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Wednesday, January 16, 2019

MannKind debuts Afrezza direct purchase program


MannKind (NASDAQ:MNKD) is up 5% after hours in response to its announced program allowing diabetics to purchase inhaled insulin Afrezza (insulin human) direct from the company for as little as $4 per day. Prescriptions will be filled and shipped to patients’ homes by Eagle Pharmacy.
Concurrently, it has launched an enhanced copay and savings card program enabling patients to fill their prescriptions at their local pharmacy for as little as $15.

Qiagen gets Japan approval for EGFR lung cancer test as companion diagnostic


Qiagen (QGEN) announced that the Japanese Pharmaceuticals and Medical Device Agency, PMDA, has approved the therascreen EGFR RGQ PCR Kit to allow its use as a companion diagnostic with Pfizer’s (PFE) VIZIMPRO, dacomitinib, for EGFR gene mutation-positive, inoperable or recurrent non-small cell lung cancer. The therascreen EGFR RGQ PCR Kit is registered in more than 40 countries globally. This marks the first companion diagnostic approval forQiagen in Japan. “As precision medicine becomes the standard of care in oncology, we are pleased to provide benefits to more lung cancer patients with our clinically proven therascreen EGFR RGQ PCR Kit. Our collaboration with Pfizer has made great strides already and will continue to improve personalized healthcare for patients around the world,” said Jonathan Arnold, Vice President, Head of Oncology and Precision Diagnostics for Qiagen . “In addition to detecting a comprehensive panel of EGFR mutations, the therascreen EGFR kit offers laboratories an efficient workflow on the Rotor-Gene Q MDx, the real-time PCR module in our widely-used QIAsymphony family of instruments.”

HTG Molecular gains on new software for EdgeSeq suite


HTG Molecular (NASDAQ:HTGM) is up 6.2% postmarket after announcing a new software product, HTG EdgeSeq Reveal.
It’s designed to streamline analysis of biomarket data from samples analyzed using the company’s EdgeSeq Precision Immuno-Oncology Panel.
The software enables applications including immunophenotyping of tumor infiltrating lymphocytes; monitoring of immunotherapy response biomarkers; and the elucidation of immune-escape mechanisms known to drive disease progression, the company says.

Inspire Medical announces positive coverage policy issued by Horizon BCBSNJ


Inspire Medical Systems announced that Horizon Blue Cross Blue Shield of New Jersey has issued a positive coverage policy of Inspire therapy. This is the second coverage policy issued by a Blue Cross Blue Shield Association healthcare plan following BCBSA Evidence Street’s January 7 report, which stated that there is sufficient evidence to determine that Inspire therapy results in a meaningful improvement in net health outcomes for patients meeting specified criteria. Horizon BCBSNJ, an independent licensee of BCBSA, is the state of New Jersey’s largest insurer and covers approximately 3.8 million members. The Horizon BCBSNJ policy became effective January 15. This Horizon BCBSNJ also includes coverage for adolescents who have Down’s syndrome. It is important to note that this indication is not yet approved by the Food and Drug Administration.

Experimental treatment approach shows potential against Staphylococcus aureus


A new class of engineered proteins may counter infection caused by Staphylococcus aureus — a bacterial species considered one of the largest global health threats, a new study suggests.
Published online Jan. 16 in Science Translational Medicine, the study is the result of a five-year research partnership between scientists at NYU School of Medicine and Janssen Research & Development, LLC (Janssen).
“To our knowledge, this is the first report showing that proteins called centyrins can potently block the effects of severe S. aureusbacterial infections in mice, and in human cell experiments,” says lead study author Victor Torres, PhD, associate professor in the Department of Microbiology at NYU Langone Health.
The preclinical study found that a select group of centyrins interfered with the action of five toxins that S. aureus depends on for escaping the human immune system and invading tissues. By taking away the bacteria’s ability to thrive without destroying it, the new approach could help to address antibiotic resistance, the problem where treatments destroy some bacterial strains, only to make more space for others less vulnerable to available antibiotics over time.
Nearly one-third of the human population are carriers of S. aureus, generally without symptoms. But for those with weakened immune systems, S. aureus infection may result in life-threatening lung, heart, bone, or bloodstream infections, says Torres. S. aureus has long posed a threat in hospitals. Strains that have become resistant to many antibiotics (including methicillin) are called methicillin-resistant S. aureus (MRSA), which leads to 11,000 deaths in the United States each year.
“MRSA remains a major threat because generations of treatment and vaccine attempts have failed to control it,” says Torres. “Our study responds to an urgent need for new thinking in anti-staphylococcal therapeutics.”
Road to a New Treatment Class
Researchers (including current NYU Langone faculty member Shohei Koide, PhD) discovered a class of proteins derived from fibronectin type III (FN3) protein subunits (domains) in 1998, which were originally called monobodies and explored for their anti-cancer potential. Centyrins, FN3 “scaffolds” optimized for pharmaceutical development, were subsequently used by Janssen for the discovery of anti-toxin versions.
Torres and others in the field spent years learning that S. aureusthrives by releasing toxins, one of which, leukocidin AB, was identified by his lab. Such toxins bore holes in immune cells, destroying them before they can destroy the bacteria. They also bore into red blood cells, which flood bacteria with nutrients when they die and burst.
Building on this work, the current study authors used a molecular biology technique to make changes in a single parental centyrin, creating a trillion slightly different centyrins — and nearly all at once thanks to automation. Out of this vast “library,” careful screening revealed 209 centyrins that happened to bind to pieces of one of the five major S. aureus leukotoxins. Those that bound the tightest were shown by the current research team, in experiments using human cells, to prevent the toxins from attaching to and destroying the cells they would otherwise bore into.
The research team then gave mice a toxic dose of LukED S. aureus toxin. Those also given ahead of time a dose of the parental scaffold centyrin (not designed to bind to this toxin) died. However, those given the centyrin called SM1S26 — chosen for its ability to interfere with the LukED S. aureus toxin — lived. Even in experiments in which mice received the anti-toxin centyrin four hours after they were infected with live S. aureus (a scenario more closely resembling clinical reality), 50 percent of the infected animals survived compared to none in the control group of infected mice.
Moving forward, the collaborative research team is also developing biologics that combine centyrins with anti-staphylococcal monoclonal antibodies (mABs) in a new class of proteins called MABtyrins, which could be more effective at neutralizing S. aureus.
“One of the most exciting aspects of this work is that scientists may be able to pick their pathogen, and then easily generate a vast, cost-effective library of centyrins shaped to interfere with the disease process at hand,” says Torres. “It’s bigger than one experimental treatment.”
Along with Torres, the study was led by co-corresponding author, Anthony Simon Lynch, PhD, Senior Scientific Director at Janssen Research & Development, LLC. First authors of the paper were Rita Chan, Aidan O’Malley, and William Sause, PhD, of the Department of Microbiology at NYU School of Medicine, and Peter Buckley, PhD, of Janssen. Study authors were Francis Alonzo 3rd, PhD, and Kristina Boguslawski at NYU; and Angela Payne, Jeffrey Fernandez, William Strohl, PhD, and Brian Whitaker of Janssen.
This work was solely supported by Janssen Research & Development, LLC of Spring House, PA. NYU and Torres have a research and licensing agreement with Janssen, which is responsible for the development of potential therapeutics stemming from the joint research effort. The specific terms of this arrangement are being managed in accordance with the policies of NYU Langone. Work in the Torres lab is also funded by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health (NIH-NIAID). Torres is also a Burroughs Wellcome Fund Investigator in the Pathogenesis of Infectious Diseases.
Story Source:
Materials provided by NYU Langone Health / NYU School of MedicineNote: Content may be edited for style and length.

Journal Reference:
  1. Rita Chan, Peter T. Buckley, Aidan O’Malley, William E. Sause, Francis Alonzo III, Ashira Lubkin, Kristina M. Boguslawski, Angela Payne, Jeffrey Fernandez, William R. Strohl, Brian Whitaker, Anthony Simon Lynch, Victor J. Torres. Identification of biologic agents to neutralize the bicomponent leukocidins of Staphylococcus aureusScience Translational Medicine, Jan. 16, 2019; DOI: 10.1126/scitranslmed.aat0882

Acupressure relieves long-term symptoms of breast cancer treatment


A new study finds acupressure could be a low-cost, at-home solution to a suite of persistent side effects that linger after breast cancer treatment ends.
Researchers from the University of Michigan Rogel Cancer Center reported in 2016 that acupressure helped reduce fatigue in breast cancer survivors.
In the new study, they looked at the impact of acupressure on symptoms that frequently accompany fatigue in this population: chronic pain, anxiety, depression and poor sleep. They found acupressure improved all of these symptoms compared with standard care.
In the study, breast cancer survivors who reported fatigue were randomized to one of two types of acupressure or to usual care, which included typical sleep-management techniques. The women were taught how to find and stimulate the acupressure points so that they could perform it at home once per day for six weeks.
Of the 424 survivors experiencing fatigue from the original study, researchers found half had at least one other symptom and 17 percent experienced all of them.
“It was actually unusual for a woman to have just fatigue. These long-term side effects are a big problem. For some women, they are significant barriers in their life,” says study author Suzanna M. Zick, N.D., MPH, research associate professor of family medicine at Michigan Medicine.
The new analysis focused on the 288 patients who reported symptoms in addition to fatigue. They were asked weekly about fatigue, sleep quality, depressive symptoms, anxiety and pain. Results are published in JNCI Cancer Spectrum.
Acupressure is derived from traditional Chinese medicine. It involves applying pressure with fingers, thumbs or a device to specific points on the body. Researchers tested two types of acupressure: relaxing acupressure, which is traditionally used to treat insomnia, and stimulating acupressure, which is used to increase energy. The two techniques differ by which points on the body are stimulated.
After six weeks, relaxing acupressure was significantly better than stimulating acupressure or standard care at improving depressive symptoms and sleep. Both types of acupressure were more effective than standard care for improving anxiety, severity of pain and pain interfering with daily life.
“If you have a person who is fatigued and depressed, it would be the obvious conclusion to use relaxing acupressure. For anxiety or pain, either approach might work,” Zick says.
The researchers also assessed whether improving one symptom helped improve other symptoms. They found that improving symptoms of depression improved sleep quality, accounting for about 20 percent of the improvement in fatigue.
“That means we don’t know 80 percent of what’s impacting fatigue. Depressive symptoms and sleep quality are a small part, and it makes sense. But clearly, there are other factors,” Zick says.
She suspects these symptoms impact several different mechanistic pathways, possibly impacting the brain in multiple ways. This means treatments will likely need to be tailored and varied based on a woman’s symptoms and other factors.
The researchers plan to gather more information using neuroimaging to understand the brain pathways involved. They’re also currently conducting two clinical trials to look at using an acupressure app. Working with U-M College of Engineering experts, they developed a special wand to assist patients in performing acupressure. The wand helps ensure appropriate pressure and tracks how long patients use it.
Acupressure is an appealing option because it can be done at home with minimal negative effects. The study showed that women could learn to apply correct pressure to the appropriate points. Some women reported minor bruising at the acupressure sites.
Additional authors: Ananda Sen, Afton L. Hassett, Andrew Schrepf, Gwen Karilyn Wyatt, Susan Lynn Murphy, John Todd Arnedt, Richard Edmund Harris
Funding: National Institutes of Health grants R01 CA151445 and 2UL1 TR000433-06
Story Source:
Materials provided by Michigan Medicine – University of Michigan. Original written by Nicole Fawcett. Note: Content may be edited for style and length.

Journal Reference:
  1. Suzanna Maria Zick, Ananda Sen, Afton Luevano Hassett, Andrew Schrepf, Gwen Karilyn Wyatt, Susan Lynn Murphy, John Todd Arnedt, Richard Edmund Harris. Impact of Self-Acupressure on Co-Occurring Symptoms in Cancer SurvivorsJNCI Cancer Spectrum, 2018; 2 (4) DOI: 10.1093/jncics/pky064

Building neck strength found to reduce concussion risk


Rutgers researchers have proposed a way to mitigate risk for football and soccer players and others at risk of concussion: Protect your head with neck-strengthening exercises in the pre-season.
A paper by researchers at the Rutgers School of Health Professions, published in the Journal of Orthopaedic and Sports Physical Therapy, examines previous studies on the role that the neck’s strength, size and posture play in reducing concussion risk. They also looked into the greater risk of head injury to female and young male athletes who play contact or impact sports, such as when heading a soccer ball.
Based on their findings and the clinical judgment of the research team, the Rutgers researchers developed recommendations that physical therapists and athletic trainers can use to protect athletes.
These include performing a thorough cervical spine assessment as part of the pre-athletic participation exam; screening for pain because baseline reports of neck pain have been associated with increased concussion risk in young athletes; and providing interventions such as exercises to strengthen neck muscles.
“Our ability to detect sports-related concussions has greatly improved, but our ability to prevent concussions and decrease post-injury outcomes remains limited,” said lead author Allison Brown, an assistant professor at the Rutgers School of Health Professions. “We have identified neck strength, size and posture as potential factors that reduce risk by lessening the magnitude of force upon impact. Thus, increasing neck strength and possibly size could substantially reduce risk or severity of injury or outcomes.”
Concussions, which are caused by an impact that makes the brain move within the skull, can lead to problems with thinking, concentration, mood or other neurological changes. Additional symptoms can include dizziness and nausea.
“A neck that is stronger, thicker or aligned in a forward posture — with the ears ahead of rather than aligned with the shoulders — may reduce the amount of energy transferred to the brain during an impact, thus reducing the risk and severity of injury,” said Carrie Esopenko, an assistant professor at the School of Health Professions and the report’s senior author.
Women typically have less neck strength and experience a greater risk of concussion as well as greater severity of symptoms and longer duration of recovery compared with their male peers, according to Esopenko.
Story Source:
Materials provided by Rutgers UniversityNote: Content may be edited for style and length.

Journal Reference:
  1. Michael Streifer, Allison M. Brown, Tara Porfido, Ellen Zambo Anderson, Jennifer Buckman, Carrie Esopenko. The Potential Role of the Cervical Spine in Sports-Related Concussion: Clinical Perspectives and Considerations for Risk ReductionJournal of Orthopaedic & Sports Physical Therapy, 2019; 1 DOI: 10.2519/jospt.2019.8582