Day: June 20, 2017

A drug that acts like a vaccine has been shown to lower “bad” cholesterol or LDL and reduce the amount of fatty plaque that can lead to heart attacks. The drug rallies the immune system against a molecule that contributes to atherosclerosis. 

The drug, called AT04A, is a form of immunotherapy that targets an enzyme, called PCSK9, that contributes to the formation of harmful plaque in coronary arteries.

In studies of mice fed fatty, Western-style diets putting them at risk for heart disease, researchers showed that AT04A reduced the total amount of cholesterol by 53 percent and shrank atherosclerotic plaques by 64 percent, according to Oliver Siegel, who is with the Austrian pharmaceutical company AFFiRiS. 

“More importantly in the mice, we have seen a very significant reduction in development of those plaques, said Siegel. “As a result, we believe the reduction of LDL which we have seen before would translate into a clinical benefit, i.e. reduction of plaque that would otherwise reduce inflammation that would otherwise be the cause of heart attack potentially.”

AT04A was able to rally the immune system to produce antibodies that blocked the PCSK9 enzyme in the circulation of mice during the study.

The study was published in European Heart Journal.

The immunotherapeutic approach, according to Siegel, is similar to, but not a vaccine per se in the sense that it doesn’t target bacteria and viruses, just the harmful enzyme.

In an accompanying editorial in the journal, Ulrich Laufs of Saarland University in Germany and Brian Ference of the University of Bristol noted that in people taking cholesterol-lowering drugs, including AT04A, there may be an increased risk of patients developing diabetes.

But Siegel said nothing like that has cropped up so far in studies of the compound. 

The authors of the editorial wrote in the short term, having a long-acting, cholesterol lowering drug may far outweigh the slight risk of new onset diabetes.

Currently, many people with high levels of cholesterol take daily medication that drives down “bad” LDL cholesterol; but, Siegel says compliance is less than ideal.

“What a few studies have shown is that patients, who…have already had a heart attack, have a relatively low adherence or compliance rate and we would imagine that patients who didn’t have a heart attack would have an even lower compliance rate,” said Siegel.

Fatty plaques that develop in the heart vessels can choke off the flow of blood, causing a heart attack. If a piece of plaque breaks off and travels to the brain, it can cause stroke.  Diseases of the coronary arteries are a leading cause of illness and death worldwide.

Siegel said the shot under the skin would have to be given once a year like an immunization.

Early human clinical trials testing the compounds safety are nearly completed, and Siegel hopes to have a cholesterol-lowering, clot-busting drug on the market in the next few years. 
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With droughts set to become more frequent due to global warming, delivering timely, long-term weather forecasts to farmers in the developing world will be key to limiting damage and saving lives, the head of the U.N. food agency said on Monday.

Droughts have killed more than 11 million people worldwide since 1900 and now affect double the land area than in 1970, according to the U.N. Food and Agriculture Organization (FAO).

Developing countries are the most exposed, with their agricultural sectors shouldering 80 percent of all damage caused by drought, FAO says.

Better access to reliable weather data and early warning systems could help farmers in rural areas get ready to endure long spells of no rain, said FAO director-general Jose Graziano da Silva.

“Most of the times poor rural communities in developing countries don’t even know that a drought is about to strike,” he told a conference at the FAO headquarters in Rome.

Measures such as planting resistant crops and building water reservoirs can greatly reduce the impact of droughts, but international responses too often focus on emergency relief, said Graziano da Silva.

“People die because they are not prepared to face the impacts of the drought – because their livelihoods are not resilient enough,” he said.

In Rome, FAO and the World Meteorological Organization (WMO) signed an accord to increase cooperation in the face of climate change, improving agro-meteorological services to help small farmers prepare for droughts.

WMO secretary general Petteri Taalas said weather forecast accuracy had greatly increased in recent years thanks developments in satellite, computing and scientific research.

“Weather forecasts are not anymore a joke, they are something you can very much rely on,” he told the conference.

Know-how related to long-term forecasts and prediction of major climate events like El Nino had to be shared between rich and poor countries, he added.

The last El Nino, a warming of ocean surface temperatures in the eastern and central Pacific that typically occurs every few years, subsided in 2016 and was linked to crop damage, fires and flash floods.
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Only 1 in 4 teens and young adults with opioid addiction receive recommended treatment medication despite having good health insurance, according to a study that suggests doctors are not keeping up with the needs of youth caught up in the worst addiction crisis in U.S. history.

“Young people may be dying because they are not getting the treatment they need,” said Brendan Saloner, an addiction researcher at Johns Hopkins Bloomberg School of Public Health who wrote an editorial published with the study Monday in JAMA Pediatrics.

Researchers looked at records for nearly 21,000 patients ages 13 to 25 from one large insurance carrier, UnitedHealthcare.

All were diagnosed with opioid addiction, but only 27 percent were given buprenorphine or naltrexone during 2001-2014, years when addiction was soaring.

“The take-home message for parents is: If you have a child struggling with opioid addiction, understand that there are medications that support and sustain recovery,” said study author Dr. Scott Hadland of Boston Medical Center.

Hadland was following a hunch when he began the study last year. In his practice, he was seeing more young people addicted to opioids. Many already had been through multiple treatment programs and they told him they’d never before been offered treatment medication.

Doctors must become more comfortable treating addiction with medications, Hadland said, noting that buprenorphine and naltrexone are recommended by the American Academy of Pediatrics.

Buprenorphine is given daily as a pill or film that dissolves under the tongue. It costs about $100 a month. Doctors need special training and a government waiver to prescribe it. A common version of buprenorphine is Suboxone.

Vivitrol is a brand-name version of naltrexone. It’s a shot given once a month and can be used only with patients who have completely detoxed from opioids. It costs about $1,000 per month.

The drugs work slightly differently, but both can ease cravings while patients work on addiction issues in counseling.

In the study, females, blacks and Hispanics were even less likely to receive the medications than males and whites. It’s unclear why, but unequal access to care or doctor bias could be to blame.

“The treatment gap is bad for everybody and even worse for certain subgroups,” Hadland said. “Even though all the youth in our sample had access to high-quality health insurance, they may not have had equal access to high-quality addiction care.”

Hadland and his colleagues plan to study access to treatment medications for youth from low-income families covered by government health insurance programs such as Medicaid.
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