Thursday, April 19, 2018

Morning Rounds by Megan Thielking

Good morning, folks! Here's what you need to know about health and medicine this morning. 

An FDA panel is reviewing a marijuana-based drug

Today, an FDA advisory committee today is reviewing the drug Epidiolex, a potential treatment for two rare forms of pediatric epilepsy — and if it’s approved, it would be the first medication made from marijuana allowed on the U.S. market. Epidiolex is made of cannabidiol, or CBD, a component of cannabis which doesn’t make people high. The FDA hinted this week that it supports the approval of the drug, noting that it reduced seizures in young patients with two types of epilepsy in clinical trials. And analysts expect a positive review from the panel, though the recommendation isn’t binding. The FDA is expected to make a decision on the drug by the end of June.

NIH changes plan to partner with pharma on opioid research

For nearly a year, health officials have touted a planned partnership between the NIH and the pharma industry to research opioids. In theory, the two groups would've split the bill in hopes of finding new medicines to treat addiction or serve as alternatives to opioids. But late last week, the NIH announced it won't take any money from drug makers, citing recommendations that an NIH advisory panel made earlier this month. The panel suggested only using federal funds for the work and not taking any money from companies involved in lawsuits over the opioid crisis to minimize the risk of real or perceived conflicts of interest. 

STAT's Lev Facher has the details on the shift in thinking and what comes next — read here

Lab Chat: A biomedical tattoo aims to catch cancer early

The cells produce a dark pigment when they detect too much calcium. (a. tastanova et. al / science translational medicine)

Scientists have designed a biomedical tattoo that changes color when calcium in the blood is too high — a tool that could one day be used to monitor for the earliest signs of disease. Here’s what Martin Fussenegger of Swiss Federal Institute of Technology in Zurich told me about the work, published in Science Translational Medicine.

What did you design the tattoo to do?

We wanted to develop a tool to detect cancer or other diseases as early as possible. And some cancers increase the amount of calcium in the bloodstream before symptoms appear. So we’ve engineered cells that can detect increased calcium levels in the blood. We encapsulated them in a gelatin and injected them under the skin in mice. And if the calcium levels are high over longer periods of time, the cells produce melanin, a pigment in the skin.

This is just a proof-of-concept paper. If this worked in humans, how could it be used?

It would be best for people who have a genetic predisposition for certain cancers or for people who’ve been treated for cancer, to monitor if the cancer comes back. And you could link it to any type of biomarker. Potentially such a tattoo could be linked to something that is slowly developing, like a neurodegenerative disorder such as Parkinson’s.  


In the fight against cancer, progress is made one step at a time

Roy Baynes, Merck Research Laboratories, shares how Merck, through its focus on translating breakthrough science into oncology therapeutics, is leading the charge into the future of cancer care.

Decision expected today on troubled dengue vaccine

An expert panel that advises the WHO is slated to announce its decision today about when Sanofi Pasteur's troubled dengue vaccine should — and shouldn't — be used. Data on the vaccine, called Dengvaxia, show that while the vaccine protects people who've previously been infected with dengue, it actually increases the risk of severe disease for people who are vaccinated without ever having been infected.

For now, the WHO has said the vaccine only be used in people with a previous infection, but experts say that would be difficult to do in practice. Sanofi is working on a point-of-care test to detect previous dengue infection before vaccination, but it won't be ready for two to three years. If the expert panel follows the WHO's interim advice, that could mean limited use of the vaccine over the next few years. 

New clues about a mysterious appetite-suppressing hormone

Scientists have for decades known that leptin — a hormone that’s secreted by white fat cells  — works to keep a person’s appetite in check. But they’ve long been puzzled by how exactly leptin works in the brain. In a new study in Nature, scientists have found some clues. Tufts researchers wanted to see whether leptin was targeting a particular group of neurons, called AgRP neurons. So they used CRISPR to delete AgRP leptin receptors in mice. In turn, the mice became obese and developed diabetes, suggesting those neurons play a big role in mediating leptin’s effects. That could help other researchers turn up new treatments for diabetes, obesity, and other conditions that can be caused by leptin that isn’t regulated the right way.  

Lawmakers look at tackling opioid misuse in Medicaid

The Senate finance committee is meeting this morning to talk about how to address substance use disorders among people enrolled in Medicare, Medicaid, and other federal health programs. In 2016, Medicaid covered 40 percent of non-elderly adults who were addicted to opioids. State Medicaid programs cover a range of addiction treatments, and states can use special waivers to expand access to treatment for Medicaid beneficiaries. But as the opioid crisis worsens, health officials and lawmakers are trying to find new ways to leverage federal health programs to tackle the epidemic. 

What to read around the web today

  • Science hinted that cancer patients could take less of a $148,000-a-year drug. Its maker tripled the price of a pill. Washington Post
  • A ‘breakthrough in organ preservation’: Study shows keeping livers warm helps preserve them for transplant. STAT
  • Can triage nurses help prevent ER overload? NPR
  • Supreme Court weighs whether to review a whistleblower case against Gilead. STAT Plus

Thanks for reading! More tomorrow,


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