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Morning Rounds Shraddha Chakradhar

Good morning, and happy Friday! STAT reporter Andrew Joseph here filling in for Shraddha for the day. To the health and medicine news:

Who should get the opioid settlement money?

With a key test trial coming up and settlements already being reached, stakeholders are eyeing how they can nab a chunk of the billions that could come from the massive opioid litigation. Now, there’s a new proposal: Former Ohio Gov. John Kasich and Gordon Gee, the president of West Virginia University and chair of the university’s health system, have formed a nonprofit called Citizens for Effective Opioid Treatment advocating that any settlement funding go to support hospitals and health infrastructure, instead of to local and state governments. “We need to make sure the money will go to treat the problem,” Kasich said on a call with reporters, adding that it should help “people on the front lines.” Kasich pointed to the tobacco settlement, which largely funded state budgets instead of treatment and prevention programs, to argue that any opioid money should be dedicated to the addiction crisis.

Separately, the Trump administration just unveiled a proposed relaxation of privacy rules for patients with a history of addiction. HHS Secretary Alex Azar told STAT it could prevent clinicians from prescribing opioids or other dangerous drugs to patients who had been treated for addiction. More on that here.

Limited gains in teen HPV vaccination rates

The CDC has released two new reports that show how much room for improvement there is in the HPV vaccination rate, and just how many cancer cases the virus is still causing. In the first report, which looked at teenage vaccine rates, federal researchers found that the rate of adolescents up to date on the HPV vaccine series increased from 48.6% in 2017 to 51.1% in 2018, a bump driven only by boys. Rates were higher among teens whose clinician recommended the vaccine. In the second report, on HPV-attributable cancers, researchers found that an estimated 34,800 cases of HPV-caused cancer happen each year in the United States, 92% of which are tied to the strain of the virus that the vaccine protects against.  

Tracking gene expression in the malaria parasite

Pointillism or a parasite? Seurat would be proud of this single cell data. (andrew russell)

For as common as it is, malaria remains poorly understood at the molecular level. Now, researchers have published a gene expression database for the parasite that causes the disease. Importantly, they found a group of genes that is active throughout the parasite’s life cycle, indicating potential targets for therapeutic development. To build the Malaria Cell Atlas, researchers sequenced genetic material from thousands of parasites and infected cells, including those from people, and tracked gene expression as the parasite matured.  
 
Meanwhile, the World Health Organization this morning reiterated its call for more research into new tools to prevent and treat malaria. Less than 1% of heath R&D investment goes to malaria, the agency said. It kills nearly half a million people each year.

Inside STAT: How will voters grade Trump on drug pricing initiatives?

During the 2016 campaign, President Trump positioned himself as a foe of the pharmaceutical industry, rejecting their donations and promising to let Medicare negotiate drug prices. As his 2020 campaign ramps up, it’s a different story. At a recent rally in Manchester, N.H., Trump barely mentioned drug prices. His supporters don’t seem to be paying much attention either. Despite polling that shows that drug pricing is a top priority for voters, many attendees weren’t aware of what the administration has proposed in Trump’s first term — and the struggles it's had implementing the plans. STAT’s Nicholas Florko has the story from Manchester.

'Polypill' reduces heart disease in trial

A once-a-day pill combining four different drugs reduced the risk of heart disease in a large clinical trial, validating an idea floated more than 15 years ago that a “polypill” could be a cheap and easy intervention. For the study, researchers followed more than 6,800 participants in Iran, half of whom took a polypill and half of whom received lifestyle advice. Over five years, 8.8% of the participants in the non-drug group had a serious cardiovascular event (heart failure, hospitalization, stroke, etc.) versus 5.9% of polypill takers. People in the polypill group who took their pill most frequently had even lower rates of heart problems. The polypill consisted of aspirin, atorvastatin, hydrochlorothiazide, and either enalapril or valsartan, which together target cholesterol and blood pressure.

What we talk about when we talk about fasting

The conclusion from a trio of papers about the effect of calorie restriction on the immune system: Researchers need more specific ways to discuss fasting. The three studies, which looked at the impact of such diets on a type of white blood cell, memory T cells, and the gut immune response, found sometimes conflicting results, but they also tested different kinds of calorie restriction. That led two experts, writing in a preview of the research, to highlight “the need to replace terms like fasting, or intermittent fasting, with those that describe the type and length of the fasting method. … Without these more precise definitions, it will be difficult to generate sufficient data to enhance our understanding of the biology of fasting responses and begin to translate this knowledge into randomized clinical trials.”

What to read around the web today

  • 'Say no to Juul': Pelosi slams SF vaping ballot measure. San Francisco Chronicle
  • Opinion: Community engagement is key to clinical trial recruitment and diversity. STAT
  • Desperate families pursue 'N-of-1' trials for ultra-rare diseases. MedPage Today
  • Q&A: Amgen’s R&D chief on the ‘slow-moving tsunami’ of Alzheimer’s and the future of disease research. STAT Plus
  • Customers handed over their DNA. The company let the FBI take a look. Wall Street Journal

Have a great weekend! 

Shraddha

Friday, August 23, 2019

STAT

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