Blood thinners sans bleeding

One of the downsides to blood thinners is that they can cause internal bleeding. But now an unholy alliance of American and Canadian researchers say they’ve found a compound that splits the difference, preventing blood clots but not causing internal bleeding.

Their trick: “[T]argeting a specific molecule^* involved in clot formation without disrupting the natural clotting process.” Of course it’s still in the lab, but clinical trials could be on the horizon. As always, though, “further research will be needed.”

^* polyphosphate, if you’re interested

A better weapon against pancreatic cancer

One of the reasons pancreatic cancer is listed among the worst is that immunotherapy often doesn’t work for it. There’s some good news, though, out of the University of Colorado, where cancer specialists have developed a new type of antibody treatment — one that “was able to boost the number of immune cells capable of fighting cancerous ones.”

Combined with radiation, it worked well against not only the main tumor site, but also in locations where it has metastasized. Downside: It’s only been tested in animals.

Still, the lead researcher was happy:

“I’ve never been more hopeful about the possibility of improving the survival rate for this disease. In just one radiation session, we saw a remarkable immune response that could change how we treat pancreatic cancer patients.”

New pill beats the, um, other way

Fecal transfusions can be (and are) used to treat C. diff infections, but there’s a certain stigma and, dare we say, discomfort involved. There’s good news, though: Seres Therapeutics has received FDA approval for the first orally administered drug that accomplishes the same reboot of the gut biome. “[B]ased on bacterial spores purified from human stool […] The therapy will be marketed under the brand name Vowst.”

In a pivotal Phase III study, taking a course of a dozen capsules over three days helped 88% of patients clear infections and prevent recurrences at eight weeks, compared with 60% of patients who got a placebo.

It’s expected to be available by June.

Side note

A new review out of the University of Minnesota “found that stool transplantation is significantly more effective at resolving recurrent Clostridioides difficile infection than antibiotics.”

One of the reasons that [fecal microbiota transplantation] is increasingly seen as a preferred option for rCDI [recurrent C. diff infection] is because antibiotics […] can wipe out both the good and bad bacteria in the gut microbiome, creating an imbalance that enables C difficile to flourish and attack the colon. As a result, repeated antibiotic treatments for rCDI can lead to more recurrences.

Tau blocker for Alzheimer’s

Alzheimer’s work continues around the world, with breakthroughs taking different angles against the disease. The new one: British scientists have found a way to block the formation of tau proteins by silencing a gene that codes for it.

They’ve tested this on humans and it’s worked … to cut down on the protein formation. No other treatment targets tau, so this could be an important step, or just another small breakthrough. As with all things Alzheimer’s, there’s a lot of missing info. To quote: “Further trials will be needed in larger groups of patients to determine whether this leads to clinical benefit.”

Leqembi follies

FDA: This July, we’re probably going to give full approval to the Alzheimer’s drug Leqembi.

CMS: Okey doke. If you do, we’ll cover it.

Alzheimer’s patients: That sounds grea—

CMS: … as long as doctors put the patient information in a registry run by private corporations.

Congress and patients: Wait, what? What registries?

CMS: Privately owned registries.

Congress: But whose — who is setting them up?

CMS: “All that we are indicating is that individuals who are taking the drug, their doctors will put that information in a privately owned registry.”^*

Congress and patients: But … what? Where are these registries?

CMS: “Private sector entities right now can start setting them up.”^*

Congress and patients: (makes angry blubbering sound)

CMS: Our goal is for the registries to be running by July 6.

Congress: But you just said you’re leaving it to private industry. So how do you know? And how will doctors know what to do‽ How will patients‽

CMS: (hums quietly to itself)

^* Actual quote

Prostate cancer is getting worse … or is it?

“A Disturbing Rise in Prostate Cancer” is the headline, but the details are a bit murkier. It seems that yes, prostate cancer rates are rising, as are diagnoses of advanced forms. But the big takeaway seems to be that a lot of it is a result of changing (and confusing) guidelines for PSA testing. More testing, more cases. Less testing, fewer cases but more of them are later stage.

So what’s it all mean? We need clearer guidelines and better tests — and more determining who’s at higher risk.

Short Takes

Vampires in danger

Garlic can somehow affect the gut biome to reduce the risk of colorectal cancer. How it does that is still up in the air; the Italian researchers who did the study say only, “The study adds data on the protective effect of dietary garlic on [colorectal cancer] risk” and they believe it’s via the microbiome.

Don’t get bitten by a black widow

Black widow spider antivenom is one of the 20 critical drugs that have been in shortage, on and off, for at least 8 years. There’s only one manufacturer — Merck — and it’s had trouble meeting demand.

How to handle a rude patient

The three words to say when someone is rude to you: “Are you okay?” That from a “Harvard-trained etiquette expert.”

“I’m not being offensive back,” she says. “I’m coming from a place of care and that is usually to put the other person in check.”