Ping An Good Doctor Launches Overseas Medical Service with Thai Med Group

On 16 December, the world’s leading healthcare ecosystem platform, Ping An Healthcare and Technology Company Limited (“Ping An Good Doctor”; stock code:01833.HK) announced that the Company and Thailand’s largest healthcare group Bangkok Dusit Medical Services (“BDMS”) jointly launched the overseas video consultation service for second opinions. The service will allow the users of Ping An Good Doctor to seek second medical opinions via video consultations with top physicians in Thailand, enabling Chinese patients to have “face-to-face” consultation with top-notch doctors from around the world in the comfort of their home and offering them access to more diverse and comprehensive treatment.

At present, Chinese users can purchase the service from the “Overseas Top-Tier Doctors” on Ping An Good Doctor’s mobile application. After purchase, they can make appointments with the doctors from BDMS and obtain more professional advice from medical experts through the video consultation function. Doctors will fully study the patients’ medical history before consultations and provide written opinions of targeted treatment according to their medical history.

Thailand’s medical services are known for their meticulousness, comprehensiveness and reasonable pricing and, in some aspects, is comparable with other developed countries such as the United States and Japan. In particular, the large medical groups in Thailand, represented by BDMS, have achieved remarkable medical advancement in cancer treatment and cardiovascular diseases. The launch of this overseas medical service is the best example to showcase how Ping An Good Doctor’s 100-million-level user resources are integrated with BDMS’s hospital network in Thailand and its globally-leading professional service capability. Leveraging the platform established by Ping An Good Doctor and BDMS, Chinese patients now have new choices for medical treatment from overseas countries. In addition, both parties will also launch overseas body examination service specially designed for Chinese users in the near term, after which Chinese users can make appointments for health check-ups through Ping An Good Doctor’s mobile application.

BDMS, founded in 1969, is the largest medical group in Thailand and one of the largest private medical groups in the Asia-Pacific region, owing the most prestigious hospital network in the Asia-Pacific region and managing 48 hospitals in major cities and tourist spots across Thailand and Cambodia. These hospitals not only cover local residents but also serve patients from the United States, Europe, China, Japan, Korea and United Arab Emirates. BBMS’ hospital team comprises over 12000 experienced doctors and over 8000 nurses, including experts specialising in various key aspects such as cancer, cardiovascular diseases and brain disorders. Besides, BDMS also has a medical service centre for Chinese patients and has established for Chinese patients a professional medical team with proficiency in Chinese, including medical experts, nurses, receptionists and Chinese interpreters, in order to gain a full understanding of their needs.

As the world’s leading healthcare ecosystem platform, Ping An Good Doctor cooperates with offline pharmacies and hospitals to provide users with 24/7 one-stop services covering online consultation, referral, registration, outpatient arrangement, second opinion and one-hour drug delivery by leveraging the innovative “Internet + AI + 1,000 in-house physicians” service model, winning the trust and recognition from users with its commitment to holistically meeting their personalised healthcare needs.

While deepening its domestic presence, Ping An Good Doctor is also expanding its footprints into the overseas markets by capitalising on its solid technological capability and mature Internet healthcare operation experience. At present, Ping An Good Doctor’s medical service network has covered nearly 10 countries and regions such as the United States, Korea, Switzerland and Singapore, and established cooperation with hundreds of well-known hospitals, helping users gain access to more convenient and precise medical services offered around the globe. Through the cooperation with international medical partners such as BDMS, Ping An Good Doctor will continue to improve its international service network and work with more partners to build a global healthcare ecosystem.

https://www.biospace.com/article/releases/ping-an-good-doctor-launches-overseas-medical-service-with-thailand-s-bdms-enabling-and-quot-face-to-face-and-quot-consultation-with-top-tier-doctors-for-users-in-the-comfort-of-their-home/

Novartis Discontinues Asthma Drug Development

Novartis AG (NOVN.EB) said Monday that it will cease development of its investigational asthma drug fevipiprant following disappointing clinical data.

A pooled analysis of the Phase 3 Luster-1 and Luster-2 studies showed that the therapy didn’t meet the clinical threshold in the reduction of moderate-to-severe asthma exacerbations when compared with placebo, the company said. The drug was, however, found safe, the Swiss drug maker said.

An analysis of safety and efficacy data from the two studies will be conducted, and details will be published at an upcoming medical conference, Novartis said.

https://www.marketscreener.com/NOVARTIS-9364983/news/Novartis-Discontinues-Asthma-Drug-Development-29731258/

Three-Meal Diet Improves Type 2 Diabetes

Eating a carbohydrate-rich breakfast followed by a substantial lunch and a small dinner — the so-called “three-meal diet” (3Mdiet) — promotes weight loss and significantly improves glucose control in type 2 diabetes, a randomized, controlled trial suggests.

In fact, the 3Mdiet improved glycemic control so significantly that patients could reduce their total daily insulin dose, along with the need for additional antidiabetic medications, relative to baseline, the same small study indicates.

“The traditional diabetic diet specifies six small meals spread throughout the day, but this ‘6Mdiet’ as it is called has not been effective for glycemic control,” lead author Daniela Jakubowicz, MD, professor of medicine, Tel Aviv University, Israel, explains in a statement from American Friends of Tel Aviv University.

“Our research proposes shifting the starch-rich calories to the early hours of the day [to] produce a glucose balance, and we believe that through this regimen it will be possible for diabetics to significantly reduce or even stop injections of insulin and most anti-diabetic medications to achieve excellent control of glucose levels,” she added.

In the study, published in the December issue of Diabetes Care, the researchers hypothesize that the 3Mdiet is more in-sync with the natural biological clock — metabolism is optimized for eating in the morning and for fasting during the evening and night, when people are supposed to be asleep.

Both Diets Had Same Macronutrients and Calories

The trial involved 28 volunteers with type 2 diabetes of 5 years’ duration or longer treated with insulin for at least 1 year prior to study entry, at a total daily insulin dose in excess of 25 units. The average body mass index (BMI) was 32.4 kg/m² and average baseline A1c was 8.1%.

“Subjects were sedentary at baseline and were asked to maintain their usual physical activity levels,” the investigators observe.

Patients were randomized to the 3Mdiet or 6Mdiet and followed for 12 weeks.

Importantly, “both diets had the same macronutrient composition of fat, protein, and carbohydrates (35%, 25%, 40%, respectively), but with different meal timing, frequency, and calorie and carbohydrate distribution over the day,” the authors point out.

For example, participants on the 3Mdiet consumed a large breakfast of, for example, bread, fruits, and sweets, of around 700 calories, a medium-sized lunch of 600 calories, and a small dinner of 200 calories, specifically lacking starches, sweets, and fruits.

In contrast, those randomized to the 6Mdiet ate breakfast, lunch, and dinner along with three snacks of 150 calories each such that caloric consumption was relatively uniform across the day, with snacks scheduled for 11:00, 17:00, and 22:00 hours.

Significant Weight Loss With 3Mdiet

After 12 weeks of the intervention, those on the 3Mdiet lost on average 5.4 kg compared with a small 0.3-kg weight gain in the 6Mdiet group, a difference that was highly significant (P < .0001), the investigators report.

Over the same 12 weeks, participants in the 3Mdiet group had a 1.2% decrease in A1c compared with a nonsignificant decrease in the 6Mdiet group (P = .5).

The magnitude of reduction in A1c is comparable to the decrease seen with the addition of a glucagon-like peptide-1 (GLP-1) receptor agonist or a sodium-glucose cotransporter 2 (SGLT2) inhibitor in patients with type 2 diabetes treated with insulin, the investigators observe.

At the end of the study intervention, fasting glucose had dropped in both groups, but the reduction was more pronounced in the 3Mdiet group than in the 6Mdiet group.

Specifically, at week 12, fasting glucose had dropped to 110 mg/dL from 165 mg/dL at baseline in the 3Mdiet group, compared with 141 mg/dL from 164 mg/dL at baseline in the 6Mdiet group.

There was also a significant reduction in daily 24-hour mean glucose levels at 12 weeks in the 3Mdiet group compared with no significant change in the same glucose parameter in the 6Mdiet group (P < .05).

Continuous glucose monitoring (CGM) assessments in both groups also showed that time spent in normoglycemia increased from 59% at baseline to 83% at week 12 in the 3Mdiet group.

“In contrast, the 6Mdiet did not change the time spent in normoglycemia throughout the study,” say Jakubowicz and colleagues.

Participants assigned to the 3Mdiet also experienced a significant decrease in hunger and overall cravings for sweets, fast food, and high-fat food by study end, whereas those assigned to the 6Mdiet did not experience any change in hunger or have less of a craving for the same foods.

And importantly, in spite of the significant improvements in glycemic measures observed in the 3Mdiet group, participants in that group were not at greater risk for hypoglycemic events.

Total Daily Insulin Dose Reduced With 3Mdiet

For those on the 3Mdiet, the total daily insulin dose dropped by 26 units across the study interval from 60 units at baseline to 34 units at 12 weeks.

Again, in contrast, there was a small increase of 4 units in the total daily insulin dose for those on the 6Mdiet across the same study interval.

The magnitude of reduction in insulin needs seen among those on the 3Mdiet is again comparable to that achieved with the addition of a GLP-1 agonist or SGLT2 inhibitor, the authors stress.

And they observe that the significant reduction in the need for insulin seen in the 3Mdiet group was also independent of any weight loss among the same participants.

This is in contrast to the usual pattern of insulin use and weight gain seen in type 2 diabetes, when many patients gradually require increasing doses of insulin to meet glucose targets.

This increase in the need for insulin often leads to a vicious cycle of weight gain, which in turn may increase insulin resistance, further escalating the need for insulin, continued weight gain, and the likelihood that patients will fall short of their glycemic targets.

The authors suggest that a circadian pattern of diet-induced thermogenesis in which thermogenesis peaks after participants consume a high-calorie breakfast might help explain why the 3Mdiet led to greater weight loss compared with the standard diabetic diet.

Diabetes Care. 2019;42:2171-2180. Abstract

https://www.medscape.com/viewarticle/922570#vp_1

Biotech week ahead, Dec. 16

Biotech stocks were seen consolidating last week after advancing in the previous week. The iShares NASDAQ Biotechnology Index IBB 0.28% reached a 52-week high of 121.16 Monday, although it has come off this level since then.

The week saw huge moves in reaction to presentations at the American Society of Hematology annual meeting. A few M&A announcements were made, including Merck & Co., Inc.’s MRK 0.36% deal to buy ArQule, Inc. ARQL 0.38% and Sanofi SA’s SNY 0.57% proposed purchase of Synthorx Inc THOR 0.27%.

Correvio Pharma Corp CORV 1.28% fell sharply in the week following an FDA panel snub of its atrial fibrillation treatment Brinavess.

The following are key catalytic events expected in the week ahead:

PDUFA Date

The FDA is set to rule on Avadel Pharmaceuticals PLC’s AVDL 0.83% NDA for AV001, a sterile injectable product for the hospital market. The PDUFA date is scheduled for Sunday following a three-month extension from the original decision date of Sept. 15.

Adcom Meeting

FDA’s Oncologic Drugs Advisory Committee will discuss Wednesday Epizyme Inc’s EPZM 0.56% NDA for tazemetostat tablets for treating patients with metastatic or locally advanced epithelioid sarcoma who are not eligible for curative surgery.

Earnings

Anavex Life Sciences Corp AVXL (Monday, after the market close)

The week could see clinical readouts from companies that have given a timeline of December/fourth quarter/second half of 2019/year-end 2019.

https://www.benzinga.com/general/biotech/19/12/14982366/the-week-ahead-in-biotech-avadel-epizyme-in-focus-in-a-quiet-week

1 in 5 U.S. Adults Use Health Apps, Wearable Trackers

• About one in three Americans have at least tried digital health products
• Higher-income households, women, young adults among top users
• Most users say health apps, wearable trackers are helpful to health goals

Nineteen percent of Americans say they currently use a wearable fitness tracker, with the same percentage saying they currently use a mobile health app. Combining present use with the percentages of Americans saying they have used each of these devices in the past, about one in three Americans report at some point having worn a fitness tracker such as a Fitbit or smartwatch (34%) or having tracked their health statistics on a phone or tablet app (32%).

More than one in four Americans currently use one product or the other: 8% are actively using only a fitness tracker, 9% are actively using only a mobile health app, and 10% are actively using both.

Combining both current and past users, nearly half of Americans (45%) have at least tried one or more of the digital health products: 13% have tried or currently use only a fitness tracker, 12% have tried or currently use only a mobile health app, and 20% have tried both products.

These data are from Gallup’s annual Health and Healthcare survey, conducted Nov. 1-14. The U.S. is the second-largest market in the world for wearable devices, according to the International Data Corporation. The most popular wearable device brands in the U.S. in late 2018 were Apple, Xiaomi and Fitbit.

Meanwhile, Americans have a variety of health applications available to them on their mobile devices — both free and paid — that can be used to track fitness, nutrition, stress, sleep and other health-related statistics. Some health apps link to wearable devices.

High-Income Households, Young Adults and Women Among Top Users

Use of these products varies across subgroups:

• Roughly half of U.S. adults in upper-income households report being current or former users of both fitness trackers and health apps, whereas about one in three adults in middle-income households report having used these products — and about one in four among those in lower-income households.
• Fitness trackers and health apps are a bit more popular among women than among men. Meanwhile, adults younger than 55 are about twice as likely to have used these products as are adults aged 55 and older.
• Gender and age differences are accentuated when considering both together — nearly half of women younger than 50 report having used these products, while men aged 50 and older are the least likely among the four gender-age groups to report having used them.
• Thirty-five percent or more of city and suburban residents report having used these products, while fewer than three in 10 residents of rural areas have used either one.

Most Users Rate the Products as Helpful in Reaching Health Goals

Gallup also followed up with those who reported having used fitness trackers or health apps about the products’ helpfulness in reaching their health goals.

About three in four current or former users of wearable fitness trackers say they find them very (30%) or somewhat helpful (46%). Even more health app users (82%) say they find them very (29%) or somewhat helpful (53%).

As might be expected, current users of both products are more likely than past users to report the products as being helpful.

The vast majority of current wearable fitness tracker users (85%) and health application users (92%) say the products are very or somewhat helpful. The majority of past users are positive about the products’ helpfulness, but to a lesser degree than current users: 64% say wearable fitness trackers were very or somewhat helpful, and 69% rate health apps positively.

Bottom Line

More than one in four adults across the U.S. are currently measuring their steps, exercise, sleep or other personal health information as they go about their daily lives — amassing a vast amount of data for companies that oversee the devices and applications they use.

Most users are positive in their reports of the products’ helpfulness in reaching their health goals, and among those who have at least tried the products, active users currently outnumber former users.

Though Gallup’s initial measure of usership of these products finds a substantial number of Americans using them, that’s not to say that usership in the U.S. is on the rise. According to the International Data Corporation, the U.S. market for wearable devices “saw its year-over-year growth decline 0.4% as it transitions from a market driven by new users to one that relies on replacement devices and upgrades.”

Meanwhile, the recent acquisition of Fitbit by Google — of whom Americans’ concerns about invasion of privacy grew from 2011 to 2018 — has raised concerns among users who don’t want their personal data compromised. Both companies have stated their commitment to customers’ privacy, and Google said it wouldn’t sell users’ personal data.

This is just one of many new frontiers where Americans are entrusting their personal data to a tech company. And while there isn’t yet a majority-level desire for greater regulation of Big Tech, that could change if Americans sense the risks of data breaches or intentional mining are hitting closer to home — in this case, data about their physical metrics and health.

View complete question responses and trends.

https://news.gallup.com/poll/269096/one-five-adults-health-apps-wearable-trackers.aspx

Exercise Labels: The Next Frontier In Food Packaging?

U.K. researchers are debating if food packaging should expand to include how much exercise is needed to burn off the calories included in a food item, according to The Guardian.

What Is Exercise Labeling?

Food packages must display nutritional information, including calorie and salt content. But researchers are evaluating if small symbols showing how much physical activity is needed to cancel out the consumption of a food item will help tackle overeating and other health problems, according to The Guardian.

For example, a fizzy beverage from Coca-Cola KO 0.48% could include a symbol of a person walking accompanied with “26 minutes.”

Professor Amanda Daley of Loughborough University told The Guardian that it’s an easy-to-understand metric.

“If I tell you something is going to take you 60 minutes of walking to burn, I think most people understand that and know that 60 minutes of walking is a long way,” she said.

Why It’s Important

A study of food packaging with exercise-based labels found that people eat 103 fewer calories when given a choice of an exercise-based label or food with no labels, according to The Guardian.

Yet the study failed to show a clear benefit when exercise-based labels were compared with other labeling.

Small dietary changes are still better than none.

The Royal Society of Public Health told CNN that “small changes” like exercise-based labels can “make a big overall difference to calorie consumption, and ultimately weight gain.”

https://www.benzinga.com/general/health-care/19/12/14981233/exercise-labels-the-next-frontier-in-food-packaging

Wood Fires Bring Cardio, Other Health Risks

Decades ago, Nat King Cole gently crooned about chestnuts roasting on an open fire. But since then, scientists have uncovered some troubling truths about wood smoke.
Although the image of a log fire is often associated with the holidays, romance and cozy nights inside shielded from plummeting temperatures, experts say wood-burning appliances are a threat to lung and heart health. They emit harmful air pollutants and fine particles that can enter the lungs and bloodstream.
"We are increasingly concerned about particulate matter air pollution and other forms of air pollution," said Dr. Joel Kaufman, professor of environmental and occupational health sciences, medicine and epidemiology at the University of Washington in Seattle. "There's increasing evidence that certain pollutants are associated with cardiac disease, heart attacks and stroke. At certain times of the year, wood burning is a major source of that pollution."

 

While roasting marshmallows or warming their hands by the flames, people breathe in a slew of toxic substances, including benzene and formaldehyde, according to the Environmental Protection Agency. The biggest threat is fine particulate matter, which can aggravate asthma symptoms, cause heart attacks, stroke and heart failure, according to the EPA.
"The size of particulate matter is much less than the width of a human hair," Kaufman said. "They're too small to be seen and also small enough they're easily inhaled and can get deep into the lungs."
Plenty of research on wood smoke backs these concerns. For people with underlying heart disease, a 2017 study in the journal Environmental Research linked increased particulate air pollution from wood smoke and other sources to inflammation and clotting, which can predict heart attacks and other heart problems.
A 2013 study in the journal Particle and Fibre Toxicology found exposure to wood smoke causes the arteries to become stiffer, which raises the risk of dangerous cardiac events. For pregnant women, a 2019 study in Environmental Research connected wood smoke exposure to a higher risk of hypertensive disorders of pregnancy, which include preeclampsia and gestational high blood pressure.
As evidence of these adverse health effects mounts, states are taking action to crack down. For example, Idaho offers a tax deduction to replace old, uncertified wood stoves. In Oregon, when a house is sold, uncertified solid fuel-burning devices must be destroyed. Michigan's Model Ordinance for Outdoor and Open Burning restricts outdoor wood-fired boilers and patio wood-burning units. The state of Washington assesses a $30 fee on the sale of wood-burning devices.
But for some communities, woodburning is a necessity. In rural U.S. communities and many areas in Asia and Africa, socioeconomically disadvantaged families cannot afford more sophisticated technology, said Dr. Sanjay Rajagopalan, chief of cardiovascular medicine at University Hospitals Harrington Heart & Vascular Institute in Cleveland.
"Wood-burning stoves are a component of many societies around the world," Rajagopalan said. "When you do this, individuals living within the home are exposed to a wide range of pollutants that vary. In a home that has a lot of woodburning, the levels approach what you see in a smoke-filled room with secondhand smoking."
Women and children often bear the brunt of these negative health effects, he said, since women often do the cooking in these societies and children often stay near their mothers.
But the topic is understudied, given that it is prevalent in poor communities, he said.
The solution, Rajagopalan said, is twofold: making more affordable alternatives to wood-burning devices and educating people about the health consequences.
"I don't think we need better wood-burning cookstoves. The answer is move away from these archaic technologies. That, and education about cardiovascular risks."
https://consumer.healthday.com/respiratory-and-allergy-information-2/air-pollution-health-news-540/aha-news-lovely-but-dangerous-wood-fires-bring-health-risks-753023.html