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Cardiovascular deaths arounds the world, making sense of AI in medicine, & a pause in Wegovy ads

May 22, 2023
Reporter, Morning Rounds Writer
Good morning. We have two dispatches involving cardiovascular disease, another on an advertising pause for a red-hot drug, and a look at where AI in medicine may be going.

global Health

Progress against cardiovascular disease is uneven

Over the last three decades, deaths from cardiovascular disease have soared by 60% around the world, a new report says, a surge partially explained by aging, growing populations. The death rate has actually fallen over this timeframe, but the decline was uneven, falling the fastest in high-income countries and starting to stall overall. While it was the leading cause of death worldwide, 4 in 5 cardiovascular deaths occurred in low- and middle-income countries.

Most heart attacks and strokes can be prevented, but risk factors such as high blood pressure, air pollution, tobacco use, and high LDL cholesterol vary with the region. Nations that spend more on health care as a percentage of gross domestic product have lower cardiovascular death rates, and death rates are higher where people pay more out of pocket for health care. "The world has the tools and knowledge to mitigate harms to cardiovascular health," the report concludes.


obesity

Amid rising demand, Novo Nordisk halts Wegovy ads

You won't be seeing any ads for Wegovy for a while. Novo Nordisk, which makes the weight loss drug, is pausing ad campaigns for the extremely popular drug as it struggles to meet demand. Wegovy contains the active ingredient semaglutide, which is effective in helping people lose weight and also in changing the conversation about obesity treatment. In that broader effort, Novo Nordisk has brought Queen Latifah and other celebrities into an online campaign about obesity in society.

There have been shortages of Wegovy since its approval in 2021, but after those issues were resolved last year, demand has continued to rise. The company said this month that it will start limiting starter doses for new patients to ensure a steady supply for people already on the drug. STAT's Elaine Chen has more on Wegovy and its competitors.


in the lab

A 'defanged' form of CRISPR reduced cholesterol levels in monkeys

CRISPR epigenome editing just got a big boost from a trial that successfully used the tool to lower "bad" cholesterol levels in monkeys. As STAT's Megan Molteni explains, epigenome editing is a "defanged" form of CRISPR. It doesn't cut or nick DNA but instead changes the chemical tags surrounding DNA that regulate genes. When scientists from Tune Therapeutics used this tool to turn down the cholesterol-associated PCSK9 gene in monkeys, the animals' blood levels of heart-disease-causing LDL cholesterol dropped by more than 50%.

The results, presented Friday at the American Society of Gene and Cell Therapy meeting, are the first published data on epigenome editing in primates. Other groups have shown similar success in mice, and PSCK9 is also the target of drugs on the market since 2015. And Verve Therapeutics is aiming at the gene with its version of CRISPR, base editing. Megan explains.



Closer Look

Understanding AI research in medicine, in one slide

Screen Shot 2023-05-21 at 12.09.27 PMCourtesy Rahul Deo

A little background: Last year STAT's Bob Herman suggested one could earn a Ph.D. in health policy from just one PowerPoint slide. Now our colleague Brittany Trang reports from a recent AI conference that one might make sense of AI research in medicine in one slide (above). Leaving aside the question of which is the more difficult challenge, here's how Atman Health chief medical officer and Brigham and Women's associate physician Rahul Deo boiled down the AI issue: The riskiest, most impactful studies draw far less attention these days than the rest of the research.

Top of the mountain are the highest-impact, highest-risk AI models that would figure out how to replace the most complex physician tasks with automation. Next important would be steps toward that goal: models that predict patient risk, clinical decision support models, and language models to automate rote office tasks. Forget the rest, Deo says. Read more.


health

The toll from tainted eyedrops continues

Another person has died and more people have suffered vision loss after using eyedrops contaminated by drug-resistant bacteria. The CDC reported a fourth death and a 14th case of vision loss on Friday, bringing total infections to 81 people, up from three deaths and eight cases of vision loss in March. Four other people had an eyeball surgically removed after infection with Pseudomonas aeruginosa, which is resistant to standard antibiotics.

Most patients had used certain brands of eyedrops, now recalled. The CDC advised people to stop using EzriCare Artificial Tears and two other products made by the same manufacturer, Delsam Pharma's Artificial Tears and Delsam Pharma's Artificial Ointment. On a trip to the plant in India that made the eyedrops,  U.S. health inspectors uncovered inadequate sterility measures, the Associated Press reports. That's not a surprise, this STAT First Opinion says.


mental health

Teens with depression more likely to say they have access to a gun, survey finds

High school students who have depression think they have greater access to guns than peers who don't experience this mental health risk for suicide, a survey has found. Guns are the most common method of suicide among teens, so previous research has focused on access to guns in the household. The new study, out in Pediatrics today, asked about guns at home or elsewhere. Questions screening for depression or suicidality found just under a quarter said yes to one or both. On guns:

  • Around 1 in 10 overall own guns, commonly as gifts.
  • More than 4 in 10 overall think they could find a gun.
  • Roughly 1 in 4 teens with depression — but not suicidality when examined separately — thought they could get a gun compared to 1 in 5 without these conditions. "This finding may be skewed because it does not include those who had increased access and completed suicide," the authors note.

If you or someone you know may be considering suicide, contact the 988 Suicide & Crisis Lifeline: call or text 988 or chat 988lifeline.org. For TTY users: Use your preferred relay service or dial 711 then 988.

In a new episode of the "Color Code" podcast, STAT's Nicholas St. Fleur zooms in on North Bellport, which sits in the shadows of a massive landfill and has the lowest life expectancy on Long Island. Listen here.


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What we're reading

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  • Back in hoodies and gym shorts, Fetterman tackles Senate life after depression treatment, Associated Press
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  • Why a warming world is costing you precious hours of sleep, Washington Post
  • Pear Therapeutics sold for parts at $6 million auction, STAT

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