Breaking News

An abortion clinic is opening in Cancun, another blockbuster is approved for obesity, & the HPV vaccine is maybe too good (in Finland)

November 9, 2023
Reporter, Morning Rounds Writer
Good morning. It's a little jarring to think of an abortion clinic opening in a resort like Cancun with women coming from the U.S. in mind, but "you have a lot more direct flights to Cancun than to any other city in Mexico," Araceli Lopez Nava Vázquez points out in today's story from Olivia Goldhill.

the obesity revolution

Here comes another blockbuster drug for weight loss

Eli Lilly's wildly successful type 2 diabetes drug Mounjaro has now been cleared to treat obesity, making it the second entry in a highly effective class of weight loss medications. The FDA's approval will pit the injectable drug, to be marketed as Zepbound for obesity, against Novo Nordisk's Wegovy, now in short supply. Many doctors had already been prescribing the diabetes version, Mounjaro, to patients with obesity, but insurers have clamped down on such off-label usage.

Both drugs (as well as Novo's diabetes drug Ozempic) target receptors of the GLP-1 hormone and in trials cut about 15% of people's body weight. But Zepbound, which targets both the GLP-1 and GIP hormones, has shown up to 21% weight loss in its trials. Novo has shared data demonstrating Wegovy's cardiovascular benefits, perhaps making it an easier call for insurers to cover it compared with Zepbound, the relevant data for which are still to come. STAT's Elaine Chen and Damian Garde have more.


health

Rethinking HPV screening requirements

GettyImages-125767560

Joe Raedee/Getty Images 

Vaccines work so well to prevent cancers caused by the human papillomavirus that it may be time to review HPV screening protocols, authors of a new paper published in Cell Host & Microbe suggest, based on their analysis of genital HPV types eight years after immunization. Their study followed more than 60,000 Finnish women randomly split by their cities' vaccination strategy: gender-neutral HPV vaccination, girls-only vaccination, and no vaccination.

The vaccine proved most efficient when both boys and girls are immunized. The researchers also asked what to do after vaccination significantly depletes high-cancer-risk HPV types. If screening post-vaccination becomes limited to high-oncogenic types, doing it less often would be sufficient, study author Ville Pimenoff said — perhaps once every 10 years. (U.S. vaccination rates are lower, so our results might differ if we tried this at home.) STAT's Annalisa Merelli has more.


Cancer

For some patients, CAR-T may awaken a latent virus

It's a frightening complication from a potentially life-saving cancer treatment: A woman infused with CAR-T cells designed to kill her lymphoma appeared cancer-free a month after getting the engineered cells. Then came the memory lapses and a scan showing brain swelling. She'd suffered the rare complication of encephalitis from a common herpes virus infection, HHV-6. STAT's Angus Chen talked with Caleb Lareau, a cancer immunologist who co-authored a Nature study on this infection.

How often does this complication occur?

We're in the very early days of understanding this. But the belief is that it's quite rare. 

What do you want patients and clinicians to take away from this?

For some patients, it may matter, but for most, CAR-T will more likely than not give you a great outcome. There's growing awareness of this for clinicians that when there is certain atypical neurotoxicity in patients, HHV-6 is something they screen for more readily. It is treatable.

Read the full interview.



closer look

Cancun abortion clinic opens with Americans in mind

GettyImages-1125671728Daniel Slim/AFP via Getty Images

You may recall that last year, just three months after the U.S. Supreme Court overturned a constitutional right to abortion, its counterpart in Mexico found that criminalization of abortion was unconstitutional. Now MSI Reproductive Choices, an international reproductive health nonprofit, is opening an abortion clinic in Cancun, partly designed to cater to travelers from the U.S. who are unable to get an abortion in their home states.

"You have a lot more direct flights to Cancun than to any other city in Mexico," Araceli Lopez Nava Vázquez, regional managing director of MSI Reproductive Choices in Latin America, told STAT's Olivia Goldhill. "That was an important thing for us to consider…. We're aiming to help more American women." Read more. 


health care

Capping ambulance rides at $100 out of pocket 

Ambulance trips are a ride nobody really asks for, STAT's Tara Bannow and Bob Herman note, so surprise bills can really sting. Now government advisers have endorsed ways for Congress to protect patients from this particularly thorny problem, including a cap on how much they would have to pay if they took an ambulance. Surprise bills have been eliminated for most health care services, but not yet for out-of-network ground ambulance rides.

After a two-day meeting, the federal ambulance committee (primarily people from the ground ambulance industry) hit upon $100 as the most a patient would pay out of pocket. But how to pick up the rest of tab remains in question. A new collaboration from STAT and the health policy podcast Tradeoffs explores how the potential solutions could pan out, based in large part on the experiences of 14 states that have already tried to fix the issue somehow. Read more.


synthetic biology

First lab-made yeast genome nears completion

For thousands of years, ordinary brewer's yeast has helped humans brew, distill, and bake our way into a delicious modern existence. But along the way, its genes got kind of stale. If this industrial workhorse was going to be put to more ambitious tasks in the future — like burping out ethanol, antibiotics, and other useful biochemicals — it would need a more flexible genome. 

STAT's Megan Molteni explains that for the last 15 years, more than 250 researchers from around the globe have been building exactly that. The project, Sc2.0, set out to swap the yeast's naturally evolved genetic material for engineered replacements more conducive to tinkering and adding in new traits. In 2014, it announced the completion of its first synthetic yeast chromosome, followed by five more in 2017

In 10 new papers published Wednesday in the journals Cell, Molecular Cell, and Cell Genomics, the group reports the assembly of eight additional non-naturally occurring chromosomes. It expects to publish the final two later this year. The final challenge will be to consolidate all 16 synthetic chromosomes into a single living yeast strain. Only once that's done will we see what a customizable synthetic life form can really do.


Yesterday, were you looking for that Nature Communications paper about the prospect of nearby tissue predicting lung cancer progression? Here's the paper. (Apologies for sending you to the journal's home page yesterday.)


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What we're reading

  • New Jersey keeps newborn DNA for 23 years. Parents are suing, Wired

  • 'A disaster waiting to happen': how USAID's $10bn health project unravelled, The Bureau of Investigative Journalism

  • Senator floats new models to manage costs of weight-loss drugs like Ozempic, STAT
  • Children in mental-health crisis surge into hospital E.R.s, Wall Street Journal

  • To fight bias against people with addiction, White House calls for 'recovery-friendly' workplaces, STAT

Thanks for reading! More tomorrow,


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