Fish vs autism

Omega-3 supplements have a lot of good science behind them for long-term cardiovascular health, and recommending them to patients is a good idea.

—BUT—

There seems to be one case where fish-oil supplements lose out to eating the fish themselves: for pregnant women. A new study funded by the National Institutes of Health found that…

Eating any amount of fish during pregnancy was associated with about a 20% lower likelihood of autism spectrum disorder diagnosis [in children].

1. The same wasn’t true for supplements.
2. The effect was greater in female children.
3. Mom doesn’t need much: “These results were consistent across all levels of fish consumption,” including less than once a week.

CVS to House committee: “Nuh uh.”

Last week we told you how House Oversight Committee Chair James Comer told PBMs he found out their CEOs lied to Congress when they testified that they didn’t treat their own pharmacies differently than they treated independents.

He offered them a mulligan — he demanded they correct their testimony or there would be … trouble.

Now CVS has responded, and it’s doubling down. It says the CEO told the truth, and that CVS Caremark doesn’t show CVS pharmacies any kind of favoritism. It said the FTC report that found otherwise was “lacking sufficient empirical data and analytical rigor” and that the people who wrote it were eating their neighbors’ dogs and cats^*.

Now the Oversight Committee is reading CVS’s response carefully before deciding what to do. Earlier Comer had threatened the CEOs with fines or even jail time. We shall see.

^* Kidding! Sheesh, take a joke!

Antidepressant doesn’t help breathing

Sometimes mirtazapine is prescribed off-label to help patients with breathlessness from various respiratory diseases. That’s a bad idea, at least according to British researchers, despite some early studies showing it could help.

They conducted a large-scale trial and found…

… that mirtazapine does not improve breathlessness in patients with respiratory disease compared with placebo. They also found that patients receiving mirtazapine had slightly more side effects and needed more care from hospitals and family members.

They also worry that those results could carry over to other antidepressants or benzos (although the trial focused on mirtazapine). But as there are no treatments for that breathlessness, the only effective option might be physical therapy.

Maybe they like the balloons

“Medical clowns shorten hospital stays for children with pneumonia” is the story. Whether they help the kids recover faster — or simply terrify them into getting out — isn’t clear.

Diabetes news

A new weekly insulin

Two new phase-3 trials have found that weekly shots of a new type of insulin— efsitora alfa — can control both type 1 and type 2 diabetes as well as daily or weekly injections of insulin degludec.

The only downside to efsitora is that there seemed to be more instances of hypoglycemia than with degludec, but that might be a matter of tweaking the dosage. As always, more research is needed.

The voice of diabetes

Using about 25 seconds of someone’s voice, AI can determine whether a patient has type 2 diabetes “with 66% accuracy in women and 71% accuracy in men.” And it’s almost as good as the American Diabetes Association’s questionnaire-based risk score. Coming soon, perhaps: A smartphone app to diagnose it at home.

Congrats to the ACA

For the first time, Obamacare enrollment is going to hit 50 million people according to the Treasury Department, with almost 21 million enrolling in 2024. (And 18.2 million of them have enrolled in an ACA plan for the first time.) That’s 1 out of every 7 Americans.

Elsewhere: Baltimore’s gamble pays off

The city of Baltimore wouldn’t sign on to Teva’s $4.25 billion national opioid settlement last year, instead opting to to negotiate on its own. It worked — now, instead of getting about $11 million over 13 years, the city will get $80 million over two years.

ICYMI: Bird flu news

A Missouri man has tested positive for H5N1 flu “despite having had no known contact with dairy cows or other animals associated with an ongoing outbreak.”