Capitalism in play

Last month HHS made its first offer for what Medicare would pay for 10 expensive drugs. The drugmakers have now spit on the ground, implied that the offers insult the memories of their dear grandmothers, and made counteroffers that are still cuttin’ their own throats … but acceptable (barely) because HHS is a dear friend of uncle Horace.

HHS will now roll its eyes, point out that it could do better in the back alley of a Detroit street market, and respond with a counter-counteroffer that’s still way better than those nogoodniks deserve.

And so it will go.

How GLP-1 drugs really work

Old assumption: GLP-1 drugs slow down the workings of the digestive system, which is what makes people feel full — they are full.

New reality: That’s true of natural GLP-1, but the artificial stuff lasts a lot longer in the body; that’s why it’s a weekly injection and not a daily one.

By indiscriminately flooding the body with long-lasting molecules, the injections likely allow engineered GLP-1 drugs to penetrate parts of the body that the natural gut hormone cannot—namely, deep in the brain.

The brain also has GLP-1 receptors that respond to the drugs. That’s why mouse studies have shown that Ozempic and kin suppress more than the desire to eat (e.g., the desire for alcohol), something that’s echoed in anecdotes from patients who say they’ve quit addictive behaviors. As the headline says, “Ozempic Is a Brain Drug.”

Speaking of Ozempic …

Novo Nordisk says it might also slow the progression of chronic kidney disease. Those shifty Danes report that a phase 3 trial found Ozempic “[cut] the risk of death from that and major cardiac events by 24%.”

First OTC CGM

The FDA has approved the first over-the-counter continuous glucose monitor — the Dexcom Stelo Glucose Biosensor System. It uses a wearable sensor (replaced every two weeks) and a smartphone app and, well, continuously monitors their glucose levels. The company says it’ll be available this summer, but hasn’t disclosed the price.

The caveat: It’s not for people taking insulin. It’s only approved for people who have diabetes but are managing it via lifestyle changes, e.g., losing weight, exercising more, skipping the Oreos, etc.

Free Covid tests end March 9

March 8 is the last day people can ask for them — at least until the feds start the program again in the fall.

Double trouble for fatty liver

A new drug fights fatty liver disease with “a one-two punch that shuts down triglyceride production and fatty acid synthesis.”

Punch #1: The drug inhibits an enzyme called DGAT2^* that the liver needs to make triglycerides.

Punch #2: It also decreases the amount of a protein called SREBP-1^†, that regulates the expression of genes required for the liver to make fatty acids and triglycerides.

The combined effect of stemming DGAT2’s role in triglyceride synthesis and blocking SREBP-1’s role in activating genes involved in fatty acid and triglyceride synthesis stops fat from depositing in the liver, reversing MASLD [metabolic dysfunction-associated steatotic liver disease, aka nonalcoholic fatty liver disease].

The University of Texas Southwestern Medical Center folks who developed the drug are already looking at phase 3 trials “in the near future.”

^* diacylglycerol acyltransferase 2, since you asked
^† sterol regulatory element binding protein 1, of course 

Quad flu vax will probably be retired

The US will probably be switching from quadrivalent flu vaccines to trivalent ones, as it’s been four years since we’ve seen the influenza B/Yamagata virus — one of the four ‘quads.’

Not seeing that strain means there’s no point including it in the vaccine, and removing it “gives us the space to replace B/Yamagata virus with a component that will give improved protection against the circulating influenza viruses.”

Not the most well-thought-out headline, if you think about  it

“Firearm ownership is correlated with elevated lead levels in children, study finds”