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The Readout Damian Garde & Meghana Keshavan

Can too much Covid-19 vaccine be a bad thing?

Is biotech in a bubble? And how do you make blind mice see again? 

We discuss all that and more on this week's episode of “The Readout LOUD,” STAT's biotech podcast. Georgetown virologist Angela Rasmussen joins us to break down AstraZeneca’s confusing Covid-19 vaccine data and what they might mean for the future of the pandemic. Then, longtime health care investor Adam Koppel calls in to offer some predictions for how 2021 will play out in biotech. Finally, we bring you a non-Covid lightning round, with the latest in hematology, a coup for AI in biology, and a breakthrough in aging research.

Listen here.

Why pharma needs to stop giving gifts to doctors

Drug and device makers gift more than $2 billion each year to more than half of the doctors in the U.S. — in the form of fancy dinners and travel, sometimes to luxury locales. Although physicians aren’t necessarily opposed to this influx of cash, the conflicts of interest are staggering — and according to a team of researchers at Memorial Sloan Kettering, it's time for a total ban on drug industry to payments. 

The researchers conducted a meta-analysis of 36 studies, all of which showed that receiving industry money increases prescribing. The findings are consistent across all specialties and all types of drugs — from Alzheimer’s to heart disease to cancer. And it harms patients, the MSK scientists opine for STAT. 

Read more.

The case against vaccinating the elderly 

A CDC advisory committee voted Tuesday in favor of prioritizing nursing home residents when it comes to Covid-19 vaccine administration. The panel had a lone dissenter: Helen Keipp Talbot, an infectious disease expert at Vanderbilt, who pointed out that the first vaccines expected to be rolled out haven't been tested for safety or efficacy in the frail elderly.

She’s been raising this alarm bell for weeks, warning at an earlier ACIP meeting that any severe adverse events among long-term care residents might ultimately undermine confidence in vaccines, STAT’s Helen Branswell writes

“I think you’re going to have a very striking backlash of, ‘My grandmother got the vaccine and she passed away,’” Talbot said. 

Read more.

Medicare spending on inhalers going up, up, up

Medicare’s spending on inhalers has skyrocketed 44% over a seven-year period — increasing by $2 billion, STAT’s Ed Silverman writes. Why? Because more people are using these devices to control their respiratory problems, but also because there’s a dearth of lower-cost generic options.

“To this day, there’s still limited generic competition and one big reason for that is manufacturers have extensive patents not only for drug substances or features of the drug product, but also on the devices,” said William Feldman, a Harvard pulmonologist who co-authored a study on the issue. “And each of these drug-device combinations has many, many patents.” 

Read more.

Quantifying the cytokine storm

One of the hallmarks of severe Covid-19 infections is the cytokine storm — a life-threatening inflammatory response that’s been triggered by CAR-T therapies, organ transplants gone awry, the Black Death, and the 1918 influenza pandemic. Carl June and David Fajgenbaum, two renowned researchers who have dedicated their careers to studying this toxic immune reaction, have penned a lengthy review article for the New England Journal of Medicine on the intricacies of the cytokine storm. 

There isn’t a unifying definition of the cytokine storm, June and Fajgenbaum point out, and it’s still challenging to parse apart what an appropriate immune response is versus a pathologic one. It can stem from pathogens, cancers, autoimmunity, and as a result of medical interventions. But the ongoing advances in “multi-omic” profiling of these conditions, along with new ways to modulate the immune system, will likely lead to improvements in treating the “cytokine storm umbrella,” they write.

More reads

  • Placebo-controlled trials of Covid-19 vaccines — why we still need them. (NEJM)
  • The 100 most influential people of 2020: Zhang Yongzhen. (Time)
  • Pfizer slashed its original Covid-19 vaccine rollout target after supply-chain obstacles. (Wall Street Journal)
  • A day in the life of Dr. Anthony Fauci. (HuffPost)

Thanks for reading! More next week,

Damian

Friday, December 4, 2020

STAT

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