Breaking News

How costs balance with benefits for a digital health tool, first transplant of a CRISPR-edited pig kidney, & where amateurs seek what elite athletes have

March 22, 2024
Reporter, Morning Rounds Writer
Good morning. Today we have a bleak outlook on the cost-benefit ratio for some digital health tools, a historic first in xenotransplantation, and a peek inside a hospital system's efforts to offer athletes personalized care — for the right price.

health tech

Digital health tools didn't deliver savings in diabetes monitoring, study says

Digital health companies have promised to improve the lives of 38 million Americans with type 2 diabetes, pitching fingerstick monitoring of blood glucose as a way to prevent amputation, kidney failure, and other serious complications. A new study paints a bleak picture of the approach, saying the digital tools cost more than they were worth. That could be challenging for companies like Teladoc, Omada, and DarioHealth that offer digital diabetes products. 

A systematic review by the Peterson Health Technology Institute found that the digital tools to manage diabetes from eight companies didn't result in clinically meaningful improvements over standard care. Instead of reducing health care spending, they drove it up. Some populations might benefit, but current evidence doesn't support broader adoption for most products, the report says. The institute is a nonprofit launched last July to independently evaluate costs and clinical outcomes for new digital health products. STAT's Katie Palmer and Mario Aguilar have more, including company perspectives.


transplantation

Gene-edited pig kidney transplanted into a living patient for the first time20240316_mcr_kidney_transplant_268-1

Massachusetts General Hospital

In another milestone for xenotransplantation, surgeons at Massachusetts General Hospital transplanted a kidney from a CRISPR gene-edited pig into a 62-year-old man last Saturday. Richard Slayman is up and walking — he's up to 20 laps a day around the ward — one of his doctors said, after receiving the pig kidney gene-engineered by eGenesis, a pioneer in making human-friendly pig parts using CRISPR gene-editing technology in hopes of easing the urgent organ shortage. Previous xenotransplants have involved genetically modified pig hearts. 

"We thoroughly discussed with the patient, on multiple occasions, all the knowns and unknowns of the procedure, and he bravely decided to move forward with xenotransplantation," said Leonardo Riella, MGH's medical director for kidney transplant, at a press briefing yesterday morning, choking back tears. The eGenesis pigs' genomes are altered to lack molecules that trip the human immune system. Researchers also added genes to make the organs more compatible with the human circulatory system and used CRISPR to snip out potentially dangerous viruses from the pigs' genomes. STAT's Megan Molteni and Eric Boodman have more.


breakthrough summit east

Summit roundup:

Yesterday was STAT's 2024 Breakthrough Summit East in New York, focusing on patients and how they shape medicine and pharma. If you couldn't join the event, STAT reporters have you covered here:

Nora Volkow, director, National Institute on Drug Abuse, on whether new weight-loss drugs can help people with addiction: Early data are "very, very, exciting," but she wants more. "This is a structural problem that we have: That we've never considered addiction as a disease that is worthwhile to invest in, despite the very high rate of mortality," she said. "We need to change those priorities. We need to see that if we don't tackle the problem of addiction — that if we don't treat [it] like other diseases, we are going to continue to face this horrific epidemic of deaths." Lev Facher has more.

CRISPR pioneer Feng Zhang on his company Editas Medicine trailing competitors but now working on a promising medicine for sickle cell disease: "Getting that focus in place at the beginning would have really helped the product development advance quickly, and also would have gotten the product out to help patients much sooner." Andrew Joseph has more.

Julia Vitarello, founder and CEO of Mila's Miracle Foundation, an organization devoted to finding a cure to Batten disease: "Science is not the limiting factor anymore, [but] we do not have the infrastructure and the processes that connect these tens of millions of dying children with the technologies that we actually have today." Annalisa Merelli has the story.



closer look

Hospital offer sports performance centers for athletes seeking that extra edge20240209-stat-cspar-0065

Tony Luong for STAT 

Ordinary mortals sometimes aspire to become just a little more like elite athletes, whether that means hitting new highs in their chosen sports or having access to training that the pros enjoy. It turns out that the same principles of injury recovery and prevention apply to both weekend warriors and professionals, but few of us have a team of experts we can call on to analyze strengths and weaknesses, customize plans to improve, and guide us individually through the workouts.

That's where hospitals are stepping in with sports performance centers like the one Mass General Brigham opened last summer near the home stadium of the New England Patriots. There's a crucial distinction: The Center for Sports Performance and Research serves athletes, not patients, after they've been cleared medically to pursue a goal if they're post-injury. Insurance doesn't cover the cost, but that has not dampened demand. "You feel like you're getting what the Patriots next door get every day," 29-year-old pickleball athlete and entrepreneur Jodi Cullity said at the tech-rich, sports-diverse facility. I have more here.


chronic disease

Fluctuating BMI linked to cardiovascular risks

We've all heard that yo-yo dieting is bad for us, long before the new weight-loss drugs changed how we view and treat obesity. But the science hasn't been clear on what fluctuating weight means for our health, especially cardiovascular disease. Researchers set out to resolve conflicting studies by analyzing health records in the large and diverse Million Veteran Program, validated against the U.K. Biobank to increase female representation. They report in JAMA Network Open that the more variation in BMI, the greater the risk of excessive changes in blood pressure, heart rate, and blood sugar. That increase translated into more heart attacks, strokes, and cardiovascular deaths.

The results, based on more than 157,000 health records, held true after accounting for age, sex, smoking, diabetes, statin use, and other factors. Why BMI fluctuations raise cardiovascular risks isn't known, but the authors call for future research focusing on understanding what they call metabolic derangements brought about by varying BMI.


medical devices

Opinion: What device makers share with Uber

Medical devices and ride-share companies like Uber and Lyft usually don't come up in the same sentence, but Kyle Sheetz of the University of Michigan and Robert Wachter of the University of California, San Francisco invite us to consider what they have in common. In the Uber model, the company created sufficient market demand in New York City to limit inevitable pushback, they write in a STAT First Opinion. Device makers hoping to leap over barriers both regulatory and behavioral may also be tempted to act first and ask permission later.

Transcatheter aortic valve repair rapidly changed practice, but evidence of benefit came years after wide adoption. Robotic surgery and proton beam therapy are two other examples. "The medical community can learn a lot from cases in which device makers successfully used an Uber-like strategy," they say, "yet a system that facilitates widespread use of, and payment for, a new device or practice in the absence of supportive evidence can also lead to harm and waste." Read more about finding "a middle ground."


More around STAT
Check out more exclusive coverage with a STAT+ subscription
Read premium in-depth biotech, pharma, policy, and life science coverage and analysis with all of our STAT+ articles.

What we're reading

  • Native Americans are hardest hit by syphilis surge, NPR

  • Regeneron's plot to 'cure' allergies, STAT
  • Cutting-edge CAR-T cancer therapy is now made in India — at one-tenth the cost, Nature

  • Prometheus team launches new startup with $400 million to tackle immune-driven disorders, STAT

Thanks for reading! More Monday,


Enjoying Morning Rounds? Tell us about your experience
Continue reading the latest health & science news with the STAT app
Download on the App Store or get it on Google Play
STAT
STAT, 1 Exchange Place, Boston, MA
©2024, All Rights Reserved.

No comments