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What didn’t cause a gene therapy trial patient’s death, a big payday for insurance CEOs, & the biggest troubles for AI in medicine

April 27, 2023

Good morning, reporter and podcast producer Theresa Gaffney here again. Monday is the deadline to apply for the Sharon Begley Science Reporting Fellowship, a one-year program for early-career journalists from racial and ethnic groups underrepresented in the profession. It combines a paid reporting position at STAT with educational offerings through MIT's Knight Science Journalism program. More information here.

exclusive

CRISPR did not kill a gene therapy trial patient, early data suggest

In February, four months after the first patient in a designer CRISPR therapy suddenly died, around 100 researchers gathered in a Tucson, Ariz., conference hall to hear investigators in the study walk through the results of an autopsy. Few details had been made public about the death of Terry Horgan, a 27-year-old man born with Duchenne muscular dystrophy, as the investigators worked to pinpoint a cause. Some people wondered if he had even gotten the drug. Others feared that CRISPR-Cas9, a technology researchers hoped to deploy against many diseases, had played a role.

At the presentation, leaders of the study put that fear to rest, STAT's Jason Mast reports in an exclusive. They did not yet know what killed Horgan, but it wasn't CRISPR. They found scarcely a trace of Cas9, the central protein used to manipulate the genome, in Horgan's tissues. It never had a chance either to benefit or harm him in the eight days between when he received the therapy and when he died. "We just need to take a step back and understand [this] a little bit better," Alex Fay, a neuromuscular specialist at UCSF, told Jason after reviewing the data. Read more.


insurance

Health insurance CEOs receive record pay, again

Business has never been better for the largest health insurers in the country, which led to another record-setting windfall last year for their chief executives. In 2022, the CEOs of the seven major publicly traded health insurance and services conglomerates — CVS Health, UnitedHealth Group, Cigna, Elevance Health, Centene, Humana, and Molina Healthcare — combined to make more than $335 million, according to a STAT analysis of annual financial disclosures. That was 18% more than the record from 2021. High-flying stock prices again fueled a vast majority of the gains.  

More than half of the total, $181 million, went to a single executive: Joseph Zubretsky, the CEO of Molina, an insurance company that gets all of its revenue from taxpayer-funded health programs. STAT's Bob Herman breaks down why insurance CEO pay packages tend to be at the top of all the largest companies, aside from technology giants. Read more.


vaccines

Europe nears approval for first RSV vaccine for older adults

The European Medicines Agency recommended approval yesterday for the first vaccine for respiratory syncytial virus, or RSV, in older adults. Scientists have worked for decades to create a vaccine for the common respiratory virus that recently left hospitals overwhelmed with cases surging among infants and toddlers across the U.S. The European Commission must now sign off on the EMA's recommendation on GSK's Arexvy, which the FDA is also set to decide on next week.

"I've been working on RSV for a long time and there's been periodic promises of having an RSV vaccine around the corner, which has never proven to be true," Larry Anderson of Emory University School of Medicine told STAT's Matthew Herper in January as Moderna and Pfizer also made progress on their own vaccines. In the U.S., 6,000 to 10,000 older adults die each year due to RSV, while another 60,000 to 120,000 of them are hospitalized. "To have three vaccines with a good chance to be licensed and this kind of efficacy data is really pretty amazing," Anderson said. 



Closer Look

The dirty truth about AI in medicine

Illustration of a billboard promoting AI tech on top of a hospital, inside the hospital doctors struggle with computers
Mike Reddy for STAT

In public, hospitals rave about artificial intelligence. They trumpet the technology in press releases, plaster its use on billboards, and sprinkle AI into speeches touting its ability to detect diseases earlier and make health care faster, better, and cheaper. But on the frontlines, caregivers complain AI models are unreliable and of limited value. Tools designed to warn of impending illnesses are inconsistent and sometimes difficult to interpret. Even evaluating them for accuracy, and susceptibility to bias, is still an unsettled science.

A new report aims to drag these tensions into the open through interviews with physicians and data scientists struggling to implement AI tools in health care organizations nationwide. STAT's Casey Ross spoke with data scientists, lawyers, bioethicists, and others from the research team about the biggest challenges, and how they are attacking them. "Each health system is kind of inventing this on their own," Michael Draugelis, a data scientist at Hackensack Meridian Health System in New Jersey, told Casey. Read more.


health

Workplace discrimination increases high blood pressure risk, study says

Experts have long known that discrimination broadly is associated with a risk for high blood pressure. A new study in the Journal of the American Heart Association deepens that research, finding that discrimination specifically within the workplace also is associated with a greater risk of high blood pressure in the U.S. 

The study defined workplace discrimination as "unfair conditions or unpleasant treatment at work because of personal characteristics, particularly race, sex or age." The researchers analyzed data from a national survey that followed participants starting in 2004-2006 for about eight years. On a scale of low to high exposure to workplace discrimination, people who reported high exposure were 54% more likely to report high blood pressure during the follow-up period than those with low exposure. Those with intermediate exposure were 22% more likely. More research is needed to better understand the connection, as respondents self-reported their blood pressure, and those who did not participate in survey follow-up were more likely to be people of color, have lower education, and have a higher prevalence of high blood pressure.


health

Did pets help ease loneliness in the pandemic? Study reports it's inconclusive

Like so many others, I got a pet during the pandemic in 2020. During that trying time, my cat Walnut kept me company when I was lonely and forced me to get out of bed to feed her and clean her litterbox. A new study from PLOS ONE says that I'm not alone in this tight bond.  

Researchers surveyed more than 4,000 people over the course of the pandemic on stress, loneliness, and for pet owners, their relationship with their pet. The results showed that cat and dog owners did grow closer to their pets from February 2020 through 2021. Dog owners consistently showed stronger decreases in stress and loneliness than cat owners and people without pets (Walnut and I aren't taking this personally). Pet owners broadly showed less romantic loneliness than people without pets. But it's a little complicated: Once researchers adjusted for confounders like income, gender, race, and the existence of other housemates, pet ownership itself did not mitigate stress or loneliness.


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What we're reading

  • Kaiser Permanente, Geisinger to merge into national health system, STAT
  • More adults think access to abortion should be easier, Pew report finds, Politico
  • Alnylam's 'upstream' Alzheimer's treatment shows early promise, STAT
  • Why work friends are crucial for your health, Time
  • FDA approves Seres microbiome drug, as field advances, STAT
  • Mattel introduces first Barbie with Down syndrome, Associated Press

Thanks for reading, more tomorrow! — Theresa

Theresa Gaffney is a reporter and podcast producer at STAT.


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