Treatment for back pain: 84 percent increase in success rate

 Lack of exercise, bad posture, overexertion, constant stress at work or at home -- back pain is a widespread condition with many causes. For a not insignificant number of sufferers, the symptoms are even chronic, meaning they persist for a long time or recur again and again. Sport and exercise therapies under instruction can bring relief. Common treatment methods include physiotherapy as well as strength and stability exercises. But how can the therapy be as successful as possible? Which approach alleviates pain most effectively? A meta-analysis by Goethe University Frankfurt, published recently in the Journal of Pain, has delivered new insights.

The starting point was data from 58 randomised controlled trials (RCTs) of over 10,000 patients worldwide with chronic low back pain. First, the data relevant to the topic were filtered out of the original manuscripts and then evaluated in groups. When evaluating these data, the researchers examined on the one hand whether and to what extent standard forms of treatment and individualised treatment differ in terms of the result. "Individualised" means that there is some type of personal coaching, where therapists specifically target the potentials and requirements of each patient and decide together with them how their therapy should look.

The study concluded that individualised treatment for chronic back pain led to a significantly increased effect in comparison to standard exercise therapies. The success rate in pain relief was 38 percent higher than with standard treatment. "The higher effort required for individual treatment is worthwhile because patients benefit to an extent that is clinically important," says lead author Dr Johannes Fleckenstein from the Institute of Sport Sciences at Goethe University Frankfurt.

However, the study went even further. The research team in Frankfurt compared a third group of treatment methods alongside the standard and individualised ones. In this group, individualised training sessions were combined with cognitive behavioural therapy (CBT). This procedure -- a type of talk therapy -- is based on the assumption that negative thoughts and behaviours surrounding pain tend to exacerbate it. Through CBT, pain patients learn to change the way they handle it. They stop being afraid to move or are taught tactics for coping with pain. This makes them realise that they are by no means helpless. But what does the psychotherapeutic support through CBT actually contribute to the success of the treatment? Analysis of the data revealed the following: When an individualised approach and CBT were combined, the success rate in terms of pain relief was an impressive 84 percent higher than with standard treatment. The combined therapy, also called multimodal therapy, thus led to the best result by far.

Fleckenstein sees in the study "an urgent appeal to public health policy" to promote combined therapies both in terms of patient care and remuneration. "Compared to other countries, such as the USA, we are in a relatively good position in Germany. For example, we issue less prescriptions for strong narcotic drugs such as opiates. But the number of unnecessary X-rays, which, by the way, can also contribute to pain chronicity, and inaccurate surgical indications is still very high." This is also due, according to Fleckenstein, to economic incentives, that is, the relatively high remuneration for such interventions. The situation is different for organisations working in the area of pain therapy, he says. Although these are not unprofitable, they are not a cash cow for investors either. In his view, it is important here to improve the economic conditions. After all, pain therapy saves a lot of money in the long run as far as health economics are concerned, whereas tablets and operations rarely lead to medium and long-term pain relief.

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Story Source:

Materials provided by Goethe University Frankfurt. Note: Content may be edited for style and length.

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Journal Reference:

1. Johannes Fleckenstein, Philipp Floessel, Tilman Engel, Laura Krempel, Josefine Stoll, Martin Behrens, Daniel Niederer. Individualized Exercise in Chronic Non-Specific Low Back Pain: A Systematic Review with Meta-Analysis on the Effects of Exercise Alone or in Combination with Psychological Interventions on Pain and Disability. The Journal of Pain, 2022; DOI: 10.1016/j.jpain.2022.07.005

https://www.sciencedaily.com/releases/2022/10/221018131143.htm

Fed Ed Dept 'hosting series' to address pandemic learning loss

 The Department of Education announced Tuesday it will be hosting five sessions to address learning loss among students amid the COVID-19 pandemic and the switch to virtual learning.

The series, called “Raising the Bar: Literacy & Math Series to Address Academic Recovery,” will begin Oct. 26 and focus on “strategies and programs to boost literacy and math outcomes,” according to a department announcement.

The series follows the release of the September National Assessment of Educational Progress, which showed substantial learning loss among students during the coronavirus pandemic. 

The report showed 9-year-old students had the biggest drop in reading scores in 30 years amid the pandemic, while mathematics dropped for the first time ever. 

The Education Department said its upcoming series was created to assist states, districts and schools in getting students back on track. 

“The series seeks to build engagement from the field; identify collaboration opportunities among research, practice, and funding; and lift best practices and resources for practitioners and policymakers to take action to address learning loss and academic recovery,” the department wrote in its announcement. 

The five sessions will take place between October and February, with one session scheduled each month. 

The first session, slated for Oct. 26, will be “a call to action to practitioners, education leaders, teachers, parents, students, and policymakers to leverage the extraordinary level of available federal resources to mitigate learning loss and accelerate academic recovery.”

The other sessions will be held Nov. 10, Dec. 8, Jan. 12 and Feb. 9. They will focus on research skills, giving support to students outside the classroom, teacher shortages and parental involvement, and how to put policy into practice.

“With the latest results from the Nation’s Report Card as our call-to-action, today, I’m pleased to announce a new expert-led speaker series that will equip educators, school leaders, and district administrators with the latest information on the science of learning and the most promising tools for accelerating academic recovery, so that they can raise the bar to support our students and level up their skills in the critical areas of math and reading,” Education Secretary Miguel Cardona said in a statement.

https://thehill.com/homenews/administration/3694516-department-of-education-hosting-series-to-address-pandemic-learning-loss/

GAO: HHS reviews of emergency medicine stockpile did not meet most statutory requirements

 A federal watchdog found that the Department of Health and Human Services (HHS) did not meet a number of requirements in maintaining the Strategic National Stockpile (SNS) of medical countermeasures.

The Government Accountability Office (GAO) conducted a review of the SNS’s operating procedures, requirements, inventory and obligatory data. The agency’s report was first issued in August but was made public on Monday.

The SNS is a multibillion-dollar reserve of drugs, vaccines and other medical supplies meant to supplement medical countermeasures among states and local jurisdictions. During the COVID-19 pandemic, medical supplies such as N95 respirators and other personal protective equipment were deployed.

The stockpile also held the U.S.’s initial supply of smallpox vaccines such as Jynneos and ACAM2000 that have been used to stem the spread of monkeypox.

As the GAO noted in its report, inventory decisions for the SNS were led by prior reviews from the assistant secretary for preparedness and response (ASPR) from 2015 to 2019.

However, this process was suspended after the agency was reorganized, resulting in no SNS reviews being conducted for three years beginning in 2017. The reviews meant to be conducted during those years would have informed inventory decisions made between 2020 and 2022.

“Instead of completing annual reviews, SNS officials told us they used recommendations from a previously completed review to inform inventory decisions for these years,” the GAO report stated.

“We have concerns about ASPR’s ability to prepare for, and respond to, public health emergencies given recent management challenges related to the SNS,” the GAO report said. “If left unaddressed, these deficiencies will continue to hamper ASPR’s ability to be prepared for, effectively respond to, and recover from future threats.”

Several of the medical countermeasures in the SNS were developed through the support of the Biomedical Advanced Research and Development Authority (BARDA). However, not all BARDA-supported products are included in the SNS, and the report found that the stockpile has had difficulty in purchasing such products in recent years.

The GAO’s analysis of the stockpile determined that most medical countermeasures were accounted for, but they were often not present in recommended amounts. HHS officials told the agency that this was due to budget constraints.

The agency recommended that ASPR update the procedure on how SNS reviews were conducted and develop a method to manage risks associated with gaps in the SNS’s inventory levels and to ensure that products being considered for the stockpile receive equal consideration regardless of whether they were supported by BARDA.

https://thehill.com/policy/healthcare/3694152-watchdog-says-hhs-reviews-of-emergency-medicine-stockpile-did-not-meet-most-statutory-requirements/

Black, Hispanic and Native American people more likely to be hospitalized for flu: CDC

 A report from the Centers for Disease Control and Prevention (CDC) found that Black, Hispanic and Native American people are more likely to be hospitalized due to the flu and are less likely to get an annual flu shot than White Americans.

For the report, flu hospitalization rates from 2009 to 2022 and vaccination rates from 2010 to 2022 were looked at.

The CDC compared demographic data from the three observed groups to similar data on White Americans.

Compared to White Americans, flu hospitalization rates were 80 percent higher for Black Americans, 30 percent higher for Hispanic Americans and 20 percent higher for Native Americans and Alaska Natives.

These hospitalization rates could be due to some minority groups having disproportionate rates of chronic illness such as asthma and diabetes. The report also observed that flu vaccination rates among these groups have been “consistently” lower since 2010.

The CDC attributed these disparities to issues including a lack of access to health care and insurance; missed opportunities for vaccination; and misinformation and distrust in vaccines.

Health care providers and government officials were advised to make “culturally appropriate” flu vaccine recommendations to counteract these observed trends.

This report comes as health officials have warned that this year’s flu season could be harsher than what has been observed during the past two years of the COVID-19 pandemic.

Due to a lack of exposure to the influenza virus, researchers believe that community immunity to the flu has been lowered. In the Southern Hemisphere, where the flu season is experienced earlier than in the Northern Hemisphere, officials observed that the flu season was more severe than in recent years.

The number of reported flu cases in the U.S. has begun to rise as colder weather sets in, pushing people closing together indoors. The rate of positive tests remains low at the moment, with only 3.3 percent of lab tests coming back as positive for the flu.

Federal officials have strongly encouraged Americans to get both the flu shot and the COVID-19 bivalent booster dose this season as they hope to avoid a major surge in cases, or a possible “twindemic” of both viruses. Officials fear that hospitals could once again become overwhelmed if cases were to rise.

https://thehill.com/policy/healthcare/3694590-black-hispanic-and-native-american-people-more-likely-to-be-hospitalized-for-flu-cdc/

J&J sets sights on $60B in pharma sales by 2025, targets 8 brands to deliver growth

 As Johnson & Johnson works through period of change—including a consumer business spinoff and a high-profile loss of exclusivity—the company is steadfast on hitting an aggressive pharmaceutical sales target.

During an investor call Tuesday, J&J execs said the company aims to generate $60 billion in pharmaceutical sales by 2025. The unit pulled down $13.2 billion in the third quarter, which would annualize at nearly $53 billion.

J&J is targeting the $60 billion goal for 2025 despite next's year's loss of exclusivity for Stelara, currently the company's top drug by sales. The immunology blockbuster generated $7.33 billion in the first 9 months of 2022, a 12% increase from the same period last year operationally.

The projection is based on the company’s current profile and pipeline, Jennifer Taubert, executive vice president and worldwide chairman of J&J pharmaceuticals, said on the company’s earnings conference call. The company believes it will have an annual compound growth rate of “at least 5%," with growth in every year, including through next year's Stelara loss of exclusivity, Taubert said.

The company will rely on eight key brands to meet the pharma goal of $60 billion, she explained.

J&J has high hopes for Bristol Myers Squibb partnered thrombosis drug-milvexian, plus a combination of amivantamab and lazertinib to treat non-small cell lung cancer, Taubert said. Taubert also highlighted the company’s TAR-200 platform for bladder cancer, and of course the Legend Biotech partnered CAR-T Carvykti. J&J remains “really bullish” on the significance of Carvykti for multiple myeloma patients “around the world," Taubert said.

Taubert also cited Darzalex sales growth of 39% as an example of a large increase for a marketed drug that would support the $60 billion goal.

“You take a look at the strength of the existing portfolio, you layer in on top of that what’s coming through with the pipeline, and that’s what gives us the confidence to hit the $60 billion organically,” Taubert said.

Meanwhile, Taubert also pointed to 14 novel therapies filed with “potential” to exceed a billion dollars in revenue, plus five that could exceed five billion.

All of this doesn’t mean J&J won’t look towards M&A, but that it won’t rely on it, execs said. With $34 billion in cash, J&J’s dealmaking priorities have not changed, Joseph J. Wolk, executive vice president and chief financial officer, said on the call. While the company is even “a little bit more bullish and eager to do something,” it won’t do anything haphazardly, he added.

During the third quarter, J&J's pharma growth largely came from the oncology and immunology sectors, thanks to Tremfya and Darzalex. Darzalex on its own achieved 38.7% growth worldwide and contributed over $2 billion in revenue during the quarter, setting the multiple myeloma drug up to be a pharmaceutical superstar. Lee Brown, global sector lead for healthcare at Third Bridge, noted the “phenomenal growth” of Darzalex in a series of remarks. Brown also expects the drug's strong sales trajectory to be sustained.

The company is “navigating the macroeconomic environment well, despite currency projected to push down sales by roughly $4.5 billion or nearly 5% in 2022," Brown wrote in a note to clients.

https://www.fiercepharma.com/financials/johnson-johnson-sticks-2025-projection-60-billion-pharma-sales-relying-eight-key-brands

Editas shops preclinical cancer pipeline during its big makeover

 Storied CRISPR gene editing pioneer Editas Medicine $EDIT is in advanced discussions regarding the sale of the preclinical oncology lineup in its pipeline as the biotech works through a makeover of the company, its executive team and the drugs it hopes to take through the clinic, Endpoints News has learned.

https://endpts.com/exclusive-struggling-editas-shops-preclinical-cancer-pipeline-during-its-big-makeover/

Immatics Corporate Presentation

 

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