologist — the part most coverage is burying: enlicitide also significantly lowered ApoB and Lp(a). If you follow me, you know why that matters. Lp(a) is the genetic, inherited cholesterol particle that roughly one in five people carry at dangerous levels — the one that triples heart attack risk and that diet, exercise, and even statins barely touch. We've had almost nothing oral that moves it. A daily pill that lowers LDL, ApoB, AND Lp(a) simultaneously is a genuinely meaningful expansion of what we can do. Who should pay attention today: Anyone above their LDL goal despite maximum statins or ezetimibe. The roughly 9.8 million high-risk Americans still not at target. Anyone with familial hypercholesterolemia — the genetic condition that loads dangerously high LDL from birth and causes heart attacks in the 40s and 50s. These patients have avoided the injectables for years. Statin-intolerant patients who need powerful additional lowering. Anyone who's had a heart attack or stroke and needs to drive LDL far lower than a statin alone can manage. The price is notable too: about $315 a month, meaningfully below the injectables — though it'll still require insurance prior authorization, and formulary placement isn't set yet, so access won't be instant. Now the honest caveats, because I'm a physician, not a hype man: This approval is based on LDL lowering, not yet on proven outcomes. The big cardiovascular outcomes trial — CORALreef Outcomes, over 14,500 patients — is still running. We expect the heart-attack reduction to follow the LDL drop, because the link between lower LDL and fewer events is one of the most rock-solid relationships in all of medicine. But the definitive proof isn't in yet, and I'll tell you that honestly. And a pill isn't automatically right for everyone. Some patients love a shot they take twice a month and never think about again. This is a powerful new tool, not a mandate. But make no mistake about the size of this. For twenty years I've told patients that LDL is one of the most important numbers they will ever own — and that for the right person, lower is better, and lower earlier is better still. Today the tool to get there stopped requiring a needle. The medicine to protect your heart just got radically easier to take. And easier medicine is medicine people actually use. If you're on a statin and still not at goal — or high cholesterol runs in your family and you've been dodging the shots — this is the week to call your doctor and ask one question: "Is the new oral PCSK9 inhibitor right for me?" The needle was the wall. Today the wall came down. Know your numbers. The science to change them keeps winning.