Eventually we’ll need to worry

The first human has died from bird flu — a man in Mexico. What’s notable is that he died from the H5N2 strain, not the H5N1 variant that’s sickened at least three people in the US of A. It’s also the first documented human case of H5N2.

If you’re the worrying type, here are a couple of other tidbits to feed your unease:

1. The gentleman in question had significant underlying health issues, but he didn’t have contact with poultry or livestock.
2. “Twelve additional people the patient came into contact with — seven with symptoms and five without — were identified near the patient’s residence.” Those could be the first human-to-human transmission of bird flu.

Fear not, though! “The Ministry of Health informs that there is no risk of contagion for the population with the detection of the first human case of low pathogenic avian influenza A (H5N2) in Mexico, since there is no identified source of infection.”

Yep: Since they don’t know where it came from, there’s no risk!

Good news from two studies

Melanoma vax leads to long-term survival

Moderna and Merck’s cancer vaccine — combined with Keytruda — worked incredibly well against melanoma.

[A]fter two and a half years, melanoma patients that had received the cancer vaccine combination showed an overall survival rate of 96%, compared with 90.2% with Keytruda alone.

Multiple myeloma breakthrough

GSK’s multiple myeloma drug Blenrep “nearly halved the risk of disease progression or death compared to standard-of-care treatments” according to a phase-3 study.

In the trial of 302 patients with relapsed or difficult-to-treat multiple myeloma, 71% of those who received Blenrep in combination with the steroid dexamethasone and pomalidomide were alive without their disease worsening at the end of a year.

Even better, Blenrep is an outpatient drug that’s (relatively) easy to produce.

A spoonful of AF-353 helps the medicine go down

Some medication is so bitter — and some people are so sensitive to tastes — that a spoonful of sugar ain’t gonna help it go down. Adults can (usually) buck up and swallow, but try convincing a five-year-old how important it is to take his Augmentin.

To the rescue are the researchers at the Monell Chemical Senses Center in Philly. Despite living in Eagles territory, they actually have something useful to contribute to society: They’ve identified “the first temporary, universal taste blocker.”

“Remarkably, and unlike our experience with blockers of bitter taste receptors, the taste-nerve blocker we tested worked for every subject and every bitter compound we tested.”

That’s a breakthrough because the tongue has several kinds of bitter taste buds, and blocking one didn’t mean blocking the others; you would need a different “bitter blocker” for each yucky med.

The only downsides to their new compound, called AF-353, is that once you put it on the tongue it lasts 60-90 minutes and it also affects other tastes. That means you couldn’t give Junior some ice cream as a treat for taking his meds.

Four scary words

“Drug-resistant jock itch.”

Cases of highly contagious and tough-to-treat cases of ringworm are appearing across the country from two different strains of fungus.

One outbreak is caused by Trichophyton mentagrophytes type VII (TMVII), which, while it seems to respond to terbinafine, can take months to clear up.

The other comes from Trichophyton indotineae — and that is resistant to terbinafine. (Even 42 days of treatment didn’t help.) It’s a new mutation that has “several variations in the genetic code that prevent terbinafine from hooking onto fungal cells and poking holes in their protective membranes.”

The good(ish) news is that Trichophyton indotineae can be treated with itraconazole. The bad news is that itraconazole has a long list of side effects.

Oh, and compounding the issue is that both “may instead be confused for lesions caused by eczema and can therefore go without proper treatment for months,” and that’s coupled with the fact that folks don’t always want to talk about issues down there.

Inhaler prices drop (probably)

The price of asthma inhalers from AstraZeneca and Boehringer Ingelheim has dropped (at least it’s supposed to have dropped) to $35 per month out of pocket. GlaxoSmithKline said it’ll be following suit in January.

The price drops come as the government has turned its attention to the fact that inhalers cost Americans a heck of a lot more than they do people in other countries. (“AstraZeneca charges $645 in the U.S. for the same inhaler it charges $49 for in the U.K. Teva Pharmaceuticals […] charges $286 in the U.S. for an inhaler that costs $9 in Germany.”)

Manufacturers are afraid that they’ll be forced to lower prices, and this way they can do it on their terms and reap the PR value. How easy it’ll be for patients remains to be seen

A spokesperson for Boehringer Ingelheim said the $35 cap will be automatically applied at the pharmacy counter for the majority of eligible patients with commercial insurance. For those without insurance or whose pharmacies aren’t participating, they’ll be able to visit the company’s website starting Saturday, where they can enroll in a copay card that will reduce the out-of-pocket cost to $35.

As one immunologist put it, “I think what you’ll find is most doctors saying, ‘I’ll believe it when it happens’.”

Short Takes

Pharma pollution

We’re drugging a heck of a lot of animals and plants. And by “we” I mean pharmaceutical manufacturers.

Swedish and British researchers have found that “discharges to the environment during drug production, use, and disposal have resulted in ecosystems around the globe being polluted with mixtures of pharmaceuticals, posing a growing danger to wildlife and human health.”

Any day now

The next next candidate for male birth control comes from YourChoice Therapeutics, which just completed a phase-1 study on 16 men “showing that doses of their drug YCT-529 are safe for men.”

What’s interesting is that the drug might be able to be taken every two weeks, making compliance less of an issue.

The Long Read

“Pharmacies are in shambles.”

The gathering tsunami of pharmacy shutdowns highlights a worsening national crisis for the United States, where health care is the most expensive in the world. As U.S. health care companies continue getting bigger and more consolidated, while the number of primary care doctors shrinks, pharmacies could have filled in some of the gaps. Instead, they’re becoming dystopian nightmares—or vanishing entirely.