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Biotechs eye the next weight loss drugs, where Kaiser might go after its Geisinger mega-deal, & a health care crisis beyond suspected poisoning in Iran

May 1, 2023
Reporter, Morning Rounds Writer
Good morning. First off, many thanks to my colleagues Theresa Gaffney and Jonathan Wosen for their coverage last week. Today we've got more on The Obesity Revolution: what biotechs think will work next.

the obesity revolution

Next up: Biotechs aim novel strategies at market opened by Wegovy and Ozempic

WeightLossDrugDesert_v2_Illustration_MollyFerguson_042023

Molly Ferguson for STAT

It's hard to imagine now, but there was a time when obesity was a desert for drug development. Now that drugs originally conceived to control diabetes appear to be such sweeping successes in weight loss, competitors may soon crowd the field. Some candidates may move beyond the current class of GLP-1-based drugs, which mimic the hormone that helps regulate insulin and hunger. 

STAT's Elaine Chen and Allison DeAngelis explore novel approaches still in development, including some that don't induce muscle loss, unlike the GLP-1 drugs, and some that mirror the effect of bariatric surgery. Still, among roughly 80 obesity treatments in development, more than half are GLP-1-based, according to tallies by STAT and analysts at TD Cowen. And combination treatments may be the future. Read more.


health

'Eat, sleep, console' method works better for opioid-exposed infants, study says

For 50 years, newborns who'd been exposed to opioids before birth were evaluated on 20 scores assessing withdrawal. A more recent approach, which encourages parental involvement along with a low-stimulation environment, assesses babies who may be going through withdrawal based on their responses to actions like swaddling, skin-to-skin contact, and breastfeeding. Now a study published yesterday in NEJM comes down definitively on the side of the new approach, known as "eat, sleep, console."

The randomized controlled trial compared the usual care to the newer method for just over 1,300 infants at 26 U.S. hospitals. On average, babies who were judged by whether they were able to eat, sleep, and be consoled left the hospital almost a week sooner than babies whose discharge was based on withdrawal signs such as tremors, excessive crying and irritability, and problems sleeping and feeding. The eat, sleep, console infants were less likely to be given opioids to manage withdrawal in the hospital; after three months, safety outcomes were similar for both groups. 


Health tech

Chatbots beat MDs answering questions in an online forum

It wasn't even close. In a study that asked three health professionals to evaluate responses to questions posed on a Reddit forum, a chatbot assistant was rated significantly higher than physicians on both quality and empathy, a study in JAMA Internal Medicine says. The research was inspired by how much more time clinicians are spending documenting care and responding not just to patient queries but also to insurers' demands. Authors of a companion commentary yearn to leave the computer and get back to the bedside. 

Responses from physicians were much shorter than from the chatbots. One example: Asked whether you'd go blind from splashing bleach in your eye, a  doctor said "Sounds like you will be fine. You should flush the eye …." The chatbot said: "I'm sorry to hear that you got bleach splashed in your eye. It's important to rinse the eye …." The upshot: Maybe chatbots can help draft replies that doctors review.



Closer Look

After scooping up Geisinger, where's Kaiser Permanent going next?

GettyImages-489882718Lisa Lake/Getty Images for Geisinger Health System

It wasn't so long ago that the Geisinger, the rural Pennsylvania hospital system and health insurer, was held up as a shining example of how high-quality health care could be provided at low cost, drawing praise from President Obama in 2009 as he campaigned for the health care model that took his name. But Geisinger's reputation was tarnished in later years by failed deals, management missteps, antitrust allegations, and local competition. In that context, its blockbuster deal with Kaiser Permanente last week makes more sense, STAT's Bob Herman explains.

What's next? "What you're seeing is the real changing nature of competition," Sachin Jain told Bob. Jain is the CEO of SCAN Group, a health insurer in California, Arizona, and Texas in the process of its own merger with an insurer in Oregon. "Competition in health care has been really regional. It's going to be increasingly national." Read more. 


mental health

To identify children at risk, researchers find factors that could signal future self-harm

The strongest predictor of self-harm among children and adolescents is a previous attempt. A study out today in Pediatrics adds more detail to what else these young people might have in common, in hopes of flagging trouble before it happens. Looking at records of more than 1,000 children age 5 to 17 who'd been admitted to hospitals in Tennessee and Colorado for neuropsychiatric reasons, they found that more than a third had seriously harmed themselves. They framed other factors in these four profiles:

  • Very high-risk: males age 10 to 13 with ADHD, bipolar disorder, autism spectrum disorder, and other developmental disorders. 
  • High risk: females ages 14 to 17 with depression and anxiety along with substance- and trauma-related disorders. Personality and eating disorders were also significant.
  • Moderate risk: No depressive disorders.
  • Low risk: children age 5 to 9 with a non-mental health diagnosis and no mood, behavioral, psychotic, developmental, or trauma- or substance-related disorders. 

health

Opinion: Poisoning schoolgirls is not the only health tragedy in Iran

Children, mostly girls, are being poisoned at their schools in Iran, sickened and some dying after exposure to a toxic gas. The chemical attacks began in November 2022, but the international community learned of them in February. Suspicions are high that the attacks are a government response to the protests led by women and girls decrying the arrest and later beating death of 22-year-old Mahsa Jina Amini for allegedly not covering her hair properly. 

"The poisoning of schoolgirls is not the first health care-related tragedy in Iran in recent months," Iranian American physician Arghavan Salles of Stanford writes in a STAT First Opinion. "The very act of practicing medicine in Iran is now hazardous." Doctors have been killed, ambulances co-opted by security forces, and medical care withheld from protesters. Salles urges medical workers here to take action. Read what Salles suggests people can do from a distance.


More around STAT
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What we're reading

  • Opinion: Our Covid data project is over, but the need for timely data is not, New York Times

  • Boston Children's Hospital pays $15 million after child dies during sleep study, Boston Globe
  • Once bullish on digital health, Orexo hits a wall on reimbursement, STAT
  • Many California hospitals are near wildfire danger zones, study says, Washington Post

  • Bright Health looks to get out of health insurance entirely, STAT

Thanks for reading! More tomorrow,


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