Breaking News

A win for precision medicine, WHO weighs in on aspartame, & what Mandy Cohen brings to CDC from North Carolina

July 14, 2023
Reporter, Morning Rounds Writer
Good morning. It was anticipated, but the approval of OTC birth control is still historic. We've also got news on drugs for one type of cancer working in another and a look at how the new CDC director built bridges as the top health official in North Carolina.

reproductive Health

OTC birth control pill wins FDA approval

Access to abortion has become more restricted in the contentious year after Roe v. Wade was overturned, but the availability of birth control just expanded. Yesterday the FDA approved the first over-the-counter birth control pill, a decision that's expected to transform how contraception is delivered in the U.S. Starting early next year, people can buy Opill online and at pharmacies, convenience stores, and grocery stores without a prescription, removing a hurdle to greater access to contraception. 

"Today, we made history," Kelly Blanchard of the advocacy group Ibis Reproductive Health said. Opill's price may not be set until the fall, but its arrival is being welcomed as a remedy for the high rate of unintended pregnancies. The pill contains only progestin, safer than pills combining progestin and estrogen, but progestin-only pills are less effective if not taken at the same time daily. STAT's Ed Silverman has more.


health

WHO reports show possible link between aspartame and cancer but little cause for concern

Most people who drink Diet Coke and Diet Pepsi once in a while don't need to worry about their cancer risk from aspartame, two new WHO reports say, even though the artificial sweetener may be associated with cancer. WHO's International Agency for Research on Cancer said yesterday it found "limited evidence" that aspartame may cause liver cancer while the Joint FAO/WHO Expert Committee on Food Additives reconfirmed previous recommendations that the sweetener is generally safe up until very large doses.

WHO is not asking businesses to withdraw aspartame-sweetened products but it warns that children might more easily hit the daily recommended limit of aspartame, based on body weight, than adults. A 200-pound person would have to drink more than 18 Diet Cokes per day to hit that limit. "There's only a very obvious recommendation to give … bring down the consumption," WHO's Francesco Branca said. STAT's Nicholas Florko has more.


cancer

A win for precision medicine: Melanoma drugs worked on a shared mutation in rare brain cancer

Here's an example of precision medicine enabling experimental treatment of a serious illness with existing medicines never offered for this purpose before. Two cancer drugs approved for treating melanoma were given to a small group of patients with papillary craniopharyngioma, or PCP, a rare type of brain cancer. Genetic sequencing had shown 95% of PCP tumors carry a specific mutation to the BRAF gene that's also quite common in melanoma.

Researchers report in NEJM that after giving two cancer drugs that target the proteins BRAF and MEK  (both involved in cell growth) to 16 PCP patients who had not received radiation therapy, their tumors shrank, on average, by more than 90%. "These types of responses are actually unprecedented," co-author Priscilla Brastianos told STAT's Bree Iskandar. There are caveats: 14 patients suffered serious side effects during treatment, and PCP did progress in three patients after treatment was stopped. Read more.



Closer Look

Mandy Cohen built bridges in North Carolina. Will that be enough to succeed at CDC?

Mandy Cohen speaks during a briefing on North Carolina.NC Department of Public Safety

Her bio — raised on Long Island, educated at Yale and Harvard — didn't make success for Mandy Cohen (above) as North Carolina's health leader a sure thing in politically divided state. But even her ideological opponents acknowledge the new CDC director is a good listener and a bridge builder capable of shoring up trust — an important challenge at the pandemic-battered CDC. Cohen's track record in North Carolina includes selling conservative lawmakers on a Medicaid expansion and surviving the pandemic without political backlash.

Not everyone's a fan, including 28 Republicans who opposed her nomination, citing her support for Obamacare, a ban on semi-automatic rifles, and a  depiction of climate change as a public health crisis. "She will never gain the support of everybody. But I think she stands a great likelihood of gaining the type of support she needs to make sure that CDC is provided the tools that she needs," former Sen. Richard Burr told STAT contributor Joanne Kenen. Read more.


chronic disease

MS drug delivery time dropped from hours to minutes in Roche clinical trial

Living with multiple sclerosis might get just a bit easier. Patients with the chronic, debilitating neurological disease often have to endure hours-long infusions of their treatments, but a new clinical trial from the maker of Ocrevus has shown a 10-minute injection beneath the skin works just as well as twice-yearly IV delivery for people with certain types of the disease. A caveat: The results from Roche were issued in a press release, not a peer-reviewed journal. More information will come when it presents the findings at a future medical conference and in regulatory filings. 

Ocrevus, already a blockbuster therapy, works by latching onto CD20, a molecule made by antibody-producing B cells, in an attempt to tamp down the contribution of these immune cells to the destruction of myelin, a fat that swaddles connections between nerve cells. The loss of this protective sheath can lead to symptoms that range from tingling and fatigue to difficulty moving and thinking. STAT's Jonathan Wosen has more.


aging

'Superagers' with sharp memory are also more mobile and in better mental health than peers

Do you know anyone in their 80s whose memory is as sharp, their movements as agile, and their minds as sound as people 30 years their junior? (I aspire to be one one day.) Here's a study from The Lancet Health Longevity connecting mobility and mental health to the remarkable memory skills defining "superagers." The researchers found this association in older people after testing them on cognitive tasks, collecting demographic data and blood samples, and imaging their brains.  

After identifying 64 superagers around age 80 for their memory skills, the scientists compared them to 55 more typical older adults who did well on cognitive tasks but didn't display superb memory. Superagers had more gray matter in brain areas linked to memory and movement while showing fewer biomarkers of neurodegenerative disease. They also moved more quickly and had lower rates of anxiety and depression. Which came first — activity or brain health — isn't clear, so more research is needed to explain the overlap.


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What we're reading

  • How a key Senate committee is planning to regulate pharmacy benefit managers, STAT
  • Some anorexia patients want the right to die. A few doctors are willing to listen, The Guardian
  • With momentum on Alzheimer's therapies, Europe sees delivery challenges ahead, too, STAT
  • Cannabis use landing more young people in emergency departments, study finds, CNN

  • Why hospitals are cutting ties with Moody's rating agency, STAT

Thanks for reading! More Monday,


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