NIAID

H5N1 bird flu virus has been found in a pig on a farm in Oregon, USDA reported yesterday. The pig did not display signs of illness. There were five pigs on the farm, all of which have been euthanized to allow for testing. A second pig may also have been infected, Oregon authorities later revealed. Two others have tested negative.

Why is this a big deal? As STAT’s Helen Branswell explains, pigs are sometimes called a “mixing vessel” for flu viruses because they can be infected with both bird flu and human flu viruses. If a pig is infected with both at the same time, the viruses can swap genes, potentially creating a hybrid virus that is better able to spread to and among people than regular bird flu viruses. This is called “reassortment.”

Oregon’s state veterinarian Ryan Scholz said this version of H5N1 was from wild birds — it’s not associated with the strain that has been spreading among U.S. dairy cows since the spring. Read more from Helen on what we know.

The latest news on GLP-1s

There were two important updates yesterday regarding the blockbuster weight loss drugs Ozempic (the diabetes version of semaglutide) and Wegovy (the weight loss version). Here’s what you need to know:

• On the regulatory side: All doses of Ozempic and Wegovy are listed as available on the FDA’s drug shortage list as of yesterday, STAT’s Elaine Chen reported. This raises the possibility that the medications could soon be taken off the list entirely, which could pose challenges to patients who rely on compounded versions of the drugs (which are only legally available because of the shortage). Read more.
• On the science: In a 68-week trial, Wegovy reduced arthritic knee pain for people with high BMIs. Participants who took the drug lost almost 14% of their body weight on average — changes that were accompanied by reductions in pain. Read more from STAT’s Isa Cueto on the research and what it could mean for patients.

gene editingWho to know in CRISPR gene editingCRISPR gene editing is advancing at a rapid clip. The science is really just a decade old, launched by pioneers like Jennifer Doudna, Emmanuelle Charpentier, and Feng Zhang. But beyond those names and associated companies, there’s a rich swath of CRISPR personalities. We’ve highlighted 10 of the biggest (less obvious) players in this space.For example, researchers like Alexis Komor, Patrick Hsu, and Charles Gersbach are expanding CRISPR’s potential with new maneuvers like base editing, RNA targeting, and epigenetic editing. Others, like Kiran Musunuru and Alexander Marson, are looking to apply gene-editing techniques to immunotherapy and cardiovascular treatment.Read more.chinaAstraZeneca top exec in China under investigationAstraZeneca’s top executive in China is under investigation by authorities there, the company said yesterday, making it the latest in a series of probes involving the company’s personnel.The nature of the investigation is not yet clear but the pharma giant is believed to already be under scrutiny because of allegedly illegal activities related to potential breaches of patient data privacy, and also the importation of a liver cancer drug that wasn’t approved for distribution in mainland China.This isn’t the first time that AstraZeneca, which is China’s largest foreign drugmaker, has faced scrutiny. In 2021, for instance, several AstraZeneca employees in China were accused of tampering with genetic test results and arrested.Read more.alzheimer’s diseaseSmall study shows TMS potential in Alzheimer’sTranscranial magnetic stimulation shows promise in slowing Alzheimer’s disease, data from a mid-stage trial show. Patients given TMS saw a 44% slower progression rate of disease, and 37% showed no progression in the year-long study compared to 17% in the placebo arm, STAT’s Jonathan Wosen writes.The study only included 32 patients at a single site. But the results are strong enough that Sinaptica, the developer of the treatment, is planning a larger, multicenter trial to validate findngs and also investigate biomarkers that might predict treatment respose.“It is very likely that, in the future, we could combine our therapy with [Alzheimer’s] drugs, especially given that they have supplementary modes of action,” Sinaptica CEO Ken Mariash said. Read more.Medical RecordsOracle reveals ‘AI’ electronic health record softwareOracle Health this week began previewing its “next-generation” electronic health record software “powered by AI” that it claims was “built from the ground up” and features “military grade security.” Given rates of adoption of new things in health care, I was somewhat skeptical we would learn what any of that means in the near future, but the company says an early adopter program for the EHR will begin some time in 2025.Oracle Health is the entity that arose from the tech giant’s acquisition of number two health record vendor Cerner several years ago. Like everyone in the space, it’s fighting a battle for market with the Epic Systems juggernaut, a company that has become so powerful that it’s facing allegations of antitrust violations. And while its hard to suss out substance from PR noise at this point, I think many in health care would agree with the spirit of Oracle’s effort to refresh health records technology. At this point, clinicians complaining about unwieldy, outmoded software they must use for hours each day is a tired joke. If Oracle’s alternative feels more like the slick software we use everywhere else in our lives, then maybe it can find some buyers.Related: Earlier this year, in the spring, my colleague Mohana Ravindranath talked to Oracle Health chairman David Feinberg.

What stem cells get up to after a transplant

Doctors have been performing stem cell transplants — also known as bone marrow transplants — for decades. But there are still a lot of unanswered questions about what goes on in a recipient’s body after transplant and how the transferred cells fare. 

In a new study in Nature, researchers sequenced the stem cells of transplant recipients, as well as those of their siblings who donated to them, to see how they differed. The 10 transplant recipients in the study had received the cells between nine to 31 years previously.

The study found that ten times more stem cells took hold in the transplant recipients if the donors were younger at the time of the transplant (18–47 years) rather than older (50–66 years). The researchers also found that the transplant recipients’ blood systems were aged about 10–15 years more than their matched donors’, mostly due to a lower diversity in their stem cells.

The better understanding of what factors make stem cells thrive in transplants will help improve the success of future transplants, the researchers said.

When doctors judge patients

Surveys indicate that most adults admit to hiding information about everything from their exercise habits to their medication regimens from their doctors. While it’s easy to say that people should just be more forthcoming, Samantha Kleinberg, Farber chair professor of computer science at Stevens Institute of Technology, says that her research shows that the onus lies with doctors, who do judge their patients negatively.

Kleinberg says doctors need to change their mindsets to focus on empathy and education, allowing patients to share more freely. Not only is open communication important for patients’ health, but it can also help uncover unexpected side effects of medicines, as was the case with the discovery that the drug combination fen-phen caused heart damage. 

Read more on Kleinberg’s findings in this STAT First Opinion.

A setback for the tau approach to Alzheimer’s

From STAT’s Andrew Joseph: In the effort to expand approaches to treating Alzheimer’s beyond targeting amyloid, some companies have sought to target another protein thought to play a role in the disease — tau. But the approach faced a bit of a setback this week.

The Belgian biopharma UCB company presented data yesterday showing that its tau-targeting antibody called bepranemab successfully slowed tau accumulation versus placebo in a Phase 2 clinical trial. But the study, which enrolled more than 450 participants, did not meet its primary endpoint of slowing Alzheimer’s progression, based on a commonly used metric known as Clinical Dementia Rating sum of boxes, CDR-SB.

UCB did some further slicing and dicing of its data, and found that patients who either had low levels of tau to begin with or who were not carriers of a particular genetic variant called APOE4 (or who fit both those groups) did see a slowing of disease progression on bepranemab. UCB’s Matthew Barton, who presented the data at the Clinical Trials on Alzheimer’s Disease conference in Madrid, said researchers were “encouraged” by the trial, and UCB said it is evaluating what steps to take next with bepranemab.

Expectations for the results were not particularly high. Last week, UCB said that Roche and its subsidiary Genentech, which had bought into bepranemab in 2020, had given back rights to the drug.