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Wednesday, September 21, 2016

Morning Rounds by Megan Thielking

Happy Wednesday! STAT's Rebecca Robbins here, filling in for Megan this morning to bring you your daily infusion of health news.

Lawmakers set to grill Mylan CEO on EpiPen price hikes

Fresh off of being skewered at the Emmy Awards, Mylan Pharmaceuticals is sending its CEO Heather Bresch to Capitol Hill today, for a House hearing on the company's aggressive price hikes of the life-saving EpiPen device. According to her prepared testimony, Bresch plans to defend the price of the device while expressing regret that the drug maker did not better anticipate consumer concern. We hope she also answers a few of our questions.

Keep an eye out for whether lawmakers bring up the latest twist in the EpiPen saga: USA Today's report yesterday that Bresch's mom leveraged her role as head of an education group to push states to require schools to buy EpiPens. Bresch's dad, it's worth noting, is a US senator.

Today at UN meeting: What to do about superbugs

In a sign of just how alarmed experts are over antibiotic resistance, it's the subject of a gathering of world leaders today, marking just the fourth time in its history that the United Nations has held a so-called "high-level meeting" on health issues. That puts the superbug threat in the company of HIV, Ebola, and diabetes and obesity. But don't expect any dramatic pledges to come out of today's meeting. STAT reporter Helen Branswell reports that it's unlikely any resolution would rise to the level of what public health experts are urging: targets limiting usage of antibiotics on a per capita basis. More here on what to expect. And here's the webcast if you want to tune in.

How journal articles underreport treatment side effects

Published journal articles are often considered the definitive record of a study on a drug or other medical treatment. But if you just read the published literature, you'd miss an average of nearly two-thirds of the side effects reported in unpublished documents, according to an analysis of 28 studies published in PLOS Medicine. The rosy portrayal in journal articles extended to both the number and range of reported side effects, the British researchers who conducted the analysis found. And as a case in point, look no further than the side-effects reporting in studies that buoyed a popular weight-loss pill.

Sponsor content by CVS Health

How tailoring medication adherence interventions can reduce health care costs

A recent study published in The American Journal of Managed Care found that interventions to keep patients with common chronic conditions adherent to their medications is extraordinarily cost-effective, with an even greater opportunity for health care cost-savings if medication adherence resources are focused on patients with three or more chronic conditions, such as hypertension, diabetes and high cholesterol. Learn how CVS Health uses predictive analytic tools to tailor adherence programs for these specific patient populations.

Inside STAT: How heroin took over an Ohio town

WELCOME TO EAST LIVERPOOL (Justin Merriman for STAT)

The heartwrenching image, published on Facebook recently by a small-town Ohio police department, was impossible to forget: Two overdosing adults slumping in the front seat of a car, with a little boy staring silently from the backseat. STAT reporter Casey Ross went to East Liverpool, Ohio, to get the story behind the photo. He found a struggling river town where scenes like the one that went viral on the internet are nothing out of the ordinary. First responders describe finding unconscious drug users in roadside ditches, outside Wal-Mart, and in living rooms. "Do you know how many houses we go into that the kids are sitting on the couch watching us?" one paramedic said. "There's kids everywhere at all times." Read the piece here.

Why is smoking so bad for you, anyway?

Scientists have long known that smoking is terrible for your health, but the molecular mechanisms by which tobacco kills are less fully understood. Now, a new meta-analysis published in Circulation: Cardiovascular Genetics provides a fuller picture of the epigenetic changes — that is, the chemical imprints that change how genes behave — caused by smoking. I called up the senior author on the study, NIH epidemiologist Dr. Stephanie London, to learn more.

What does your analysis contribute?

We found orders of magnitude more signal than was found in any individual study that's been recorded in the literature. So we have a very comprehensive picture of the changes to methylation [a type of epigenetic change] across the genome that are induced by smoking. And by doing this very powerful study, we identified a large number of genes that haven't necessarily previously been implicated in smoking-related health effects.

Why is that information useful?

You might identify genes that you know are important in some diseases where there hasn't necessarily been enough data to know whether smoking causes it. And where we know smoking is a cause of certain diseases, these methylation signals might give you some hints about why this occurs and how you might be able to prevent it.

Opioid addiction drug barely prescribed, briefly used

Until recently, doctors who've been approved to prescribe the opioid-addiction drug buprenorphine were limited to 100 patients, a ceiling which was doubled earlier this year in an effort by the Obama administration to combat the opioid crisis. But prior to the policy change, the vast majority of these doctors weren't even coming close to their prescribing limits, new research published in the Journal of the American Medical Association shows. Fewer than 10 percent of approved doctors were treating more than 75 patients in 2010-2013, researchers from the nonprofit RAND Corporation found. The researchers also found that during this period patients were getting the drug for a median of just 53 days, far briefer than generally needed to beat the addiction.

'Obesity gene' doesn't affect weight-loss efforts

These days, it seems like efforts are underway to use patients' unique genetic makeup to tailor treatment approaches for just about everything. But a new large-scale analysis published in the BMJ suggests that approach might not be necessary for obesity. Across nearly 10,000 people, those who carried the so-called "obesity gene," which is linked to increased body weight, responded equally well to weight-loss interventions as did those without the gene. The British researchers who conducted the analysis concluded that the focus would be better placed on diet and exercise, regardless of people's genotypes.

What to read around the web today

  • The team that wants to do a human head transplant tested their technique in a dog. Critics aren't convinced. New Scientist
  • Doctors have questions about the story of a memoirist who spent a decade in the dark. New Yorker
  • The CRISPR patent dispute, explained in comic book form. The Nib
  • Patients turn to San Diego stem cell companies for costly, unproven treatments. KPBS

More reads from STAT

Thanks for reading! My colleague Melissa Bailey will be back with more health news tomorrow.

Megan

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