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Outcry over affirmative action ban, barriers to hep C cures, & the heartbreaking limits of disease advocacy

June 30, 2023
Good morning, STAT reporter Jason Mast here, filling in Liz. Morning Rounds will be taking a summer break next week and will return in your inbox on Monday, July 10.

supreme court

Medical leaders speak out against Supreme Court's affirmative action ban

The US Supreme Court building on a cloudy day.Stefani Reynolds/AFP via Getty Images

The Supreme Court's decision yesterday to strike down affirmative action provoked outcry among medical leaders, who say the ruling could reverse decades of progress toward diversifying the nation's physician workforce, STAT's Usha McFarling reports. That progress was seen as an important part of reducing health disparities in the U.S., where less than 6% of physicians are Black and Black people live about six years less than white people. 

"The justices think we are living in a post-racial America and nothing could be further from the truth," James Hildreth, the CEO and president of Meharry Medical College, told Usha. "This represents a potentially critical blow to our efforts to make sure the medical workforce is diverse." There are ways medical schools could continue to diversify their ranks, as Usha documented earlier this year, such as prioritizing lower-income applicants and improving the climate for students from underrepresented backgrounds. But some fear many schools will take the easy way out. Read more.


infectious disease

New report spotlights barriers to curative hep C drugs

A cure for hepatitis C has been available since 2013, but, as STAT has extensively documented, treatment has not reached many people with the disease. Yesterday, the CDC put a figure on the shortfall in a new report: Only 1 in 3 adults diagnosed with the disease has been cured since new medicines became available.

There are myriad reasons, as STAT's Abdullahi Tsanni reports. The medications cost $24,000 per course, and some state Medicaid programs and private insurers have been reluctant to foot the bill. The virus is complicated to diagnose, requiring cumbersome testing. It often impacts marginalized people, including those who are incarcerated, who already have difficulty accessing care. The White House is now pushing an $11 billion plan to end the disease by negotiating lower drug prices and developing new tests. Former NIH chief Francis Collins, who is leading the push, said it would save the country money by preventing liver disease and cancer that hepatitis can cause. Read more.


cancer

Study of cancer deaths in Hispanic people finds concerning trends

Cancer deaths among Hispanic individuals in the U.S. fell 1.3% annually from 1999 to 2020, according to a new JAMA Oncology paper. But that larger trend belied worrying signs among some sub-groups. Although overall cancer mortality fell, driven in large part by dramatic declines in lung cancer deaths, cancer mortality actually rose among Hispanic men ages 25 to 34, driven by an increase in colon and testicular cancer. 

Liver cancer rates rose among both Hispanic men and women, possibly because of an increase in risk factors such as hepatitis B and C infections. And overall, in 2020, Hispanic individuals had the second highest mortality rate among ethnic and racial groups the authors tracked. They attributed the subgroup and overall disparity to systemic inequalities, such as decreased access to care and inclusion in clinical trials. "Future studies should focus on understanding the consequences of cultural and social inequities for cancer mortality," they wrote.



Closer Look

For the Duchenne moms who pushed for cures, a breakthrough can't rebuild what's lost

Patrick and Christopher Furlong sit in their wheelchairs outside.Courtesy Pat Furlong

For Duchenne muscular dystrophy patients and their families, the approval last week of the first gene therapy for the degenerative disease was a landmark moment. For the first time, most 4- and 5-year-olds will be offered a therapy that, if results hold up, could alter the course of their lives. Yet for some, jubilation comes with heartbreak.

Over two decades, moms of boys with Duchenne mobilized to lay the groundwork for this breakthrough, raising funds for research, lobbying legislators, and participating in research studies. For the most part, their sons will not benefit. Some, like Patrick and Christopher Furlong (above), have died. Others are older now and have already lost much of their muscle function. Gene therapy might preserve muscle, but it can't bring it back. Their fight over 30 years is the story of modern disease advocacy, its power to bring about transformational drugs, and the limits on how fast even the most determined activists and scientists can make drug development go. I have more here.


surgery

Stop Ozempic before your surgery, anesthesiologist group says

Patients have long fasted before surgery to ensure food doesn't get into the lungs while under anesthesia. But, STAT's Elaine Chen reports, people who take Ozempic or one of the similar new weight loss medications, known as GLP-1 drugs, are recommended to take a second step — stop their drugs.

The guidance from American Society of Anesthesiologists comes after anecdotal reports that delayed stomach emptying, a side effect of these drugs, could increase the risk of regurgitation and food aspiration into lungs when patients are on anesthesia. There are, however, scarce data on the drugs' effects on people during surgery. If patients did not stop taking their GLP-1 before surgery, the group recommends doctors perform an ultrasound. If the stomach is empty, they may proceed with the operation. Read more.


addiction

Report highlights how xylazine is contributing to overdose deaths

Over the last few years, a powerful veterinary sedative called xylazine, or tranq, has emerged as a growing public health threat. The drug, when mixed with fentanyl, can lead to overdoses that are difficult to reverse with naloxone and has adverse effects not seen with opioids alone. A new CDC report spotlighted how widely the drug has spread. 

From January 2019 to June 2022, across 20 states and Washington D.C., the percentage of illicit fentanyl-related deaths in which the sample included xylazine rose from 3% to 11%. That doesn't mean xylazine caused the person's death. The exact effects of xylazine are still unknown, and different jurisdictions varied widely in whether they included the drug as a cause of death. But researchers wrote the findings emphasized the need to study the drug further, conduct more routine toxicological studies after suspected overdose deaths, and spread the word that people may need to seek treatment beyond naloxone.


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