Friday, March 9, 2018

Morning Rounds by Megan Thielking

Happy Friday, folks! And welcome to Morning Rounds. 

Mississippi passes 15-week abortion ban

Mississippi lawmakers have passed a bill that bans most abortions after 15 weeks of pregnancy. The measure — which Republican Gov. Phil Bryant has promised to sign — would be the earliest abortion limit in the U.S. The only exceptions: if a pregnant woman’s life or “major bodily function” are threatened by the pregnancy or if a fetus has a problem that’ll make it impossible to survive outside the womb at full term. There’s no exemption for pregnancies that are the result of rape or incest. The measure would further restrict abortion access in the state, which only has one abortion clinic. The owner of that clinic has promised to challenge the measure in court.

The latest in the FDA's court battle over "right to try"

Today’s the deadline for the FDA to explain to a court why it doesn’t want to offer any more details on an internal decision to allow at least two American patients with Ebola to take an unapproved drug. The Goldwater Institute, a libertarian think tank, went to court in 2015 to force the FDA to cough up more information on its decision to approve the use of experimental Ebola drugs. So far, the FDA has refused to elaborate to the judge’s satisfaction.

Goldwater’s interest is political — the think tank has pushed to pass “right-to-try” laws and hopes to show that the FDA didn’t stick to protocols in the case of the Ebola crisis. That could potentially undermine the idea that the current approval process is good enough, which has been used to swat away attempts at passing new bills. 

Another salmonella outbreak is sickening dozens

The CDC says a salmonella outbreak that’s swept across seven states has sickened 170 people, 62 of whom have been hospitalized. The outbreak has been linked to chicken salad sold at Fareway grocery stores which has since been recalled. The last reported illness started in mid-February, and food safety and health officials say they're still investigating the outbreak. It's the latest in a string of salmonella outbreaks this year, including those blamed on kratom, shredded coconut, and raw sprouts. 

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Can this pricey cholesterol drug curb heart attacks?

Keep an eye out this weekend for important new data on a pricey cardiovascular drug. Regeneron is set to release clinical trial data at a conference tomorrow that’ll show whether Praluent — an injected therapy that lowers bad cholesterol — is better than older drugs when it comes to preventing heart attacks, strokes, and hospitalizations. There’s a lot riding on the trial — Regeneron has hoped that data showing the drug’s long-term benefits will boost sales. Doctors have been hesitant to prescribe Praluent, which has a list price of more than $14,000 a year, and payers have been reluctant to shell out that much for a drug that might not cut hospitalization costs.

Lab Chat: How migrating gut bacteria might do damage


small intestines studded with e. gallinarum bacteria. (Manfredo Vieira et al., Science 2018)

Scientists have discovered a particular microbe that can venture out of the gut and set up shop in other organs, where it seems to trigger an autoimmune response that’s similar to what’s seen in patients with lupus. The finding gives researchers new clues about the potential link between the microbiome and autoimmune disease. Here’s what Dr. Martin Kriegel of Yale told me about the work, published in Science.

What did you discover about a potential link between the microbiome and lupus?

Studies have suggested autoimmune disease might have a microbial trigger. We gave mice that modeled autoimmune disease broad spectrum antibiotics to manipulate the microbes in the gut. We almost completely prevented mortality. But a big hurdle is figuring out which bacteria are behind the link, and how. So we tracked the bacteria with fluorescent tags.

What did you see?

We saw that E. Gallinarum bacteria somehow crossed the barrier of the gut and impacted immune cells. The bacteria tipped the balance from being prone to developing autoimmune disease to actually developing it. When we went to human liver tissue, we also found these microbes. We think it drives important autoimmune pathways.

GOP works to relax law that would put drug makers on the hook for more costs

Republicans in Congress are working to relax a law that would force drugmakers to pay a higher percentage of costs for Medicare beneficiaries. Democratic aides and health industry lobbyists confirmed that congressional Republicans are trying to use an upcoming spending bill to make the change, which the drug industry has spent weeks pushing for since the law was enacted in February. What's not clear yet: whether the industry can agree to the particulars of the policy before a March 23 deadline — and whether Democrats will accept the policy. STAT's Erin Mershon has more here

What to read around the web today

  • Trump officials tell Idaho it can’t dump Obamacare. Politico
  • Why hemophilia drugs are so expensive. Kaiser Health News
  • An obituary for Henrietta Lacks, whose cells led to a medical revolution. New York Times

More reads from STAT

The latest from STAT Plus

Clarification: Yesterday's newsletter included an item on a report which found drug spending rose between 2012 and 2016 among patients with hypertension. The authors of the new report say that might reflect rising prices or the use of different, more expensive brand-name drugs.

As always, thanks for reading! Have a great weekend, 


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