Morning Rounds Shraddha Chakradhar

Purdue Pharma files for chapter 11 bankruptcy

Purdue Pharma, the maker of OxyContin, filed for bankruptcy late last night. The company was facing thousands of lawsuits related to its purported role in fueling the opioid epidemic, and the bankruptcy declaration is part of a larger deal that the company struck with 24 states and thousands of cities and counties across the U.S. The funds from the bankruptcy — which could be as much as $10 billion — will go towards fighting the ongoing opioid crisis, which has killed more than 47,000 people in 2017. Still, many states are opposed to the terms of the deal, and the fight over the settlement in bankruptcy court is expected to be fierce. 

What’s still unclear is what this news will mean for individual members of the Sackler family, which owns Purdue and have also been named in many lawsuits. Late last week, some $1 billion in wire transfers was tracked by New York prosecutors, suggesting the Sacklers may have been trying to hide their wealth amid all the litigation.

Physicians and other health care professionals rally for gun safety

Doctors, nurses, medical students, and other health professionals across the country are rallying today against gun violence. At noon, members of the national group known as Scrubs Addressing the Firearm Epidemic, or SAFE, will stand in medical scrubs outside their respective hospitals for five minutes. The various SAFE chapters include Stanford, where the group was founded, as well as Harvard Medical School, NYU, and more than 45 other medical schools across the country. “SAFE is naming gun violence for what it is — a health threat of epidemic proportion — in order to rally the medical community to fight for the interests of our patients,” the organization’s mission states. Among the things that the SAFE chapters say they want to call attention to today is better firearm safety education for both patients and health providers.

Office-based physicians commonly order drugs off label for children

Physicians in outpatient settings — or office-based physicians — commonly prescribe off-label medicines to children, according to new research. Scientists looked at survey data from 2006-2015, and found that these doctors ordered at least one off-label drug — one that was prescribed for a condition it wasn’t approved for — for almost 20% of visits. The most common reason was because the drug was not approved for the patient’s condition. The most off-label prescriptions were written for adolescents, although the rate of off-label prescriptions was highest among newborn infants. Rates of ordering antihistamines, anti-inflammatories, and drugs for gastrointestinal conditions increased over time, while prescriptions for some antibiotics decreased. In a related editorial, experts call for more research into how unapproved drugs work against various conditions in children. 

Inside STAT: Could editing the DNA of embryos with CRISPR help save people who are already alive?


One big reason the so-called CRISPR babies made news was because they represented what the gene editing technology could one day do: try and eradicate disease before people are even born. But what could CRISPR do for people who are already alive? That’s the question of hopeful parents for “savior siblings,” where one healthy sibling serves as a donor to help an ill sibling with some kind of tissue donation. At least one couple, whose toddler has a rare genetic condition, wish that CRISPR were far enough along so it could be used to help them conceive a healthy savior sibling for their young daughter. And even though this application for CRISPR is not yet in the clinic, “I’m hopeful that they’ll eventually find a way to deploy [CRISPR] in a productive way,” Keith, the father, said. STAT’s Andrew Joseph has more here

Nearly two-thirds of researchers in a new survey say they’re happy with peer review

A new survey of more than 3,000 researchers and their views on measures of scientific rigor finds that more of them now are satisfied with the peer review process than a decade ago. Here’s more: 

  • Overall trends: Some 69% of researchers reported being satisfied with the peer review process for publishing in 2009, but now some 75% say the same. 

  • Trust in research: More than 60% said they trusted the majority of research — whether data, papers, or videos — but about 37% said they doubted the quality of at least some such source in the week prior to being surveyed. 

  • By specialty: About 15% of those in the life sciences were likely to believe all the research they encountered was trustworthy, while only 11% of those in medicine thought the same. 

Common Alzheimer’s drug may have a higher risk of hospitalization for muscle injury

Aricept, a drug commonly used to manage cognitive decline in Alzheimer’s patients, may be associated with a higher risk of hospitalizations. In a new study, researchers looked at more than 220,000 Canadian patients who were prescribed drugs for managing dementia — about 152,000 of these patients were prescribed Aricept. Although the overall rate of hospitalizations was still low, more people who took Aricept were hospitalized for a type of muscle injury — a known side effect of these drugs — than the people who took other drugs, including Exelon and Razadyne. There were 88 hospitalizations in the Aricept group compared to 16 in the other group. The study only included adults older than the age of 65, so the authors write that the findings may not be generalizable to adults below that age with dementia. 

What to read around the web today

  • You donated to kids with cancer. This Vegas telemarketer cashed in. Center for Public Integrity
  • Inside the drug industry's plan to defeat the DEA. The Washington Post
  • Planned Parenthood and fired former chief mired in escalating dispute. The New York Times
  • Five big questions about the outbreak of vaping-related illnesses. STAT
  • A detox drug promises miracles—if it doesn't kill you first. Wired

Thanks for reading! More tomorrow,


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Monday, September 16, 2019


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