the obesity revolution
Wegovy's successful heart trial raises vital questions about weight loss
Bloomberg
They're called topline results, and when they're as good as yesterday morning's numbers correlating Novo Nordisk's weight loss drug Wegovy with improved cardiovascular outcomes, the reaction was positive, with a dash of skepticism while awaiting full data (expected later this year). Novo's drug and medications like it are already blockbusters, despite being injections that insurance may not cover. Cardiologists told STAT they think news that Wegovy cut the risk of cardiovascular disease by 20% in the large SELECT trial will change medicine's approach to obesity and heart disease — and increase the likelihood of insurance coverage. But none of them thought the obesity drugs would replace existing heart disease drugs.
The landmark study leaves an unanswered question: What exactly is the relationship between weight and health? The results don't prove obesity treatments improve heart health just by helping people lose weight, experts said. There could be other key mechanisms at play.
"I think the conclusion that people will jump to in a vacuum is, 'oh well, significant weight loss, which you get with these drugs, will lead to reduction in cardiovascular risk,'" Ethan Weiss, a cardiologist at UCSF, told STAT. But "we're not there yet."
Understanding how the drug improves cardiovascular outcomes will be critical both for drug developers making future treatments and for doctors trying to determine which treatment might work best for their patients. Then there are implications for the ongoing societal debate over the relationship between body weight and health.
"We have to be careful not to extrapolate this to the general population and say it should be prescribed to every single person with a BMI over 30," Gregory Dodell, an endocrinologist who practices weight-neutral medicine at Mount Sinai in New York, warned. "A lot of people in larger bodies are metabolically healthy."
Read more on what doctors are saying and what weight loss might mean.
pandemic
After 2.5 years and a $1 billion, few trials will test long Covid treatments, budget breakdown reveals
On July 31, after 2.5 years and a $1 billion mandate from Congress to study and treat long Covid, the NIH launched clinical trials for a condition that has brought debilitating symptoms to some people suffering since the pandemic's earliest days. NIH has spent most of that money, according to a new and detailed budget breakdown shared with MuckRock and STAT. Most of the funds support observational research — studying symptoms — rather than clinical trials to test treatments.
Scientists and patients are disappointed that only 15% of the funding — $171.5 million — went to clinical trials, under the leadership of Duke University's Clinical Research Institute. This funding "has been largely wasted," said David Putrino, director of rehabilitation innovation at Mount Sinai and a clinician studying long Covid. If those clinical trials fail, it would be "really a travesty," said Julia Moore Vogel, a scientist at the Scripps Translational Institute living with long Covid. Read more.
Hospitals
Senators from both sides of the aisle press for probe of nonprofit hospitals' tax breaks
Here's how the deal is supposed to work: Nonprofit hospitals often stay afloat with state or federal funding while exempt from many taxes. In exchange, they are expected to help the area they serve through public health programs and free or discounted care to low-income patients. Now a bipartisan group — Sens. Elizabeth Warren (D-Mass.), Raphael Warnock (D-Ga.), Bill Cassidy (R-La.), and Chuck Grassley (R-Iowa) — wants federal tax regulators to probe nonprofit hospitals' compliance with these community benefit requirements.
Central to the longtime debate is what counts as community care and charity. As Sarah Owermohle explains in her exclusive story, 82% of nonprofit hospital systems spent less on community programs than the value of their tax exemptions in 2019, according to a Lown Institute report. The American Hospital Association countered that Lown ignored a range of community investment categories. Lown did so intentionally, arguing many of those categories should not count. Read more.
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