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Thursday, September 22, 2016

Morning Rounds by Megan Thielking

Top of the morning to you. Melissa Bailey, STAT's national health care reporter, here filling in for Megan. Let's dive into today's news.

STAT Exclusive: Oxycontin sales playbook revealed

Photo illustration by Anthony Tiuli for STAT

Sales reps were trying to get through to a doctor to prescribe their potent painkiller. But he wasn’t taking their calls. Then his staff tipped them off: The doctor liked sweets. So they lined a box with doughnuts and snack cakes arranged to spell out the word “OxyContin” and dropped it off at his office. The gambit worked: The surgeon listened to the sales talk. Each week after that, the sales reps were back, asking him to switch more patients to OxyContin.

That’s one scene described in a trove of internal documents from Abbott Pharmaceuticals that STAT reporter David Armstrong uncovered in West Virginia. They show how Abbott sales representatives, under a boss who called himself the “King of Pain,” wooed doctors across the country with free meals, free books — and misleading information that downplayed the risk of addiction and had no basis in science. With Abbott's help, OxyContin became  a billion-dollar blockbuster — and one of the most abused prescription opioids in the country. Read the full investigation here

And the Nobel Prize goes to ...

Will this be the year CRISPR snags a Nobel Prize? Thomson Reuters, which probes scientific papers to predict winners each year, thinks it might be: George Church and Feng Zhang, pioneers of the gene-editing tool, are among its top picks announced this week. Other nods go to work in cancer drugs, non-invasive prenatal testing, and the human immune system. 

The real winners will be announced next week, so for now it's all speculation. Join in! Who do you think will win? Weigh in here.

Lab Chat: Sensing pressure on palms and hairy arms

Two patients with undiagnosed neuromuscular disorders sought help at clinics in Canada and California. Scientists found out they both have mutations in the same gene, PIEZO2 — and determined just how that gene can hamper a person's ability to sense their own body and move through space. I caught up with Alex Chesler, a scientist at the National Institutes for Health, about his research, published yesterday in the New England Journal of Medicine.

What’s PIEZO2?

It's a gene that was identified in 2010 by Ardem Patapoutian at the Scripps Institute. This was the first molecule that really looked like it may be a sensor for pressure. It's like the new iPhone screen: The harder you push on your iPhone, it can detect it. PIEZO2 is one of those sensors. It sits in the neurons in your skin ... and also in the neurons that innervate your muscles and tendons.

How did the patients perform on the sensory tests?

These patients have major problems being able to detect objects in their palms … yet on [softly brushing] their hairy skin [which is significantly different than the smooth skin of the palm], they performed much better. Their other sensations to other types of things you can feel — such as heat — was completely the same [as the control subjects]. The deficits were highly specific.

How did you link those behaviors to the gene?

We modeled these mutations in vitro, and showed that if you have these changes, the sensor itself is non-functional. It's as if someone came in with a scissor, and cut the molecule in half.

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How bees, screwworms, and geniuses advance science

“The sex life of the screwworm” — yes, the federal government sponsored that study. Researchers who worked on it will be honored tonight at the 5th annual “Golden Goose Awards” at the Library of Congress, honoring research “that may have seemed obscure, esoteric or downright funny,” but made a big impact. The screwworm study pioneered a new “sterile insect technique” of eradicating pests, which is widely used in agriculture and may help quell the Zika virus. Other honorees studied honeybees to come up with an algorithm that is now used to handle web traffic. Read about all the winners here.

And speaking of awards, the MacArthur "genius grants" were announced this morning. Among the winners: microbiologist Dianne Newman of the California Institute of Technology, whose research on ancient bacteria could help lead to new treatments for chronic infections; bioengineer Rebecca Richards-Kortum of Rice University, who develops medical technologies for use in low-income countries; and synthetic chemist Jin-Quan Yu of the Scripps Research Institute, whose work has implications for the pharmaceutical industry.

Sparks fly over Right to Try

Congress convenes a hearing today on controversial Right to Try laws, which aim to allow terminally ill patients quicker access to experimental drugs, bypassing years of red tape. Thirty-one states have passed such laws, and now the Senate and House are considering federal bills. Sparks are flying even before the hearing begins, writes Ed Silverman: The chairman of the Senate Homeland Security and Governmental Affairs Committee, which is hosting the event, is miffed that one of the scheduled experts, FDA commissioner Dr. Robert Califf, is sending a deputy to speak in his stead. 

Christmas weight gain knows no nationality

Candy canes. Pocky. Lebkuchen. Sweets have different names in the US, Japan, and Germany, but they cause similar effects: Holiday weight gain. In a letter published yesterday in the New England Journal of Medicine, researchers describe how they distributed wireless scales to nearly 3,000 people in those countries. They found that participants in all three countries got plumper during the 10 days after Christmas, compared to 10 days before. Participants shed half of their weight gain shortly after the holidays, but the other half lingered until summer months or beyond. 

What to read around the web today

  • Bariatric surgery: The solution to obesity? New Yorker
  • Should cops be required to provide medical aid to people they’ve shot? Washington Post
  • Breaking taboo, Swedish scientist is editing the genes of healthy embryos. NPR

More reads from STAT

Thanks for reading! More tomorrow,

Megan

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