Latest / Morning Medical with Dr. Chow / Gene-Edited Organ Transplants, Long COVID Therapy, and New FDA Food Labeling Standards

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Gene-Edited Organ Transplants, Long COVID Therapy, and New FDA Food Labeling Standards · Morning Medical with Dr. Chow

0:00
Hello and welcome to Morning Medical with Dr.
0:02
Chow, your daily dose of the latest medical and health news from around the world, powered by
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artificial intelligence.
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I'm Dr.
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Chi-Ming Chow, your host for today's episode.
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As a family physician, general internist, and cardiologist, I am thrilled to share today's
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groundbreaking stories from the medical field.
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Let's dive right in!
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Today, we're starting with an incredible breakthrough in organ transplantation.
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An Alabama woman, Towana Looney, has made history by receiving a gene-edited pig kidney
0:34
transplant at NYU Langone Health.
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This marks the seventh successful pig organ transplant performed by the surgeons at NYU
0:42
Langone, and it is a monumental step forward in the field of xenotransplantation.
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Towana Looney, 53, walked out of the hospital just days after the procedure, describing her
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experience as a 'second chance at life.' During a press conference at NYU Langone, Looney
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expressed her joy and gratitude, saying she felt 'overjoyed' and 'blessed' to have received
1:06
this life-saving gift.
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Her story is not just a medical success but a beacon of hope for others who are on dialysis
1:14
or waiting for organ transplants.
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Dr.
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Marc Siegel, a senior medical analyst and clinical professor of medicine at NYU Langone,
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highlighted the significance of this achievement on Fox News.
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He emphasized the severe shortage of available organs and how xenotransplantation can
1:34
potentially fill this gap.
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According to Dr.
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Siegel, even with more people donating organs, the demand far exceeds the supply, making
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alternatives like gene-edited pig organs a crucial development.
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Looney's journey is especially remarkable.
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She donated a kidney to her mother 25 years ago, only to later experience kidney failure
1:58
herself due to a rare complication during pregnancy.
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Her resilience and generosity have been praised by many, including Dr.
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Robert Montgomery, the Director of the NYU Langone Transplant Institute.
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He called Looney a hero, noting her significant sacrifice and her pioneering role in advancing
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transplantation medicine.
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Dr.
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Montgomery, who himself underwent a heart transplant after surviving multiple cardiac
2:27
arrests, understands the critical need for new sources of organs.
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He explained that less than 1% of people who die each year are eligible organ donors, which
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starkly contrasts with the increasing number of people who could benefit from transplants.
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This pioneering procedure used a pig kidney modified with ten genetic changes, which helped
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it function successfully in Looney's body.
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The key challenge now, as Dr.
2:54
Siegel pointed out, is immunology.
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Ensuring that recipients' immune systems do not reject these genetically modified organs is
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crucial for the future of such transplants.
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This development is a promising glimpse into the future, as xenotransplantation could
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eventually be applied to other organs like hearts and livers, potentially transforming the
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landscape of organ transplantation.
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Currently, about 100,000 people in the United States are waiting for organ transplants, with
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80,000 of them needing kidneys.
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The success of Looney's transplant brings hope that xenotransplantation might soon become a
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viable option for many patients.
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Dr.
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Montgomery noted that while lab-manufactured organs are still a distant goal,
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xenotransplantation is an immediate reality that could alleviate the organ shortage crisis.
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Today, we're diving into an encouraging development in the treatment of long COVID
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symptoms.
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A new study from Norway has shown that a brief outpatient intervention based on cognitive and
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behavioral therapy can significantly improve physical function in individuals suffering from
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long COVID.
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This intervention, which has been in practice for over a decade for patients with persistent
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physical symptoms, is proving to be effective for long COVID as well.
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The study, led by Dr.
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Tom Farmen Nerli from Vestfold Hospital Trust, involved 314 patients with mild to moderate
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long COVID.
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They were either assigned to a rehabilitation program or received usual care at a single
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referral center in Norway.
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The intervention consisted of two to eight outpatient visits, spaced approximately two to
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six weeks apart, with the goal of restoring physical function through cognitive and
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behavioral therapy.
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Patients in the intervention group reported better physical function compared to those
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receiving usual care.
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This was measured using the Short-Form Health Survey 36 Physical Function Subscale, where
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scores in the intervention group improved by 9.2 points on a 100-point scale.
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Importantly, these improvements were not just immediate; they were sustained over a 12-month
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period, suggesting lasting benefits from the therapy.
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Dr.
5:11
Nerli emphasized the importance of providing patients with an explanation for their
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symptoms, which helps them understand and relate to their condition.
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The therapy is grounded in the cognitive activation theory of stress, which posits that
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stress requires an adaptive response, heavily influenced by cognitive factors like
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subconscious expectancies.
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Trudie Chalder, a psychologist from King's College London, noted in an accompanying
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editorial that this study adds to a growing body of evidence supporting the use of
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cognitive behavioral therapy for improving symptoms of long COVID.
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She highlighted that cognitive behavioral therapy not only improves physical conditions
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but also has positive associations with immune parameters, outperforming some pharmacological
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treatments in terms of long-lasting effects.
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It's important to note that long COVID affects a significant portion of the population, with
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recent data from the Centers for Disease Control and Prevention suggesting that 6.4% of
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U.S.
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adults experience long COVID, and about one in five of these individuals report major
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limitations in their daily activities.
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While the study had some limitations, such as being conducted at a single center and lacking
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objective measures of physical and social function, the findings are promising.
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They suggest that a brief, targeted intervention can make a meaningful difference
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in the lives of those struggling with long COVID, offering hope and a path to improved
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health.
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Today, we're turning our attention to a significant development in healthcare policy
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from Alberta, Canada.
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The Alberta government has unveiled a new pay model aimed at rewarding family doctors for
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expanding their patient base and compensating them for essential work that often goes unseen.
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This initiative is set to roll out in the spring, provided that at least 500 doctors
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enroll by January.
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The new model is designed to provide financial incentives to physicians who maintain a
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full-time practice with a minimum of 500 patients and offer after-hours care.
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This is a strategic move to alleviate the pressures on emergency rooms and improve
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patient care continuity.
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Alberta Premier Danielle Smith emphasized the importance of this initiative, stating that it
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will significantly enhance Alberta's ability to recruit and retain primary care physicians.
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She acknowledged the challenges faced by the healthcare system, such as high administrative
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costs and burnout, which have historically made it difficult for the province to attract
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medical professionals.
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Premier Smith expressed confidence that this new compensation model would make Alberta an
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attractive and competitive place for doctors to establish their practices.
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"With this announcement, I think the risk of losing family physicians to more attractive
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jurisdictions is done," she said during a news conference.
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The initiative is seen as a way to stabilize and sustain family practices and clinics across
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the province.
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Dr.
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Shelley Duggan, president of the Alberta Medical Association, expressed optimism about
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the new model, highlighting its potential to restore Alberta as a preferred destination for
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physicians, residents, and medical students who are interested in practicing comprehensive
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care.
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She pointed out that the traditional fee-for-service system is increasingly unable
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to support the healthcare needs of Albertans, making this new model a necessary evolution.
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The financial commitment from the province is substantial, with $150 million allocated for
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2025 and approximately $250 million in subsequent years.
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This funding aims to make Alberta doctors some of the highest paid in Canada, not only
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encouraging them to handle a larger number of patients but also to provide after-hours care.
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Additionally, the plan includes incentives for adopting technology to streamline operations
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and for implementing team-based care.
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This approach allows patients to be supported by a multidisciplinary team, including nurses,
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dietitians, nurse practitioners, and pharmacists.
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Opposition NDP health critic Sarah Hoffman acknowledged the new compensation model as a
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positive first step, albeit "way overdue." She expressed hope that this agreement would stem
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the loss of healthcare workers who have been leaving the province or even the profession due
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to previous challenges.
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Paul Parks, past president of the Alberta Medical Association and an emergency room
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doctor, described the model as potentially "game-changing." He noted that it could lead to
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more continuous, long-term care and strengthen primary care, which is critical for improving
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the overall healthcare system, from emergency services to cancer care.
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However, Parks pointed out a potential hurdle: the requirement for doctors to have at least
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500 patients to qualify for the model might exclude new doctors and those nearing
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retirement.
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He suggested that targeted deadlines for doctors to build their patient panels could be
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a more inclusive approach.
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Despite these challenges, Parks remains optimistic about the model's potential to
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evolve and expand access to primary care for all Albertans.
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He emphasized the need for ongoing efforts to build effective healthcare teams and transform
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service delivery to ensure that every Albertan has access to primary care.
10:51
Today, we're focusing on a pivotal update from the United States Food and Drug Administration
10:56
regarding food labeling standards.
10:59
The FDA has finalized new criteria that foods must meet to be labeled as "healthy." This
11:04
marks the first significant overhaul of these standards in three decades, aligning them with
11:09
contemporary nutritional science to aid consumers in making informed food choices.
11:15
The updated guidelines introduce limits on saturated fat, sodium, and added sugars.
11:21
Additionally, foods must contain a certain amount of one or more key food groups, such as
11:26
fruits, vegetables, or low-fat dairy, as outlined in the current Dietary Guidelines for
11:32
Americans.
11:33
This means that while some foods like white bread and heavily sweetened cereal and yogurt
11:39
will no longer qualify for the "healthy" label, others like nuts, seeds, salmon, olive oil,
11:46
peanut butters, and certain canned fruits and vegetables will.
11:51
Dr.
11:52
Robert Califf, the FDA Commissioner, emphasized the importance of these changes, stating that
11:57
food should be a vehicle for wellness.
12:00
The aim is to improve public health by providing better access to nutrition
12:04
information, thus helping people establish healthier eating patterns.
12:08
According to Dr.
12:09
Califf, focusing on healthy eating is crucial for combating chronic diseases.
12:15
The FDA's Deputy Commissioner for Human Foods, Jim Jones, highlighted the role of food
12:20
labeling in addressing diet-related diseases, such as heart disease, cancer, and diabetes,
12:25
which are leading causes of disability and disease in the United States.
12:29
Jones pointed out that these conditions significantly contribute to the country's
12:33
comparatively low life expectancy among high-income nations.
12:38
He believes that food labeling can be a powerful tool for change.
12:43
While using the "healthy" label is voluntary for food manufacturers, those that meet the new
12:48
criteria can start labeling their products early next year.
12:52
Those that do not currently meet the standards have a three-year window to comply.
12:57
Jones expressed hope that this updated definition could encourage manufacturers to
13:02
reformulate products to meet these standards, potentially resulting in a healthier food
13:07
supply.
13:09
The FDA is also developing a new symbol for healthy foods, which will be displayed on
13:14
packaging to help consumers easily identify nutritious options.
13:19
This initiative is part of a broader national strategy on hunger, nutrition, and health
13:25
outlined by the Biden Administration in 2022.
13:30
Nancy Brown, CEO of the American Heart Association, supports the FDA's efforts, noting
13:36
that the updated definition should boost consumer confidence in the "healthy" claim seen
13:42
while grocery shopping.
13:44
She also stresses the importance of the FDA's work on front-of-pack nutrition labeling, which
13:48
would provide consumers with quick and valuable information about the nutritional value of
13:52
foods and beverages, helping them identify healthier options more easily.
13:59
In a recent report from the Centers for Medicare and Medicaid Services, it was revealed
14:03
that United States healthcare spending surged by 7.5% in the year 2023, reaching a staggering
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total of four point nine trillion dollars.
14:15
This is a notable increase from the previous year's growth rate of 4.6%.
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The rise in expenditure was primarily driven by non-price factors, according to the report.
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The Centers for Medicare and Medicaid Services highlighted several contributing elements to
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this trend.
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A significant factor was the increase in the volume and intensity of healthcare services
14:37
being utilized.
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As the population ages, there's a higher demand for healthcare services, contributing to this
14:44
uptick in spending.
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Another contributing factor was the expansion of coverage under various health insurance
14:51
plans, leading to more individuals accessing healthcare services.
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This expansion is partly due to policy changes that have made health insurance more accessible
15:00
to a broader segment of the population.
15:04
Prescription drug spending also played a crucial role in the overall increase in
15:08
healthcare costs.
15:09
The report noted a rise in the use of high-cost specialty drugs, which are often used to treat
15:15
complex, chronic conditions.
15:17
These medications, while life-saving for many, contribute significantly to the increasing
15:22
healthcare expenditure.
15:24
Hospital care remains the largest single component of healthcare spending, and its costs
15:29
continued to rise in 2023.
15:32
This is due to a combination of factors, including labor costs, technological
15:37
advancements, and increased patient volume.
15:40
As hospitals strive to provide high-quality care, these factors are pushing costs upward.
15:46
The report also pointed out that despite these rising costs, efforts are being made to improve
15:52
efficiency and reduce unnecessary spending.
15:55
Initiatives aimed at preventive care and better management of chronic diseases are being
16:01
prioritized to help curb long-term costs.
16:04
Programs that focus on wellness and preventive care are seen as pivotal in addressing the root
16:09
causes of many health issues, potentially reducing the need for more expensive treatments
16:15
down the line.
16:17
Looking ahead, the Centers for Medicare and Medicaid Services projects that healthcare
16:21
spending will continue to grow, driven by demographic changes, technological
16:25
advancements, and policy shifts.
16:28
However, there's a strong emphasis on finding sustainable solutions to manage this growth
16:33
without compromising the quality of care.
16:38
Today, we turn our focus to a significant decision by the United States Food and Drug
16:44
Administration concerning knockoff versions of Eli Lilly's obesity and diabetes drugs.
16:51
The FDA has announced that specialty pharmacies and online companies selling off-brand copies
16:57
of these blockbuster medications must phase out their versions by next year.
17:02
This decision comes after the FDA confirmed that the nationwide shortage of Eli Lilly’s
17:07
Zepbound and Mounjaro has been resolved, eliminating the need for these copycat drugs.
17:14
This move is a notable victory for Eli Lilly, which had been urging the FDA to take action
17:19
for several months.
17:20
The outcome is expected to affect patient access to these drugs, including their costs.
17:25
Zepbound is officially approved by the FDA to treat obesity, while Mounjaro is approved for
17:30
diabetes.
17:31
Both medications use the active ingredient tirzepatide, and they belong to the GLP-1 class
17:36
of drugs, which have shown remarkable results in weight loss by reducing appetite and
17:42
enhancing feelings of fullness.
17:45
Interestingly, even though the FDA has declared that Lilly’s supply now meets or exceeds the
17:50
current demand, other competing drugs like Wegovy and Ozempic from Novo Nordisk remain on
17:56
the FDA’s shortage list.
17:58
This highlights the continuing challenges in the supply chain for these types of
18:02
medications.
18:04
With the growing popularity of GLP-1 drugs, compounding pharmacies and telehealth companies
18:09
like Hims and Ro have entered the market, offering cheaper versions online.
18:14
Typically, consumers could obtain a month's supply for several hundred dollars.
18:19
However, the FDA's recent decision mandates that these businesses have between 60 and 90
18:24
days, depending on their size, to phase out their products.
18:29
The FDA allows compounded versions of brand-name drugs during shortages, and with the
18:34
shift back to Lilly’s medications, there is an expectation of improved safety for consumers.
18:41
The agency had previously warned patients about issues with the ingredients and formulations of
18:46
some GLP-1 drugs sold online.
18:49
It's important to note that the FDA has limited oversight of compounding pharmacies, which are
18:55
mainly regulated by state authorities.
18:59
Compounding pharmacies play a crucial role in creating customized versions of prescription
19:04
medications, especially for patients with allergies to certain ingredients.
19:08
However, over the past decade, the industry has expanded into a multibillion-dollar business,
19:15
driven by increasing drug shortages.
19:18
The demand for off-brand GLP-1 drugs has been further fueled by aggressive online promotions
19:25
from telehealth companies, which are not bound by the same marketing rules as traditional drug
19:30
manufacturers.
19:32
It's worth mentioning that the FDA had previously declared an end to the shortage of
19:37
Mounjaro and Zepbound in early October, but reversed its decision following public pushback
19:42
and a lawsuit from compounding pharmacies.
19:45
This underscores the complex dynamics between pharmaceutical companies, regulatory bodies,
19:51
and the compounding pharmacy industry.
19:55
Today, we're focusing on a pivotal update from the United States Food and Drug Administration
20:00
regarding food labeling standards.
20:02
The FDA has finalized new criteria that foods must meet to be labeled as "healthy." This
20:08
marks the first significant overhaul of these standards in three decades, aligning them with
20:13
contemporary nutritional science to aid consumers in making informed food choices.
20:20
The updated guidelines introduce limits on saturated fat, sodium, and added sugars.
20:26
Additionally, foods must contain a certain amount of one or more key food groups, such as
20:31
fruits, vegetables, or low-fat dairy, as outlined in the current Dietary Guidelines for
20:37
Americans.
20:38
This means that while some foods like white bread and heavily sweetened cereal and yogurt
20:42
will no longer qualify for the "healthy" label, others like nuts, seeds, salmon, olive oil,
20:49
peanut butters, and certain canned fruits and vegetables will.
20:54
Dr.
20:54
Robert Califf, the FDA Commissioner, emphasized the importance of these changes, stating that
20:59
food should be a vehicle for wellness.
21:02
The aim is to improve public health by providing better access to nutrition
21:06
information, thus helping people establish healthier eating patterns.
21:10
According to Dr.
21:10
Califf, focusing on healthy eating is crucial for combating chronic diseases.
21:16
The FDA's Deputy Commissioner for Human Foods, Jim Jones, highlighted the role of food
21:21
labeling in addressing diet-related diseases, such as heart disease, cancer, and diabetes,
21:27
which are leading causes of disability and disease in the United States.
21:32
Jones pointed out that these conditions significantly contribute to the country's
21:36
comparatively low life expectancy among high-income nations.
21:41
He believes that food labeling can be a powerful tool for change.
21:46
While using the "healthy" label is voluntary for food manufacturers, those that meet the new
21:51
criteria can start labeling their products early next year.
21:56
Those that do not currently meet the standards have a three-year window to comply.
22:01
Jones expressed hope that this updated definition could encourage manufacturers to
22:06
reformulate products to meet these standards, potentially resulting in a healthier food
22:12
supply.
22:14
The FDA is also developing a new symbol for healthy foods, which will be displayed on
22:19
packaging to help consumers easily identify nutritious options.
22:25
This initiative is part of a broader national strategy on hunger, nutrition, and health
22:32
outlined by the Biden Administration in 2022.
22:37
Nancy Brown, CEO of the American Heart Association, supports the FDA's efforts, noting
22:43
that the updated definition should boost consumer confidence in the "healthy" claim seen
22:49
while grocery shopping.
22:51
She also stresses the importance of the FDA's work on front-of-pack nutrition labeling, which
22:56
would provide consumers with quick and valuable information about the nutritional value of
23:01
foods and beverages, helping them identify healthier options more easily.
23:07
This concludes today's episode of Morning Medical with Dr.
23:11
Chow.
23:12
I hope you found our coverage on these pivotal health updates informative and engaging.
23:18
We'll continue to bring you the latest in medical and health news, so be sure to tune in
23:22
tomorrow.
23:23
Thank you for listening, and have a wonderful day!