'Rare Syndrome After COVID Vaccines Described'

 People who experienced rare long-term adverse events after COVID-19 vaccination often had neurologic symptoms, survey data showed.

Among 241 people who self-reported a post-vaccination syndrome (PVS), the five most common symptoms were exercise intolerance (71%), excessive fatigue (69%), numbness (63%), brain fog (63%), and neuropathy (63%), reported Harlan Krumholz, MD, of Yale School of Medicine in New Haven, Connecticut, and co-authors in a paper posted on the preprint server medRxivopens in a new tab or window. The paper has not been peer-reviewed.

"The study is the largest investigation of the experience of people reporting a chronic, debilitating condition that began soon after a COVID-19 vaccination," Krumholz told MedPage Today.

"It raises awareness about what these individuals are experiencing and points attention to the need for more studies to understand what is underlying this condition and how to relieve suffering," he continued. "These people are not anti-vaxxers -- they were all vaccinated -- but because of politics, many have had the experience of being dismissed and ignored."

Ongoing symptoms after COVID vaccines are rarely studied. "Even the definition of post-vaccination syndrome is in flux, but a working definition could be symptoms that begin with a week of a vaccination and persist for at least 2 months," Krumholz said.

Last year, an NIH-funded study on medRxiv evaluated new neuropathic symptomsopens in a new tab or window in 23 people that started soon after they received a COVID vaccine. About half (52%) of the 23 participants had objective evidence of small-fiber peripheral neuropathy; of those, 58% who were treated with oral corticosteroids had complete or near-complete improvement after 2 weeks. Some participants improved without immunotherapy.

Case reports suggested post-vaccine neuropathy and tinnitusopens in a new tab or window may be treated with plasma exchange. Postural orthostatic tachycardia syndrome (POTS) also has been diagnosedopens in a new tab or window after COVID vaccines.

Reports to the Vaccine Adverse Event Reporting Systemopens in a new tab or window (VAERS) after COVID vaccination include a variety of neurologic and systemic manifestations, Krumholz and co-authors noted. These symptoms may share mechanisms with post-COVID complications, they observed.

"Importantly, immune-mediated neurological adverse events post-vaccination are rare and often less severe than those that follow actual infection," they wrote.

Krumholz and colleagues surveyed 241 adults who self-reported PVS after COVID-19 vaccination and who joined the online LISTENopens in a new tab or window study from May 2022 to July 2023. People with long COVID were excluded from the study.

Median participant age was 46. Most were women (80%), white (87%), and from the U.S. (88%). About half (55%) received the Pfizer-BioNTech (Comirnaty) vaccine and 37% had the Moderna (Spikevax) shot. A third (34%) said they had SARS-CoV-2 infection at least once.

PVS symptom onset occurred within a median of 3 days of the index vaccination. Symptoms began after the first, second, third, and fourth (or more) vaccinations for 44%, 33%, 14%, and 9% of participants, respectively.

Participants completed surveys from November 2022 and July 2023, a median of 595 days after vaccination. From a list of 96 symptoms, they were asked to identify health conditions they had as a result of vaccine injury. They also reported their self-perceived health status on a 5-point scale of excellent, very good, good, fair, or poor.

In addition, participants rated their quality of life with the Euro-QoL visual analogue scale (EQ-VASopens in a new tab or window; a score of 100 represented the best), and reported symptom severity by rating symptoms on their worst days, with 0 meaning trivial illness and 100 being unbearable.

The median number of symptoms attributed to PVS was 22. Overall, 44% rated their current health as fair or poor. The median EQ-VAS score was 50; in people without previous comorbidities, it was 52. Participants reported a median symptom severity of 80 on their worst days.

The median number of treatments tried was 20. The most common prescription therapies were oral steroids (48%), gabapentin (25%), low-dose naltrexone (20%), ivermectin (18%), propranolol (11%), and bronchodilators (11%).

The most common non-drug treatments included limiting exercise or exertion (51% of participants), quitting alcohol or caffeine (44%), hydration and increasing salt intake (44%), and intermittent fasting (39%).

In the week before completing the survey, most participants said they felt unease (93%), fearfulness (82%), or overwhelmed by worries (81%), and reported feelings of helplessness (80%), anxiety (76%), depression (76%), or hopelessness (72%) at least once.

This report is a step toward acknowledging the effects of PVS, Krumholz noted. "The next step is to correlate what these people are experiencing with deep investigations of immune function," he said. The LISTEN study continues to recruit participants, he added.

The study had limitations; participants were self-referred and symptoms were self-reported. "The participants are not representative, so it is not possible to estimate the incidence or who might be most susceptible to this condition," the researchers acknowledged.

Disclosures

This project was in part supported by the Howard Hughes Medical Institute Collaborative COVID-19 Initiative and in part from a grant from the National Center for Advancing Translational Science of the NIH.

Krumholz received expenses and/or personal fees from Element Science, Eyedentify, and F-Prime in the past 3 years. He is a co-founder of Refactor Health and Ensight-AI. He and his spouse are co-founders of, and have equity in, Hugo Health, the personalized health data platform company that developed the Hugo Kindred platform. The Yale Conflict of Interest Committee oversees his involvement in this study. He is the editor of Journal Watch: Cardiology of the Massachusetts Medical Society and a section editor for UpToDate. He is associated with contracts through Yale New Haven Hospital from CMS, and through Yale University from Janssen, Johnson & Johnson Consumer, and Pfizer.

Co-authors reported relationships with RIGImmune, Xanadu Bio, PanV, Paratus Sciences, InvisiShield Technologies, Roche Holding Ltd., the NIH, the Patient-Centered Outcomes Research Institute, Sentara Research Foundation, the American Heart Association, the Agency for Healthcare Research and Quality, CMS, Pfizer, and the Yale-Mayo Clinic Center of Excellence in Regulatory Science and Innovation.

Primary Source

medRxiv

Source Reference: opens in a new tab or windowKrumholz HM, et al "Post-vaccination syndrome: a descriptive analysis of reported symptoms and patient experiences after COVID-19 immunization" medRxiv 2023; DOI: 10.1101/2023.11.09.23298266.

https://www.medpagetoday.com/neurology/generalneurology/107644

Prone Positioning Falls Flat for Weaning COVID Patients Off ECMO

 Early application of prone positioning did not help patients with severe acute respiratory distress syndrome (ARDS) -- mostly from COVID -- get off venovenous extracorporeal membrane oxygenation (VV-ECMO) any faster compared to supine positioning, a randomized trial found.

Among ARDS patients receiving ECMO, an identical 44% of patients were successfully weaned off ECMO after 60 days whether they were placed in sessions of prone positioning or simply kept supine (P=0.64), reported Matthieu Schmidt, MD, of the Hôpital de la Pitié-Salpêtrière in Paris, and colleagues.

Within 90 days, there was no significant difference seen in ECMO duration between prone and supine groups (28 vs 32 days, P=0.13). Also no different were 90-day mortality rates between positions (51% vs 48%, P=0.62), according to the French PRONECMO study published in JAMAopens in a new tab or window.

"Despite promising findings in observational studies, prone positioning of patients undergoing ECMO failed to reduce ECMO duration or mortality in this randomized trial," Schmidt and coauthors concluded.

Prone positioning has been shown to reduce mortality in ARDSopens in a new tab or window, and promotes "better overall ventilation/perfusion matching through a more homogeneous distribution of gas-tissue ratios along the dependent-nondependent axis in addition to decreased levels of lung stress and strain," the investigators explained in their introduction.

But whether the benefit extended to ARDS patients on VV-ECMO was unclear. One recent meta-analysis of 13 observational studiesopens in a new tab or window had found prone positioning during ECMO for ARDS -- COVID-19 or not -- to be associated with a significant improvement in ventilator-free days and intensive care unit (ICU) survival, Schmidt's group noted.

Prone positioning is strongly recommended in current clinical practice guidelines, noted Ricardo Teijeiro-Paradis, MD, and Niall Ferguson, MD, MSc, both of the University of Toronto, in an accompanying editorialopens in a new tab or window.

"Based on these results, routine prone positioning during VV-ECMO does not facilitate earlier liberation from ECMO or improve outcomes. This suggests that on average, prone positioning does not facilitate further lung protection than that already provided with an ultraprotective ventilation strategy facilitated by VV-ECMO," Teijeiro-Paradis and Ferguson wrote.

"Results of the PRONECMO trial may lead us to turn our backs on routine prone-position ventilation during VV-ECMO and face forward toward novel group-specific interventions targeting lung and diaphragm-protective ventilation, early awakening, and patient mobility," the duo commented.

Study authors and editorialists posed several factors that may explain PRONECMO's neutral results for prone positioning.

"First, the majority of enrolled patients were placed in prone position before ECMO, compared with widely variable proportions of patients in previous cohorts. Second, the majority of patients had COVID-19-related ARDS, perhaps with a greater severity of pulmonary injury," Schmidt and colleagues wrote.

They added that a person's response to prone positioning may depend on his or her specific etiology or severity of respiratory illness. "The COVID-19 variant may also contribute to prone positioning response, as less favorable pandemic outcomes were observed in late 2020, and the Delta variant was predominant in France during part of the trial. This contrasts with early reports of prone positioning benefit in COVID-19 patients receiving ECMO during predominance of the wild-type SARS-CoV-2 strain," they wrote.

Additionally, Teijeiro-Paradis and Ferguson suggested that sedation may have played a role in prone positioning's lack of benefit in the trial.

"Not infrequently, our patients develop complete lung collapse/consolidation with resulting tidal volumes far below anatomical dead space," the pair wrote. "Such derecruitment is exacerbated by the lack of respiratory effort due to deep sedation and paralysis often needed to maintain adequate ECMO flow and safe inspiratory pressures. A similar phenomenon may explain the progressive decrease in respiratory system compliance observed in both groups in the PRONECMO study."

The randomized trial was conducted at 14 ICUs in France with clinicians having the experience and capability to perform prone positioning during ECMO. Study participants were patients undergoing ECMO for severe ARDS. From March to December 2021, adult patients were enrolled if they were undergoing invasive mechanical ventilation and were supported by VV-ECMO for less than 48 hours.

The study cohort included 170 patients (median age 51, 35% women). Approximately 93% of the cohort presented with COVID-19-related ARDS, the remainder having bacterial pneumonia or another etiology.

Those assigned to prone positioning underwent at least four prone position sessions of 16 hours during the first 4 days (unless a patient met predefined criteria for early stopping of the prone intervention), whereas the supine ECMO group was not allowed to be put in prone before day 60.

All individuals in the prone group were placed in this position immediately after randomization. Overall, 80% received at least four prone sessions, with discontinuation most commonly due to respiratory system compliance and improvements in oxygenation.

Among the study's limitations were its small sample size and unblinded trial methods. A caveat to the study's generalizability was the observation that approximately 40% of study participants had been enrolled from a single very experienced center, Schmidt and colleagues cautioned.

Disclosures

This study was supported by funding from the Programme Hospitalier de Recherche Clinique-PHRC 2018 (French Ministry of Health).

Schmidt reported relationships with Getinge, Dräger, Baxter, and Fresenius Medical Care.

Teijeiro-Paradis and Ferguson reported no disclosures.

Primary Source

JAMA

Source Reference: opens in a new tab or windowSchmidt M, et al "Prone positioning during extracorporeal membrane oxygenation in patients with severe ARDS: The PRONECMO randomized clinical trial" JAMA 2023; DOI: 10.1001/jama.2023.24491.

Secondary Source

JAMA

Source Reference: opens in a new tab or windowTeijeiro-Paradis R, Ferguson ND "Prone positioning during venovenous ECMO for severe ARDS" JAMA 2023; DOI: 10.1001/jama.2023.22456.

https://www.medpagetoday.com/criticalcare/generalcriticalcare/107645

ADC and GLP-1 Rocket Ride Continues as 2023 Comes to Close

 With just a month left in what has been a challenging year for biopharma, two product categories that remain rock steady are antibody-drug conjugates and glucagon-like peptide 1 agonists. Targeted toward the cancer and diabetes/weight loss markets, respectively, ADCs and GLP-1 drugs are not new technologies—the first FDA approval of an ADC came in 2000 and GLP-1s were first introduced in 2010—but subsequent advancements and regulatory green lights have cemented their place in the industry.

The rise of ADCs with their targeted and potent cytotoxic payloads are transforming cancer treatment. Last year, BioSpace took a look at how, amid waves of biotech layoffs, ADC developers such as ImmunoGen were thriving. This week, ImmunoGen’s ship came in as AbbVie agreed to acquire the Waltham, Mass.-based company for $10.1 billion. AbbVie gains access to ImmunoGen’s FDA-approved Elahere ADC for platinum-resistant ovarian cancer and a pipeline of promising next-generation ADCs.

The multibillion-dollar deal comes the same week AbbVie scored a Phase II win for its investigational c-Met protein directed ADC in patients with previously treated non-small cell lung cancer. While AbbVie’s Teliso-V is not approved by any regulatory authority and its safety and efficacy have not been established, it could become the first ADC targeting c-Met to be approved by the FDA. AbbVie will discuss with global health authorities the potential to support an accelerated approval.

So, where does ADC technology go from here? Despite their payload targeting, these novel agents come with their share of challenges. “Even very, very stable ADCs have toxicity problems,” according to Nathan Tumey, associate professor at the School of Pharmacy and Pharmaceutical Sciences at Binghamton University. BioSpace this week examined the next-generation of ADCs that are striving to overcome these toxicities and payload problems.    

If the ADC market is red hot in cancer, then the GLP-1 market is a full-fledged weight loss drug craze fueled by the FDA’s approval of Eli Lilly’s obesity drug Zepbound (tirzepatide) earlier this month and Novo Nordisk’s phenomenal success with Wegovy (semaglutide).

While there are currently no head-to-head randomized clinical studies pitting these two therapies against each other, a comparative analysis of electronic health records by healthcare data and analytics firm Truveta found that tirzepatide might be a better choice than semaglutide. These are interesting real-world data. The caveat is that the research, its methods, results, analysis and conclusions have yet to be peer reviewed.

Among the most common side effects of Novo’s Wegovy and Lilly’s Zepbound injections are nausea, diarrhea, abdominal pain, vomiting and constipation. Apparently, these are problems also shared by oral GLP-1 drugs.

Pfizer announced Friday that while its twice-daily oral GLP-1 candidate met its primary endpoint in a Phase IIb obesity trial, danuglipron resulted in high rates of adverse events including nausea, vomiting and diarrhea. The company said the twice-daily danuglipron formulation “will not advance into Phase III studies.” Future drug development will focus on a once-daily form, with data coming in the first half of 2024.

Finally, Altimmune this week scored a Phase II win showing that its investigational GLP-1/glucagon dual receptor agonist pemvidutide induced strong weight loss in adults with overweight or obesity. Patients treated with Altimmune’s pemvidutide saw up to 15.6% weight loss, and nearly a third of those taking the highest dose lost at least 20% of their body weight.

https://www.biospace.com/article/adc-and-glp-1-mania-continue-as-2023-comes-to-close/

The Urgency Of Strengthening America’s Electric Grid Cybersecurity

 by Paul Steidler via RealClear Wire,

The U.S. electric grid continues to face a bevy of foreign and domestic cyberattack threats. Therefore, it makes more sense than ever before for utilities and transmission operators to aggressively fortify their cyber defenses. In fact, failure to do so is a classic case of being penny wise and pound foolish. 

The evidence includes the following: 

• On November 16, following two days of cybersecurity scenario testing by more than 250 organizations, Manny Cancel, Senior Vice President of the North American Electric Reliability Corporation (NERC) said, “The threat landscape in which we are operating is unprecedented – we are facing challenges that are increasingly difficult to detect and protect against.”
• NERC added that evolving cyber threats to the grid are “guided by geopolitical events, new vulnerabilities, changes in technologies, and increasingly bold cyber criminals and hackers.”
• China, Russia, and other countries continue to impose cybersecurity threats to the U.S. electric grid, as discussed in the Office of the Director of National Intelligence’s Annual Threat Assessment.
• Cybersecurity insurance premiums continue to rise sharply, making preventative actions more compelling from a cost-benefit standpoint. 
• The shift to renewable energy and distributed resources opens additional vulnerabilities for electric utilities. As Bruce Walker, President and Chief Executive Officer of the Alliance for Critical Infrastructure Security said in July 18 Congressional testimony, “Importantly, the risk associated with cyber is exacerbated by the rapid transformational changes happening in the electric sector. The transition away from a centralized generation and command and control model to a decentralized model, has increased the surface area for cyber penetration.  

The grid’s Operational Technology (OT) vulnerabilities are particularly notable. OT refers to the remote monitoring and control of components in the electric system. This encompasses supervisory control and data acquisition (SCADA) and industrial control systems (ICS) networks. 

An October 2022 U.S. Department of Energy study found, “Another industry trend is increased attacker experimentation and exploitation targeting OT systems.” 

The U.S. Government Accountability Office has issued a similar warning: “Grid distribution systems – which carry electricity from transmission systems to consumers – have grown more vulnerable, in part because their operational technology increasingly allows remote access and connections to business networks.”

One way to simplify critical infrastructure protection and keep OT secure is to place a device that only allows pre-defined, legitimate signals to be sent to the OT on a network. This reduces the costs of more holistic network changes. It also prevents non-specific commands from passing through a protected device. 

One such system, Binary Armor, places an in-line barrier to cyber intrusion, while monitoring all communications to a piece of OT. The device is small, approximately five by three inches, and weighs less than a pound. It can be deployed throughout the distribution grid, including on main substation data lines and within substations. 

Legitimate commands can pass through. Those that would cause the device to behave in dangerous, destructive ways are thwarted. 

Binary Amor cannot be modified or reconfigured without physical access to the system, thereby providing robust security for remote facilities and critical infrastructure. The system allows the system operator to define the rules for SCADA/ICS traffic and to inspect every byte of information. 

The scope of threats that the U.S. electric grid will continue to face are likely to rise in complexity and severity. Rather than waiting for dictates from regulators, utilities and transmission grid operators should identify important areas for cybersecurity protection, especially where there are efficient, cost-effective solutions. In this environment, OT protection is especially important and likely to be even more so soon. 

Paul Steidler is a senior fellow of the Lexington Institute who researches, studies, and discusses logistics and energy issues.

https://www.zerohedge.com/energy/urgency-strengthening-americas-electric-grid-cybersecurity

38 Lawmakers Leaving Congress In 2024 (Twice As Many Democrats As Republicans)

 by Mark Tapscott via The Epoch Times,

Nearly 40 Congressional lawmakers aren't seeking reelection in 2024... and most of them are Democrats...

Twenty-one House Democrats are opting out of another term compared to 11 Republicans. On the Senate side, six senators, four Democrat and two Republican, said they're leaving public office, and one has opted to pursue a state governorship.

In comparison to the 38 lawmakers departing Congress so far this cycle, only 24 lawmakers retired before the 2022 election. Twenty-seven had done so before the 2020 election and 31 in 2018, according to Ballotpedia.

A spokesman for the Democratic Congressional Campaign Committee (DCCC), which serves the same purpose for House Democrats as the National Republican Congressional Committee (NRCC) does for House Republicans, didn't respond to The Epoch Times' request for comment.

David Carlucci, a veteran New York state Democratic legislator and campaign consultant with a growing client list, described the wave of Democratic departures as partly attributable to "a normal confluence of events that happens where you have members leaving Congress."

"Usually, the party that is not in power, you find that there are resignations from Congress," he said. "If you are in power and you have chairmanships, you stick it out."

Mr. Carlucci cautioned against ascribing too much significance to the retirement imbalance, noting that, for example, three of the 21 departing Democrats are members of the California delegation and are announced candidates for the Senate seat of the deceased former Sen. Dianne Feinstein (D-Calif.).

House Democrats rally on the East Steps of the U.S. Capitol in Washington on Oct. 13, 2023. (Photo by Chip Somodevilla/Getty Images)

The three include Reps Katie Porter (D-Calif.), Barbara Lee (D-Calif.), and Adam Schiff (D-Calif.). Ms. Porter is serving her third term in the House, while Mr. Schiff and Ms. Lee are long-serving veterans of 11 and 12 terms, respectively. Mr. Schiff and Ms. Lee represent safe Democratic districts, while Ms. Porter's district is competitive, being targeted by both the NRCC and the DCCC in 2024.

Republicans have a ready explanation for the imbalance of retirees that's centered on Mr. Biden's mounting problems with voters.

“A civil war in their caucus over support for Israel, a historically unpopular president, and an inexperienced [House Minority] leader in Rep. Hakeem Jeffries (D-N.Y.) begs the question, why stay? Combine that with the climb out of the minority getting steeper by the day, House Democrats are smart to make a mad dash for the exits,” NRCC national press secretary Will Reinert told The Epoch Times.

The NRCC is the command center of GOP efforts to defend and expand the party's narrow four-seat majority in the November 2024 elections.

Courtney Parella, communications director for the Congressional Leadership Fund (CLF), told The Epoch Times that Democrats are "looking for the exits," thanks to “a historically unpopular president, a toxic and damaging agenda, and an unfavorable political environment."

Ms. Parella said that "as Democrats continue to lose some of their top fundraisers in the House, several now-open seats have quickly become even better pickup opportunities for Republicans and remain pivotal to growing the majority in 2024.”

 

(L–R) Committee Chairman Bennie Thompson (D-Miss.), Rep. Adam Kinzinger (R-Ill.), Rep. Pete Aguilar, (D-Calif.), and Rep. Adam Schiff (D-Calif.) arrive as the House Select Committee to Investigate the Jan. 6 Attack on the U.S. Capitol holds its last public meeting in the Canon House Office Building on Capitol Hill in Washington on Dec. 19, 2022. (Photo by Andrew Harnik-Pool/Getty Images)

The CLF is a political action committee that describes itself as "the only outside group to have the endorsement of the entire House Republican leadership."

"The CLF supports Republican candidates for the House of Representatives and counters the efforts of well-funded left-wing groups seeking to elect liberals to Congress," it stated.

Mr. Carlucci said the increasing partisan rancor in Congress specifically and more generally throughout American politics is a factor that's motivating representatives to opt out of reelection bids.

"I think there is something to the fact that politics is changing. It's always changing but now more rapidly than ever. We have seen the decorum in Congress degraded, at least to us watching it through cable TV. I'm sure there have always been side comments and digs, but now it has spilled over to a former Speaker of the House elbowing a colleague or a sitting senator challenging a witness to fight in a Senate hearing," he said.

Mr. Carlucci referred to recent incidents in the Capitol in which former Speaker Kevin McCarthy (R-Calif.) was alleged to have elbowed Rep. Tim Burchett (R-Tenn.) in the back and Sen. Markwayne Mullin (R-Okla.) challenged a union leader during a Senate hearing to make good on his previously tweeted threats of physical violence.

Mr. Carlucci also suggested that in the case of long-serving members, there's a growing incentive "after a distinguished career to pack it in because the style of politics now is one where the electorate does not really reward results; it's much more driven by the theater."

Then-House Speaker Kevin McCarthy (R-Calif.) talks to reporters inside the U.S. Capitol in Washington on Oct. 2, 2023. (Photo by Anna Moneymaker/Getty Images)

National Republican strategist Jimmy Keady said a significant factor in the retirement imbalance is that Democrats are having difficulty recruiting quality candidates.

“Candidate quality matters for all levels of government. What we are seeing is a Democratic Party with a deficiency of quality candidates who can win in highly competitive races. Instead of recruiting from the outside, the Democratic Party is having to recruit from their own ranks, jeopardizing their control of competitive districts across the country,” Mr. Keady told The Epoch Times.

“We just saw this in Virginia where Del. Kim Taylor was a key recruit for Virginia Republicans, and she won reelection in a Biden+11 district. Republicans are focused on pulling leaders outside of the beltway to run in these districts, and based on retirements so far, Democrats are going to have a hard time keeping up."

In addition to Mr. Schiff, Ms. Lee, and Ms. Porter, House Democrats leaving to pursue Senate seats include Reps. Ruben Gallego (D-Ariz.), Elissa Slotkin (D-Mich.), Colin Allred (D-Texas), David Trone (D-Md.), Lisa Blunt Rochester (D-Del.), and Andy Kim (D-N.J.).

Other House Democrats who are retiring to pursue another political office include Rep. Jeff Jackson (D-N.C.), who hopes to be elected state attorney general; Rep. Abigail Spanberger (D-Va.); a Virginia gubernatorial candidate; Rep. Sheila Jackson Lee (D-Texas), who's running for mayor of Houston; and Rep. Dean Phillips (D-Minn.) who's seeking the presidency.

 

Members-elect of the 118th Congress leave the House Chamber after three ballots failed to elect a new speaker of the House at the U.S. Capitol in Washington on Jan. 3, 2023. (Photo by Chip Somodevilla/Getty Images)

Retiring House Democrats who aren't seeking other offices include California Reps. Anna Eshoo, Grace Napolitano, and Leo Cardenas; Michigan Rep. Dale Kildee; Virginia Rep. Jennifer Wexton; Washington Rep. Derek Kilmer; Maryland Rep. John Sarbanes; and Oregon Rep. Earl Blumenauer.

House Republicans who are departing to seek a different political office include Rep. Alex Mooney (R-W.Va.) and Rep. Jim Banks (R-Ind.), both of whom are Senate candidates, and Rep. Dan Bishop (R-N.C.), who's a candidate for state attorney general.

Retiring House Republicans include Rep. Victoria Spartz of Indiana, Rep. Debbie Lesko of Arizona, Rep. Ken Buck of Colorado, Reps. Kay Granger and Michael Burgess of Texas, and Reps. Brad Wenstrup and Bill Johnson of Ohio. New York's Rep. George Santos is expected to be expelled from Congress imminently as a result of a scathing House Ethics Committee report.

Senate Democrat retirees include Sens. Debbie Stabenow of Michigan, Ben Cardin of Maryland, Tom Carper of Delaware, LaPhonza Butler of California, and Joe Manchin of West Virginia.

Republican Senate retirees include Sens. Mitt Romney of Utah and Mike Braun of Indiana, who's running for governor of the Hoosier state.

 

https://www.zerohedge.com/political/here-are-38-lawmakers-leaving-congress-2024-twice-many-democrats-republicans

2nd approval to Eli Lilly's drug for type of blood cancer

 Eli Lilly said on Friday the U.S. Food and Drug Administration (FDA) gave a second approval for its drug Jaypirca, which is used to treat a form of blood cancer.

The company said the health regulator gave the new approval to the drug for the treatment of chronic lymphocytic leukemia (CLL), a type of cancer in which the bone marrow makes too many of certain white blood cells.

Jaypirca was first given accelerated approval by the FDA on Jan. 27 for the treatment of mantle cell lymphoma (MCL), a rare type of blood cancer that starts in white blood cells and spreads to other parts of the body.

MCL is a more aggressive form of cancer compared to CLL, according to the National Institutes of Health.

The drug aims to treat adults with CLL after at least two lines of therapy.

https://finance.yahoo.com/news/us-fda-gives-second-approval-230851630.html

CENTENE: ARIZONA COMPLETE HEALTH GETS STATEWIDE LTC MEDICAID CONTRACT

  Centene Corporation (NYSE: CNC), a leading healthcare enterprise committed to helping people live healthier lives, announced today that its subsidiary, Arizona Complete Health, the largest Medicaid health plan in Arizona, has been selected by the Arizona Health Care Cost Containment System (AHCCCS) – Arizona's single state Medicaid agency – to provide managed care for the Arizona Long Term Care System (ALTCS). The program supports nearly 26,000 Arizonans who are elderly and/or have a physical disability (E/PD) with physical and behavioral healthcare, as well as provides pharmacy benefits.

The ALTCS-E/PD contract will begin on Oct. 1, 2024, and is a three-year term with four optional one-year extensions, for a total of seven possible contract years.

https://www.prnewswire.com/news-releases/centene-subsidiary-arizona-complete-health-awarded-statewide-long-term-care-medicaid-contract-302003741.html