Fighting infection with bacteria

Instead of attacking an infection with boring ol’ chemicals, why not train a different bacteria to be your army? That’s what researchers in Spain did, creating a “living medicine” from a genetically modified version of the Mycoplasma pneumoniae bacteria. (Yes, the one that causes a form of pneumonia.)

To treat a Pseudomonas aeruginosa lung infection, they used a combo of low-dose antibiotics and the pneumonia bacteria. The bacteria attack the P. aeruginosa, the antibiotics clean up any stragglers, and the body clears out the soldiers when they’re done.

Clinical trials are next.

FDA keeps Lilly in the slow lane

Looks like the FDA is slowing down on accelerated approvals for Alzheimer’s meds. It denied the approval for Eli Lilly’s donanemab, the latest anti-amyloid drug to attempt to enter the market.

It’s not clear whether that’s because previous drugs were only partially effective despite gushing headlines (looking at you, lecanemab), the fact that drugmakers were pricing those drugs sky-high (looking at you, Aduhelm), or because Lilly’s phase-2 results were only so-so.

The company expects to seek normal approval later this year when its phase 3 study is done.

Stroke treatment through the nose

If you have a rat that’s had a stroke, getting drugs to its brain isn’t easy thanks to the ol’ blood-brain barrier. But now — working with the idea that smell-detecting cells might have an easier path to the brain — Swiss scientists are testing a stroke treatment delivered by nasal spray.

The drug is actually antibodies that (in theory) would get to the brain and block a compound called Nogo-A, which inhibits the growth of brain cells. Turns out the theory is right.

[They] found that the treated rats had sprouted more new nerve fibres. “It shows there’s a natural regenerative power within the brain and you just have to take the brakes off to let it happen.”

RSV vax could be coming soon

Moderna’s RSV vaccine just passed its phase 3 trial with flying colors, demonstrating an efficacy of 83.7% for people 60 and older. The trial included 37,000 people from 22 countries, so it would seem to have ticked all the boxes.

The vaccine was also found to be safe and well tolerated, with a few mild or moderate adverse reactions reported. The most common side effects were injection site pain, fatigue, headache, myalgia and arthralgia.

It’s not the crime, it’s the coverup

Pro tip: If you’re going to try to deceive FDA inspectors, don’t leave piles of shredded documents around — certainly not “inside a ‘large black plastic bag that was hid under the staircase’” — or douse them with acid. Eagle-eyed inspectors are likely to notice.

The Indian plant in question received an FDA forms 483, but “the regulatory wrist slap could escalate to a Warning Letter.” Ooh, scary.

Easier continuous monitoring

If you want to monitor someone’s health continuously, there’s not that much you can use. Sweat is easy, but doesn’t provide a lot of info. Blood gives more data, but that would mean wearing a needle in a vein all day.

What about something in between?

That’s what University of Cincinnati bioengineers think as they look to create a way to monitor interstitial fluid — the liquid surrounding cells — which could (soon?) be done using microneedle patches.

Those patches only need to pierce the skin by less than a millimeter to sample that interstitial fluid, and “contains many of the same chemicals in the same proportions as blood, offering a potential alternative to costly and time-consuming lab work.”

At the moment it’s just an idea, but the technology is available to start a proof of concept.

I mean, it makes sense

In places where you can get marijuana over the counter, there’s less use of prescription codeine.

What’s different about this study is that it used data from the DEA that tracks shipments of controlled substances (e.g., codeine). Thus it found, among other things…

A 26% reduction in pharmacy-based distribution of codeine and as much as a 37% reduction after recreational cannabis laws have been in effect for four years.

Cannabis comes with its own set of issues, of course, but they’re a lot milder than, say, opioid addiction.

It’s safe to give out safety drugs

One of the arguments against making buprenorphine easier to get is that having a treatment for opioid abuse would make opioid abuse more common. Not surprisingly, that’s just not true.

An NIH/CDC study confirmed for buprenorphine what was already known about methadone. Despite the hand-wringing…

The proportion of opioid overdose deaths involving buprenorphine, a medication used to treat opioid use disorder, did not increase in the months after prescribing flexibilities were put in place during the Covid-19 pandemic.

Now that we know this, it should open the door to more buprenorphine availability — unless, of course, people ignore the data.