Death of patient in Alzheimer’s trial raises question of possible risks

Early data on the experimental Alzheimer’s drug lecanemab delivered a surprising win: It slowed patients’ cognitive decline. Now STAT’s Jason Mast has learned it may have contributed to the death in June of a patient in the study. One study investigator concluded the death, which came after bleeding in the brain, was related to the drug, according to documents obtained by STAT. The drug’s maker, Eisai, disagreed, pointing to the patient’s previous falls, heart attack, respiratory infection, and mini-stroke-like events.

The death is under investigation and fuller clinical trial details will come next month, but it underscores side effects for this class of drug — swelling and bleeding in the brain — that are worse for people on blood thinners, as the patient who died was. “It is a tough issue because so many older adults are on anticoagulants, and if that means they can’t take these medications, that’s going to be a big deal,” said Joy Snider, a neurologist at Washington University in St. Louis and an investigator on the trial. Read Jason’s exclusive story here.

In a shortage, maker of an old chemo drug hikes the price tenfold

The law of supply and demand seems hard at work here. There’s a shortage of a drug important in preparing cancer patients for a bone marrow transplant or for CAR-T cell therapy. One manufacturer has returned to the market — but the price is 10 to 20 times what the only other companies with available supplies charge. Over the past week, STAT’s Ed Silverman reports, Areva Pharmaceuticals began marketing fludarabine at a wholesale price of $2,736, compared to the $272 Fresenius Kabi charges and the $109 price tag from Teva Pharmaceuticals for the same dosage.

“It’s a critical, life-saving drug, one that our patients desperately need,” medical oncologist Jason Westin of MD Anderson Cancer Center told Ed. To explain its price, Areva pointed to a complex manufacturing and regulatory landscape that led to the decision to slap a high price tag on fludarabine. Read more.

Long Covid estimated for 15% of infected Americans; Paxlovid disparities reported

Two themes have endured throughout the Covid pandemic: one is long Covid and another is racial and ethnic inequities in health care. For long Covid, in which symptoms persist throughout the mind and body long after infection strikes, a new estimate in JAMA Network Open says 15% of U.S. adults have the condition — similar to other prevalence studies. Being older and female was linked to higher risk; people who were vaccinated were less likely to say they had long Covid.

As for disparities, compared to white and non-Hispanic patients, the percentage of Covid patients treated with the antiviral therapy Paxlovid was 36% lower among Black patients and and 30% lower among Hispanic patients, with the gap growing to 44% between Black and white patients who were 65 to 79 years old, a CDC report notes.

Closer look: New RNA-sensing tools could help scientists target certain cells

(adobe)

Move over CRISPR, there’s a new player in town. Called ADAR, short for “adenosine deaminases acting on RNA,” it’s all about a shortcut to making proteins that upsets dogma dictating the DNA-to-RNA-to-protein-expression order of battle for the flow of genetic information. It’s important because it allows scientists to measure gene expression changes over time and space, picking out particular cell types, tracking cells as they get infected with a virus, become cancerous, or transition into senescence — and maybe one day delivering therapeutic payloads, like CRISPR, exclusively to specific types of cells.

“ADARs are turning out to be really amazing proteins,” Jonathan Gootenberg, who co-led work on the latest of these systems, published yesterday in Nature Biotechnology, told STAT’s Megan Molteni. That work is the latest in a flurry of publications converging on this new technology of RNA sensing. Read more.

Cancer deaths are trending downward, pre-pandemic analysis reports

Overall, the news about cancer is good, a new annual national report says, as death rates continue to trend downward for a period ending before Covid emerged. But the incidence of some common cancers is rising, possibly because risk factors, screening test uptake, and diagnostic practices have changed. The data also reflect racial and ethnic differences in incidence and mortality. Some details:

From 2015 to 2019, overall cancer death rates fell by 2.1% per year (down 2.3% for men and 1.9% for women).
Death rates fell the most per year for lung cancer (4%) and melanoma (5%) but increased for pancreatic, brain, and bone and joint cancers in men and pancreatic and uterine cancers in women.
Incidence rates during were highest among non-Hispanic American Indian and Alaska Native people, followed by non-Hispanic white people and non-Hispanic Black people. Rates were lowest among non-Hispanic Asian/Pacific Islander and Hispanic people.

Clues from Chile on flu season's early start, vaccine effectiveness

As Helen Branswell’s story earlier this month said, signs are pointing to an early start to the U.S. flu season. Cases have already ticked up in Southern states, and now a CDC report from the Southern Hemisphere offers a glimpse at what may be in store. This year in Chile, flu hit months earlier than typical before Covid-19. Hospitalizations were up compared to the last two seasons during the coronavirus pandemic, but down from 2017 through 2019.

Vaccine effectiveness against flu hospitalization in Chile was 49%, which is important for two reasons. First, natural immunity to flu has probably fallen over the last two seasons when flu was less active (and we were more cautious) and the flu vaccine now being given in the U.S. includes the same H3N2 component used in Chile, which could predict effectiveness if these viruses also spread here this time around.

What we're reading

Tuberculosis deaths rose during pandemic, reversing years of decline —WHO, U.S. News & World Report
Delta ‘weaponized’ mental health rules against a pilot. She fought back, Seattle Times
How experts think we can put health data back 'in the hands of the patient,' STAT
A new category of 'never events' — ending harmful hospital policies, JAMA Forum
Opinion: The need for regulatory grade evidence: Are you in the stadium or the sandbox? STAT