Breaking News

Gene silencing for obesity, second U.S. case of bird flu, & UnitedHealth argues lawsuits target 'the wrong defendants'

May 23, 2024
Cardiovascular Disease Reporter
Good morning. I'm back for a one-day appearance while Theresa's off. And what a day: We have new targets in obesity drug research, a second case of bird flu in a farm worker reported in the current dairy cow outbreak, and UnitedHealth's view of class action lawsuits over its algorithm determing rehab coverage.

obesity

Next-gen obesity therapies turn to gene silencing1-STAT-NEWS_Muted-Genes-©Marian-F.Moratinos-web

MARIAN F. MORATINOS FOR STAT

Biotech companies are already turning to the next big thing after the obesity blockbusters known as GLP-1s. Their new approach recruits RNA interference, the Nobel Prize-winning discovery that silences genetic instructions for making problematic proteins. Companies like Alnylam have successfully treated rare diseases with RNAi, but now their sights are trained on obesity.

In the crosshairs are genetic mutations that lead to lower BMI, obesity, or waist-to-hip ratios through more physical activity. Biotechs hope the therapies would last longer than GLP-1s like Wegovy that reduce hunger but must be injected frequently; they also aim to avoid the loss of muscle mass along with fat. "If you want to be healthy, is it better to starve yourself to death, or is it better to exercise yourself to health?" asks George Yancopoulos, CEO of Regeneron, which is working on a drug with Alnylam.

Check out the latest update of STAT's Obesity Drug Tracker to see how many RNAi drugs are in development — from Regeneron, Alnylam, Amgen, Wave, Arrowhead, and even Novo Nordisk. STAT's Allison DeAngelis and Elaine Chen have more.


H5N1

Michigan farm worker is second U.S. bird flu case tied to outbreak in dairy cows

A farm worker exposed to infected dairy cows has become the second U.S. case of bird flu in the current outbreak, Michigan officials said yesterday. The news follows a man in Texas who was infected on a dairy farm in March, triggering alarm about the first-known outbreak in cattle, which may have preceded his case by several months. In both cases, positive tests for H5 flu virus indicated an eye infection, matching the patients' symptoms; confirmation that it's the H5N1 subtype awaits genetic sequencing, the CDC said. In cattle, outbreaks have been confirmed in 51 herds in nine states, including 19 in Michigan — more than any other state.

Experts say the national number is likely a significant underestimate. Farmers have been reluctant to allow testing of their cows or their workers, but not in Michigan, where bird flu previously had a devastating impact on poultry. "Hundreds and hundreds of farm workers here in Michigan have been interviewed," Tim Boring, director of Michigan's Department of Agriculture, said last week. "They understand the importance of understanding how this is moving around." Helen Branswell and Megan Molteni have more. And Megan tells us about an infectious disease-tracking sewage surveillance network led by Stanford University and Emory University in partnership with Verily Life Sciences that's scaling up to track H5-specific influenzas across the country.


insurance

UnitedHealth says class action suit targets 'the wrong defendants'

Patients suing UnitedHealth Group for cutting off care based on what an algorithm dictated have got the wrong guys, the insurer's lawyers argued in court filings this week. STAT's Bob Herman and Casey Ross have documented how extremely sick and injured patients were forced to pay for care out of their own pockets or return home even if they couldn't walk or go to the bathroom by themselves. 

Gene Lokken's family is among them, stuck in the Medicare appeals process for nearly two years. "This is devastating for families," his daughter said. But even if these Medicare Advantage members survived the years-long process of appealing to Medicare (and some died before resolution), UnitedHealth's lawyers argued their grievances are with the federal government, not the company and its subsidiary NaviHealth. "The plaintiffs have sued the wrong defendants," their filing states. Read more. 



first opinion

To tackle burnout, look at health care workers' trauma AP515470983515

RICARDO ARDUENGO/AP

In health care, trauma is an occupational hazard. Medical professionals witness pain, suffering, injustice, and death, in addition to microaggressions, workplace violence, and moral injury. But for some people, these professional stressors are piled on top of challenging life events, including adverse childhood experiences, primary care physician Sadie Elisseou writes in a First Opinion. Such a history increases the risk of burnout, analogous to the greater risk of PTSD in veterans who have seen combat. 

"So far, no single framework has been successful in offering a comprehensive strategy to shield health care workers, and the systems they work in, from burnout," Elisseou says. "Adopting a trauma-informed approach may have a transformative impact on anti-burnout solutions, redirecting the course of the health care crisis." Read what that recognition and response can entail.


in the lab

Gilead's antiviral defused coronaviruses in mice, but human testing is not in the cards 

Covid-19 is still with us. Despite the success of Covid vaccines and because of waning interest in boosters, we still need antiviral drugs to combat infections. There are downsides to old stand-bys remdesivir (transfused), Paxlovid (rebound risk), and molnupiravir (weakness), so better solutions are needed for people who are unvaccinated, immunocompromised, or otherwise unable to build an antibody response to a vaccine.

Scientists testing an experimental drug in mice report success in Science Translational Medicine against a range of coronaviruses for their small molecule obeldesivir. Developed in collaboration with Gilead, the drug was also combined at a different dosage with Paxlovid. The cocktail worked better than obeldesivir alone, but plans to test the molecule in people are on hold. "It's really hard to test at this stage in the post-pandemic, because the virus causes so little disease," study author David Martinez told STAT's Annalisa Merelli. Read more.


infectious disease

Fighting antimicrobial resistance, one patient at a time

It shouldn't be shocking, but still: Pretty much every health care building has antimicrobial-resistant bacteria living somewhere inside. Of course, so do we humans, when you consider the bugs residing in our microbiomes. But the danger is higher for hospital patients who might have weakened immunity or open wounds, from trauma or surgery. When the population of microbes living within us expands through greater exposure, that can lead to infections in vulnerable people, particularly when the bacteria are resistant to antibiotics that disrupt the human microbiome and weaken its defenses.

Pathogen reduction, which whittles down the number of resistant bacteria colonizing the human microbiome, is the goal described in a new report from the CDC journal Emerging Infectious Diseases. Strategies include giving combined oral antimicrobial drugs to patients before elective colorectal surgery and using anti-staphylococcal treatments for patients undergoing orthopedic surgeries or procedures involving the heart and chest.


More around STAT
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What we're reading

  • A security camera caught an employee beating a patient. It took 11 days for anyone to take action, ProPublica 
  • Despite setback, Neuralink's first brain-implant patient stays upbeat, New York Times
  • Eyeing GLP-1 opportunity, Click buys assets of Better Therapeutics, STAT
  • Study finds mental disorders spread between teenagers, Newsweek

  • Cue Health, Covid-19 testing company, is shutting down, STAT

Thanks for reading! More tomorrow,


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