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Doctors Win $7 Million Settlement in EEOC Forced Retirement Case
In a victory for clinicians who fought to keep working regardless of age,
In a statement, the US Equal Employment Opportunity Commission (EEOC) said the settlement will resolve an age and disability discrimination charge filed against Scripps Clinic Medical Group. The medical group is part of Scripps Health, a major provider of medical services in the San Diego region that operates five local hospitals.
The EECO said it found “reasonable cause” that the medical group violated the Age Discrimination in Employment Act and the Americans with Disabilities Act.
US health systems are facing lawsuits that claim they’ve engaged in age discrimination by requiring physicians to take cognitive tests when they reach specific ages.
The Scripps medical group’s mandatory retirement policy began in 2016 and was consistent with California law, which specifically allows for mandatory retirement of physicians in medical groups at age 70, Scripps said in a statement, adding that it rescinded the policy in 2018.
“This policy was put in place to enhance patient safety,” Scripps said. “The EEOC took the position while such a policy is expressly legal under California law; it is not allowed under federal law.”
The Federal Age Discrimination in Employment Act, passed in 1967, states that employers may not “fail or refuse to hire or to discharge any individual or otherwise discriminate against any individual with respect to his compensation, terms, conditions, or privileges of employment because of such individual’s age.” There are exceptions, however, in cases of public safety for professions such as air traffic controllers.
California law has a similar provision banning age discrimination, but it makes an exception for “any employee who has attained 70 years of age and is a physician employed by a professional medical corporation, the articles or bylaws of which provide for compulsory retirement.”
In 2020, an estimated 12% of US licensed physicians were at least 70 years old — more than 120,000 in total — up from 9% in a 2010, according to a Federation of State Medical Boards 2021 report.
Scripps Clinic Medical Group settled with the EEOC “without any admission of fault or wrongdoing to avoid the continued expense and distraction of litigation,” its statement said. It agreed to pay $6.875 million to the affected physicians.
When asked about how many physicians were affected by the policy, a Scripps human resources official said, “this was disputed but very few. The policy was only in effect for 2 years, 2016 and 2017. Additionally, by age 75, most doctors have retired. And those who have not almost always have voluntarily limited their practice.”
The Scripps official didn’t respond to questions about the number of patients served by the medical group and how many physicians it employs.
According to the EEOC, the medical group has agreed to tell employees that the policy has been scrapped and must “clarify that the company does not have any policy in which age is a factor in making employment decisions, including termination, retirement, and terms and conditions of employment.”
Scripps Clinic Medical Group also agreed to require division and department heads, executive leadership, and human resources employees to be trained regarding the Age Discrimination in Employment Act and the Americans with Disabilities Act.
A version of this article appeared on Medscape.com.
In a victory for clinicians who fought to keep working regardless of age,
In a statement, the US Equal Employment Opportunity Commission (EEOC) said the settlement will resolve an age and disability discrimination charge filed against Scripps Clinic Medical Group. The medical group is part of Scripps Health, a major provider of medical services in the San Diego region that operates five local hospitals.
The EECO said it found “reasonable cause” that the medical group violated the Age Discrimination in Employment Act and the Americans with Disabilities Act.
US health systems are facing lawsuits that claim they’ve engaged in age discrimination by requiring physicians to take cognitive tests when they reach specific ages.
The Scripps medical group’s mandatory retirement policy began in 2016 and was consistent with California law, which specifically allows for mandatory retirement of physicians in medical groups at age 70, Scripps said in a statement, adding that it rescinded the policy in 2018.
“This policy was put in place to enhance patient safety,” Scripps said. “The EEOC took the position while such a policy is expressly legal under California law; it is not allowed under federal law.”
The Federal Age Discrimination in Employment Act, passed in 1967, states that employers may not “fail or refuse to hire or to discharge any individual or otherwise discriminate against any individual with respect to his compensation, terms, conditions, or privileges of employment because of such individual’s age.” There are exceptions, however, in cases of public safety for professions such as air traffic controllers.
California law has a similar provision banning age discrimination, but it makes an exception for “any employee who has attained 70 years of age and is a physician employed by a professional medical corporation, the articles or bylaws of which provide for compulsory retirement.”
In 2020, an estimated 12% of US licensed physicians were at least 70 years old — more than 120,000 in total — up from 9% in a 2010, according to a Federation of State Medical Boards 2021 report.
Scripps Clinic Medical Group settled with the EEOC “without any admission of fault or wrongdoing to avoid the continued expense and distraction of litigation,” its statement said. It agreed to pay $6.875 million to the affected physicians.
When asked about how many physicians were affected by the policy, a Scripps human resources official said, “this was disputed but very few. The policy was only in effect for 2 years, 2016 and 2017. Additionally, by age 75, most doctors have retired. And those who have not almost always have voluntarily limited their practice.”
The Scripps official didn’t respond to questions about the number of patients served by the medical group and how many physicians it employs.
According to the EEOC, the medical group has agreed to tell employees that the policy has been scrapped and must “clarify that the company does not have any policy in which age is a factor in making employment decisions, including termination, retirement, and terms and conditions of employment.”
Scripps Clinic Medical Group also agreed to require division and department heads, executive leadership, and human resources employees to be trained regarding the Age Discrimination in Employment Act and the Americans with Disabilities Act.
A version of this article appeared on Medscape.com.
In a victory for clinicians who fought to keep working regardless of age,
In a statement, the US Equal Employment Opportunity Commission (EEOC) said the settlement will resolve an age and disability discrimination charge filed against Scripps Clinic Medical Group. The medical group is part of Scripps Health, a major provider of medical services in the San Diego region that operates five local hospitals.
The EECO said it found “reasonable cause” that the medical group violated the Age Discrimination in Employment Act and the Americans with Disabilities Act.
US health systems are facing lawsuits that claim they’ve engaged in age discrimination by requiring physicians to take cognitive tests when they reach specific ages.
The Scripps medical group’s mandatory retirement policy began in 2016 and was consistent with California law, which specifically allows for mandatory retirement of physicians in medical groups at age 70, Scripps said in a statement, adding that it rescinded the policy in 2018.
“This policy was put in place to enhance patient safety,” Scripps said. “The EEOC took the position while such a policy is expressly legal under California law; it is not allowed under federal law.”
The Federal Age Discrimination in Employment Act, passed in 1967, states that employers may not “fail or refuse to hire or to discharge any individual or otherwise discriminate against any individual with respect to his compensation, terms, conditions, or privileges of employment because of such individual’s age.” There are exceptions, however, in cases of public safety for professions such as air traffic controllers.
California law has a similar provision banning age discrimination, but it makes an exception for “any employee who has attained 70 years of age and is a physician employed by a professional medical corporation, the articles or bylaws of which provide for compulsory retirement.”
In 2020, an estimated 12% of US licensed physicians were at least 70 years old — more than 120,000 in total — up from 9% in a 2010, according to a Federation of State Medical Boards 2021 report.
Scripps Clinic Medical Group settled with the EEOC “without any admission of fault or wrongdoing to avoid the continued expense and distraction of litigation,” its statement said. It agreed to pay $6.875 million to the affected physicians.
When asked about how many physicians were affected by the policy, a Scripps human resources official said, “this was disputed but very few. The policy was only in effect for 2 years, 2016 and 2017. Additionally, by age 75, most doctors have retired. And those who have not almost always have voluntarily limited their practice.”
The Scripps official didn’t respond to questions about the number of patients served by the medical group and how many physicians it employs.
According to the EEOC, the medical group has agreed to tell employees that the policy has been scrapped and must “clarify that the company does not have any policy in which age is a factor in making employment decisions, including termination, retirement, and terms and conditions of employment.”
Scripps Clinic Medical Group also agreed to require division and department heads, executive leadership, and human resources employees to be trained regarding the Age Discrimination in Employment Act and the Americans with Disabilities Act.
A version of this article appeared on Medscape.com.
‘Real-World’ Registry Study of Upadacitinib Supports Clinical Trial Data
, results from an analysis of registry data showed.
“We know from clinical trials that upadacitinib is effective, but we have very little real-world experience on its effectiveness,” presenting study author Melinda Gooderham, MD, medical director of the Skin Center for Dermatology in Peterborough, Ontario, Canada, said during a late-breaking abstract session at the Revolutionizing Atopic Dermatitis (RAD) Virtual Conference.
For the analysis, she and her coauthors evaluated the real-world clinical and patient-reported outcomes of 335 adults enrolled in the CorEvitas AD Registry from July 21, 2020, through Aug. 7, 2023. They included patients who were on upadacitinib for at least 4 weeks and persisted on the drug until the time of evaluation.
The CorEvitas AD Registry is a prospective, non-interventional registry of adults diagnosed with AD by a dermatologist or qualified dermatology practitioner. Outcomes measures included the proportion of patients who achieved skin clearance as defined by a Validated Investigators Global Assessment Scale for Atopic Dermatitis (vIGA) score of 0 or 1, an Eczema Area and Severity Index (EASI) score of 3 or less, a Peak Pruritus Numeric Rating Scale (PP-NRS) score of 0 or 1, Patient-Oriented Eczema Measure (POEM) scores of 0-2, Dermatology Life Quality Index (DLQI) scores of 0 or 1, or an Atopic Dermatitis Control Tool (ADCT) score of <7.
The researchers evaluated cross-sectional data from three different cohorts: data from the last registry visit (the overall cohort), data from a visit within 1 month to less than 5 months of upadacitinib initiation (the 1-5 months cohort), and data from a visit within 5-9 months following upadacitinib initiation (the 5-9 months cohort). They also conducted subgroup analyses of patients with prior use of biologics for AD (bio-experience) and those with no such history (bio-naive). Safety events were not assessed in this analysis.
The mean age of the 335 patients was 45.6 years, 51.6% were female, 64.2% were White, 64.2% were based in the United States and the rest were based in Canada. Most patients (70.8%) were treated with the 15-mg dose of upadacitinib. The median duration of treatment was 6.9 months. Slightly more than one-quarter of patients (28.1%) reported concomitant use of topical corticosteroids for AD, while 45.4% reported prior use of dupilumab and 6% reported prior use of tralokinumab.
Dr. Gooderham reported that 57.5% of patients in the total cohort total cohort achieved clear or almost clear skin (a vIGA-AD score of 0 or 1), with slight differences between the bio-naive (60.6%) and bio-experienced (54.1%) subgroups.
The other outcomes were similarly close between the 176 bio-naive and 159 bio-experienced patients. Specifically, 74.8% in the total cohort, 79.4% in the bio-naive subgroup, and 69.6% in the bio-experienced subgroup achieved an EASI score of 3 or less. In the measure of the worst itch in the past 24 hours, 45.3%, 47.7%, and 42.8% respectively achieved a PP-NRS of 0 or 1. In the patient-reported disease burden, 36.4%, 41%, and 31.4% achieved a POEM score of 0-2. In the quality of life measure, 39.8%, 42.8%, and 36.5% achieved a DLQI score of 0 or 1. In the measure of disease control, 69.3%, 70.5%, and 67.9% achieved an ADCT score of <7. In a combination of skin clearance and itch control, 40.9%, 43.2%, and 38.4% of the total cohort, bio-naive, and bio-experienced respectively achieved both an EASI score of 3 or less and a PP-NRS of 0 or 1.
The study outcomes were similar between the 1-5 months cohort and the 5-9 months cohort, but there was a trend toward more clearance the longer patients were on therapy.
“The findings suggest that low levels of disease severity are observed in patients on upadacitinib in a real-world setting,” Dr. Gooderham concluded. “This confirms what we see in the clinical trials.”
She disclosed that she is a consultant to, a speaker for, and/or a member of the advisory board for many pharmaceutical companies, including AbbVie.
, results from an analysis of registry data showed.
“We know from clinical trials that upadacitinib is effective, but we have very little real-world experience on its effectiveness,” presenting study author Melinda Gooderham, MD, medical director of the Skin Center for Dermatology in Peterborough, Ontario, Canada, said during a late-breaking abstract session at the Revolutionizing Atopic Dermatitis (RAD) Virtual Conference.
For the analysis, she and her coauthors evaluated the real-world clinical and patient-reported outcomes of 335 adults enrolled in the CorEvitas AD Registry from July 21, 2020, through Aug. 7, 2023. They included patients who were on upadacitinib for at least 4 weeks and persisted on the drug until the time of evaluation.
The CorEvitas AD Registry is a prospective, non-interventional registry of adults diagnosed with AD by a dermatologist or qualified dermatology practitioner. Outcomes measures included the proportion of patients who achieved skin clearance as defined by a Validated Investigators Global Assessment Scale for Atopic Dermatitis (vIGA) score of 0 or 1, an Eczema Area and Severity Index (EASI) score of 3 or less, a Peak Pruritus Numeric Rating Scale (PP-NRS) score of 0 or 1, Patient-Oriented Eczema Measure (POEM) scores of 0-2, Dermatology Life Quality Index (DLQI) scores of 0 or 1, or an Atopic Dermatitis Control Tool (ADCT) score of <7.
The researchers evaluated cross-sectional data from three different cohorts: data from the last registry visit (the overall cohort), data from a visit within 1 month to less than 5 months of upadacitinib initiation (the 1-5 months cohort), and data from a visit within 5-9 months following upadacitinib initiation (the 5-9 months cohort). They also conducted subgroup analyses of patients with prior use of biologics for AD (bio-experience) and those with no such history (bio-naive). Safety events were not assessed in this analysis.
The mean age of the 335 patients was 45.6 years, 51.6% were female, 64.2% were White, 64.2% were based in the United States and the rest were based in Canada. Most patients (70.8%) were treated with the 15-mg dose of upadacitinib. The median duration of treatment was 6.9 months. Slightly more than one-quarter of patients (28.1%) reported concomitant use of topical corticosteroids for AD, while 45.4% reported prior use of dupilumab and 6% reported prior use of tralokinumab.
Dr. Gooderham reported that 57.5% of patients in the total cohort total cohort achieved clear or almost clear skin (a vIGA-AD score of 0 or 1), with slight differences between the bio-naive (60.6%) and bio-experienced (54.1%) subgroups.
The other outcomes were similarly close between the 176 bio-naive and 159 bio-experienced patients. Specifically, 74.8% in the total cohort, 79.4% in the bio-naive subgroup, and 69.6% in the bio-experienced subgroup achieved an EASI score of 3 or less. In the measure of the worst itch in the past 24 hours, 45.3%, 47.7%, and 42.8% respectively achieved a PP-NRS of 0 or 1. In the patient-reported disease burden, 36.4%, 41%, and 31.4% achieved a POEM score of 0-2. In the quality of life measure, 39.8%, 42.8%, and 36.5% achieved a DLQI score of 0 or 1. In the measure of disease control, 69.3%, 70.5%, and 67.9% achieved an ADCT score of <7. In a combination of skin clearance and itch control, 40.9%, 43.2%, and 38.4% of the total cohort, bio-naive, and bio-experienced respectively achieved both an EASI score of 3 or less and a PP-NRS of 0 or 1.
The study outcomes were similar between the 1-5 months cohort and the 5-9 months cohort, but there was a trend toward more clearance the longer patients were on therapy.
“The findings suggest that low levels of disease severity are observed in patients on upadacitinib in a real-world setting,” Dr. Gooderham concluded. “This confirms what we see in the clinical trials.”
She disclosed that she is a consultant to, a speaker for, and/or a member of the advisory board for many pharmaceutical companies, including AbbVie.
, results from an analysis of registry data showed.
“We know from clinical trials that upadacitinib is effective, but we have very little real-world experience on its effectiveness,” presenting study author Melinda Gooderham, MD, medical director of the Skin Center for Dermatology in Peterborough, Ontario, Canada, said during a late-breaking abstract session at the Revolutionizing Atopic Dermatitis (RAD) Virtual Conference.
For the analysis, she and her coauthors evaluated the real-world clinical and patient-reported outcomes of 335 adults enrolled in the CorEvitas AD Registry from July 21, 2020, through Aug. 7, 2023. They included patients who were on upadacitinib for at least 4 weeks and persisted on the drug until the time of evaluation.
The CorEvitas AD Registry is a prospective, non-interventional registry of adults diagnosed with AD by a dermatologist or qualified dermatology practitioner. Outcomes measures included the proportion of patients who achieved skin clearance as defined by a Validated Investigators Global Assessment Scale for Atopic Dermatitis (vIGA) score of 0 or 1, an Eczema Area and Severity Index (EASI) score of 3 or less, a Peak Pruritus Numeric Rating Scale (PP-NRS) score of 0 or 1, Patient-Oriented Eczema Measure (POEM) scores of 0-2, Dermatology Life Quality Index (DLQI) scores of 0 or 1, or an Atopic Dermatitis Control Tool (ADCT) score of <7.
The researchers evaluated cross-sectional data from three different cohorts: data from the last registry visit (the overall cohort), data from a visit within 1 month to less than 5 months of upadacitinib initiation (the 1-5 months cohort), and data from a visit within 5-9 months following upadacitinib initiation (the 5-9 months cohort). They also conducted subgroup analyses of patients with prior use of biologics for AD (bio-experience) and those with no such history (bio-naive). Safety events were not assessed in this analysis.
The mean age of the 335 patients was 45.6 years, 51.6% were female, 64.2% were White, 64.2% were based in the United States and the rest were based in Canada. Most patients (70.8%) were treated with the 15-mg dose of upadacitinib. The median duration of treatment was 6.9 months. Slightly more than one-quarter of patients (28.1%) reported concomitant use of topical corticosteroids for AD, while 45.4% reported prior use of dupilumab and 6% reported prior use of tralokinumab.
Dr. Gooderham reported that 57.5% of patients in the total cohort total cohort achieved clear or almost clear skin (a vIGA-AD score of 0 or 1), with slight differences between the bio-naive (60.6%) and bio-experienced (54.1%) subgroups.
The other outcomes were similarly close between the 176 bio-naive and 159 bio-experienced patients. Specifically, 74.8% in the total cohort, 79.4% in the bio-naive subgroup, and 69.6% in the bio-experienced subgroup achieved an EASI score of 3 or less. In the measure of the worst itch in the past 24 hours, 45.3%, 47.7%, and 42.8% respectively achieved a PP-NRS of 0 or 1. In the patient-reported disease burden, 36.4%, 41%, and 31.4% achieved a POEM score of 0-2. In the quality of life measure, 39.8%, 42.8%, and 36.5% achieved a DLQI score of 0 or 1. In the measure of disease control, 69.3%, 70.5%, and 67.9% achieved an ADCT score of <7. In a combination of skin clearance and itch control, 40.9%, 43.2%, and 38.4% of the total cohort, bio-naive, and bio-experienced respectively achieved both an EASI score of 3 or less and a PP-NRS of 0 or 1.
The study outcomes were similar between the 1-5 months cohort and the 5-9 months cohort, but there was a trend toward more clearance the longer patients were on therapy.
“The findings suggest that low levels of disease severity are observed in patients on upadacitinib in a real-world setting,” Dr. Gooderham concluded. “This confirms what we see in the clinical trials.”
She disclosed that she is a consultant to, a speaker for, and/or a member of the advisory board for many pharmaceutical companies, including AbbVie.
FROM RAD 2023
What Makes Patients Vulnerable to Delusions of Parasitosis?
Delusions of parasitosis (DOP) affects mostly middle-aged women and has associations with renal failure and some medications, wrote corresponding author Colleen Reisz, MD, a dermatologist with the department of internal medicine at the University of Missouri–Kansas City School of Medicine, and her coauthors. The study was published online December 15, 2023, in the Journal of the American Academy of Dermatology.
“We hypothesize that vulnerability to DOP emerges when multiple factors combine, such as age, sex, medications, and changes in [drug] clearance capacity,” Dr. Reisz and her coauthors wrote. “Changes in health care, such as the dramatic increase in stimulant prescriptions and alternatives to opioids in pain management, may be contributing to off target drug effects on the brain.”
To test their hypothesis, the researchers conducted a case-control study of biometric and pharmaceutical data from 34 patients with DOP which they compared to an age-matched control group of 53 women presenting with a dermatitis above the clavicle from a general dermatology practice between 2012 and 2020. They de-identified the data and performed statistical analysis on variables that included biometric data and intake of pharmaceuticals and nutraceuticals. Polypharmacy was defined as five or more drugs.
Of the 34 patients with DOP, 27 were women with a mean age of 58 years and 7 were men with a mean age of 60 years. Dr. Reisz and her colleagues observed statistical significance between cases and controls in terms of polypharmacy (P = .011), attention-deficit/hyperactivity disorder medications (P < .001), selective serotonin reuptake inhibitors (P = .005), opioids (P = .003), and gabapentin (P = .003).
In other findings, half of DOP cases presented with samples of perceived parasitic material, and four associated the perceived infestation with a single emotion-laden event. This prompted the researchers “to consider that DOP may share mechanisms with fear conditioning and extinction,” they wrote. “Fear conditioning refers to the process of memory acquisition and extinction. This process is essential for survival and has been studied in posttraumatic stress disorder.”
They acknowledged certain limitations of the study, including its retrospective single-center design and the lack of control for factors such as socioeconomic background and level of education.
“Patients with DOP should undergo detailed drug histories and examination of clearance profiles, especially renal function,” the researchers concluded.
Evan A. Rieder, MD, a New York City–based dermatologist and psychiatrist who was asked to comment on the study, said that delusional infestation is one of the most difficult medical conditions to treat and study.
“Though the numbers of cases in this research letter are small, they are instructive in demonstrating a high burden of polypharmacy including psychostimulants, opioids, and SSRIs in such patients,” he told this news organization. “Dermatologists should be performing detailed drug histories, obtaining comprehensive lab work, and considering the effects of medications — both illicit and prescribed — on clinical presentations. While in many cases, delusional patients refuse to consent to psychopharmacologic medications (or treatment in general), the elimination or decrease in dose of certain problematic medications may be helpful in and of themselves.”
The researchers reported having no financial disclosures. Dr. Rieder disclosed that he is a consultant for AbbVie, L’Oréal, Pierre Fabre, Procter & Gamble, and Unilever.
Delusions of parasitosis (DOP) affects mostly middle-aged women and has associations with renal failure and some medications, wrote corresponding author Colleen Reisz, MD, a dermatologist with the department of internal medicine at the University of Missouri–Kansas City School of Medicine, and her coauthors. The study was published online December 15, 2023, in the Journal of the American Academy of Dermatology.
“We hypothesize that vulnerability to DOP emerges when multiple factors combine, such as age, sex, medications, and changes in [drug] clearance capacity,” Dr. Reisz and her coauthors wrote. “Changes in health care, such as the dramatic increase in stimulant prescriptions and alternatives to opioids in pain management, may be contributing to off target drug effects on the brain.”
To test their hypothesis, the researchers conducted a case-control study of biometric and pharmaceutical data from 34 patients with DOP which they compared to an age-matched control group of 53 women presenting with a dermatitis above the clavicle from a general dermatology practice between 2012 and 2020. They de-identified the data and performed statistical analysis on variables that included biometric data and intake of pharmaceuticals and nutraceuticals. Polypharmacy was defined as five or more drugs.
Of the 34 patients with DOP, 27 were women with a mean age of 58 years and 7 were men with a mean age of 60 years. Dr. Reisz and her colleagues observed statistical significance between cases and controls in terms of polypharmacy (P = .011), attention-deficit/hyperactivity disorder medications (P < .001), selective serotonin reuptake inhibitors (P = .005), opioids (P = .003), and gabapentin (P = .003).
In other findings, half of DOP cases presented with samples of perceived parasitic material, and four associated the perceived infestation with a single emotion-laden event. This prompted the researchers “to consider that DOP may share mechanisms with fear conditioning and extinction,” they wrote. “Fear conditioning refers to the process of memory acquisition and extinction. This process is essential for survival and has been studied in posttraumatic stress disorder.”
They acknowledged certain limitations of the study, including its retrospective single-center design and the lack of control for factors such as socioeconomic background and level of education.
“Patients with DOP should undergo detailed drug histories and examination of clearance profiles, especially renal function,” the researchers concluded.
Evan A. Rieder, MD, a New York City–based dermatologist and psychiatrist who was asked to comment on the study, said that delusional infestation is one of the most difficult medical conditions to treat and study.
“Though the numbers of cases in this research letter are small, they are instructive in demonstrating a high burden of polypharmacy including psychostimulants, opioids, and SSRIs in such patients,” he told this news organization. “Dermatologists should be performing detailed drug histories, obtaining comprehensive lab work, and considering the effects of medications — both illicit and prescribed — on clinical presentations. While in many cases, delusional patients refuse to consent to psychopharmacologic medications (or treatment in general), the elimination or decrease in dose of certain problematic medications may be helpful in and of themselves.”
The researchers reported having no financial disclosures. Dr. Rieder disclosed that he is a consultant for AbbVie, L’Oréal, Pierre Fabre, Procter & Gamble, and Unilever.
Delusions of parasitosis (DOP) affects mostly middle-aged women and has associations with renal failure and some medications, wrote corresponding author Colleen Reisz, MD, a dermatologist with the department of internal medicine at the University of Missouri–Kansas City School of Medicine, and her coauthors. The study was published online December 15, 2023, in the Journal of the American Academy of Dermatology.
“We hypothesize that vulnerability to DOP emerges when multiple factors combine, such as age, sex, medications, and changes in [drug] clearance capacity,” Dr. Reisz and her coauthors wrote. “Changes in health care, such as the dramatic increase in stimulant prescriptions and alternatives to opioids in pain management, may be contributing to off target drug effects on the brain.”
To test their hypothesis, the researchers conducted a case-control study of biometric and pharmaceutical data from 34 patients with DOP which they compared to an age-matched control group of 53 women presenting with a dermatitis above the clavicle from a general dermatology practice between 2012 and 2020. They de-identified the data and performed statistical analysis on variables that included biometric data and intake of pharmaceuticals and nutraceuticals. Polypharmacy was defined as five or more drugs.
Of the 34 patients with DOP, 27 were women with a mean age of 58 years and 7 were men with a mean age of 60 years. Dr. Reisz and her colleagues observed statistical significance between cases and controls in terms of polypharmacy (P = .011), attention-deficit/hyperactivity disorder medications (P < .001), selective serotonin reuptake inhibitors (P = .005), opioids (P = .003), and gabapentin (P = .003).
In other findings, half of DOP cases presented with samples of perceived parasitic material, and four associated the perceived infestation with a single emotion-laden event. This prompted the researchers “to consider that DOP may share mechanisms with fear conditioning and extinction,” they wrote. “Fear conditioning refers to the process of memory acquisition and extinction. This process is essential for survival and has been studied in posttraumatic stress disorder.”
They acknowledged certain limitations of the study, including its retrospective single-center design and the lack of control for factors such as socioeconomic background and level of education.
“Patients with DOP should undergo detailed drug histories and examination of clearance profiles, especially renal function,” the researchers concluded.
Evan A. Rieder, MD, a New York City–based dermatologist and psychiatrist who was asked to comment on the study, said that delusional infestation is one of the most difficult medical conditions to treat and study.
“Though the numbers of cases in this research letter are small, they are instructive in demonstrating a high burden of polypharmacy including psychostimulants, opioids, and SSRIs in such patients,” he told this news organization. “Dermatologists should be performing detailed drug histories, obtaining comprehensive lab work, and considering the effects of medications — both illicit and prescribed — on clinical presentations. While in many cases, delusional patients refuse to consent to psychopharmacologic medications (or treatment in general), the elimination or decrease in dose of certain problematic medications may be helpful in and of themselves.”
The researchers reported having no financial disclosures. Dr. Rieder disclosed that he is a consultant for AbbVie, L’Oréal, Pierre Fabre, Procter & Gamble, and Unilever.
FROM THE JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
From Mentee to Mentor
Mentoring is universally recognized as a key contributor to a successful career in academic medicine. Most of those who recently transitioned from fellow to faculty got to their current positions with the help of one or more mentors. While many will still need mentoring, coaching, and sponsoring, many are also eager to give back and wonder when and how to make that transition from mentee to mentor.
Dr. Lok: Senior Mentor’s Perspective
I (ASL) completed my hepatology fellowship training in London under Professor Dame Sheila Sherlock. I did not realize how fortunate I was until Dame Sheila’s retirement celebration (2 months before the end of my fellowship) when more than 200 former mentees flew in from all over the world to express their appreciation. Dame Sheila had always embraced all of us as part of the Sherlock family. I benefited tremendously not only from clinical and research training with Dame Sheila and her motherly love that continued well after I completed my fellowship but also the connections and support from my “siblings” who were the Who’s Who in Hepatology.
My transition from mentee to mentor occurred insidiously after my return to Hong Kong, coaching and collaborating with residents, fellows, and early career faculty in their research projects. A key tip I shared with them was the importance of establishing a robust database and sample repository — a vital element to success as a clinical investigator. Working in a busy clinical environment with no protected time and limited resources, we began by identifying clinical dilemmas that we faced in clinics each day and determined which ones were “solvable” if we dove deep. Through keen observations, protocolized clinical care, and robust data recording, we published in Gastroenterology one of the first prospective studies of hepatitis B reactivation in patients receiving chemotherapy, and it continues to be cited. Many principles in mentoring apply universally. Indeed, one of my most accomplished mentees in Hong Kong is a nephrologist with whom I continue to coauthor topics in UpToDate. This is an example of how mentee-mentor relationship can evolve and last, and how each can learn from the other to provide guidance on multi-disciplinary care of complex medical problems.
I became more involved in mentoring after I moved to the United States. I was first hired as Hepatology Program Director at Tulane University and then at the University of Michigan. These roles gave me a sense of responsibility not just to mentor one resident, fellow, or faculty on a research project but to have a holistic approach, providing the necessary guidance and support to help mentees make the best of their potentials and build successful careers, which in turn allows me to build a world-class program.
Over the years, I have mentored more than 60 trainees from all over the world, some of whom have now become division chiefs, department chairs, and chief medical officers of hospitals. Every mentor has a different style, and I had been criticized for being a “Tiger Mom.” I have mellowed over the years, and I hope I am no longer perceived as a “tiger,” though tough love is crucial in mentoring. I hope I am still considered a “mom,” because I see the role of a mentor as that of a parent, providing unconditional love and support with the only expectation that the mentees try to do their best to maximize their potentials and reach their goals. Mentoring is a time investment. It can be exhausting, frustrating, and heart-breaking. It is rarely recognized, and the time and effort rarely compensated. Thus, one should take on mentoring as a calling, a desire to pay it forward, and an understanding that problems can be solved only when generations of physicians and researchers continue to work on them.
A mentor, just like a parent, helps mentees recognize their potentials — passion, strengths, and weaknesses — and to set ambitious yet realistic goals. A very important role of a mentor is to help mentees determine their short- and long-term goals by guiding them to leverage their strengths and passion toward areas and niches that are important and attainable.
Each goal must be accompanied by a plan on how to get there based on resources available. Here is where tough love comes into play. Because there are so many distractions in life, mentees can veer off and be lost. Research projects (and life) never go exactly as planned, and it is difficult to keep going when projects hit a roadblock and papers and grants are rejected. A mentor must help mentees accept and learn from failures and persevere with renewed commitment or find an alternative path (when it is clear the original path is doomed). The most important role of the mentor is to continue to believe in the mentee. Project failure must not be equated to mentee failure though there are times when it is clear some mentees have their interests and talents in other areas. Helping mentees find an alternative path to success and fulfillment can be a blessing. Indeed, two of my mentees who were successful researchers during their early careers have now become successful chief medical officers of major hospitals. They are happy, and I am very proud of them. Times have changed, so my coauthor, who has been faculty for 3.5 years, will share his journey from mentee to mentor.
Dr. Chen: Early Mentor’s Perspective
I (VLC) completed training in 2020 and have mentored only people who are early in their careers, i.e., medical students, residents, and fellows. My transition from mentee to mentor was primarily motivated by gratitude to my past mentors. Watching my own former trainees move on to the next stages of their careers has been hugely fulfilling. It is important that mentee-mentor relationships are mutually beneficial, and I offer a few points to junior faculty considering taking on trainees as mentees.
Taking on a mentee is a commitment. Take it seriously. While a mentee’s success is ultimately their responsibility, mentors are implicitly agreeing to give them opportunities commensurate to their skills and motivation. If you are not in a position to offer such opportunities, do not accept mentees.
Mentorship takes time. Explaining and reviewing research protocols, reading abstract or manuscript drafts, and meeting with mentees to plan for next steps take more time than one might expect.
Understand what potential mentees want. Most trainees are looking for help making it to the next stage of their career (college to medical school, residency to fellowship, etc.) and need abstracts and/or publications to get there. When I work with residents applying to GI fellowship, the goal is that by the time fellowship applications are submitted (early in third year of residency), they have at a minimum presented an abstract at Digestive Diseases Week (DDW) in their second year and submitted an abstract to the American College of Gastroenterology and/or American Association for the Study of Liver Diseases meetings in their third year. This requires planning to ensure they start working early enough to meet conference abstract deadlines. In my opinion, it is reasonable to give the trainee a less ambitious project or a piece of a larger project (i.e., middle authorship on a paper).
By contrast, for trainees who are seriously interested in a research career, the goal is not superfluous abstracts. Rather it is crucial to ensure that the trainee leads a meaningful project that will be a steppingstone to their future career and/or provide preliminary data to support grant applications. Similarly, training in research methodology should be more rigorous for these mentees.
Recognize the limitations of your circumstances. Early-stage faculty often operate on a shoestring budget and little protected time. Even those with 50% or more protected research time and excellent nursing support will find that the time they spend on patient care extends far beyond the time spent in endoscopy units and clinics. Time management and discipline — including not getting bogged down on low-impact research studies — are essential skills.
Be (slightly) selfish. Make sure that you get something out of the mentee as well. Ask yourself:
Do I have work they can help me with? Avoid creating projects simply to give a trainee something to do. It is much better to have them work on a project that you want to do anyway.
How do the trainee’s skills fit in with the type of work that I do? A trainee with no background in statistics may not be able to conduct analyses but may be able to do chart reviews.
Consider “testing” a potential mentee by assigning a limited, straightforward task. If the mentee completes this quickly and to a high standard, then move on to progressively more important or high-stakes projects.
Set concrete and realistic expectations, keeping in mind that trainees have other commitments such as classes and clinical rotations.
Serving as a mentor to the next generation of gastroenterologists is a privilege that junior faculty should not take lightly, and an opportunity for a symbiotic relationship.
Dr. Chen and Dr. Lok are with the Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan. They have no financial conflicts related to this article.
Mentoring is universally recognized as a key contributor to a successful career in academic medicine. Most of those who recently transitioned from fellow to faculty got to their current positions with the help of one or more mentors. While many will still need mentoring, coaching, and sponsoring, many are also eager to give back and wonder when and how to make that transition from mentee to mentor.
Dr. Lok: Senior Mentor’s Perspective
I (ASL) completed my hepatology fellowship training in London under Professor Dame Sheila Sherlock. I did not realize how fortunate I was until Dame Sheila’s retirement celebration (2 months before the end of my fellowship) when more than 200 former mentees flew in from all over the world to express their appreciation. Dame Sheila had always embraced all of us as part of the Sherlock family. I benefited tremendously not only from clinical and research training with Dame Sheila and her motherly love that continued well after I completed my fellowship but also the connections and support from my “siblings” who were the Who’s Who in Hepatology.
My transition from mentee to mentor occurred insidiously after my return to Hong Kong, coaching and collaborating with residents, fellows, and early career faculty in their research projects. A key tip I shared with them was the importance of establishing a robust database and sample repository — a vital element to success as a clinical investigator. Working in a busy clinical environment with no protected time and limited resources, we began by identifying clinical dilemmas that we faced in clinics each day and determined which ones were “solvable” if we dove deep. Through keen observations, protocolized clinical care, and robust data recording, we published in Gastroenterology one of the first prospective studies of hepatitis B reactivation in patients receiving chemotherapy, and it continues to be cited. Many principles in mentoring apply universally. Indeed, one of my most accomplished mentees in Hong Kong is a nephrologist with whom I continue to coauthor topics in UpToDate. This is an example of how mentee-mentor relationship can evolve and last, and how each can learn from the other to provide guidance on multi-disciplinary care of complex medical problems.
I became more involved in mentoring after I moved to the United States. I was first hired as Hepatology Program Director at Tulane University and then at the University of Michigan. These roles gave me a sense of responsibility not just to mentor one resident, fellow, or faculty on a research project but to have a holistic approach, providing the necessary guidance and support to help mentees make the best of their potentials and build successful careers, which in turn allows me to build a world-class program.
Over the years, I have mentored more than 60 trainees from all over the world, some of whom have now become division chiefs, department chairs, and chief medical officers of hospitals. Every mentor has a different style, and I had been criticized for being a “Tiger Mom.” I have mellowed over the years, and I hope I am no longer perceived as a “tiger,” though tough love is crucial in mentoring. I hope I am still considered a “mom,” because I see the role of a mentor as that of a parent, providing unconditional love and support with the only expectation that the mentees try to do their best to maximize their potentials and reach their goals. Mentoring is a time investment. It can be exhausting, frustrating, and heart-breaking. It is rarely recognized, and the time and effort rarely compensated. Thus, one should take on mentoring as a calling, a desire to pay it forward, and an understanding that problems can be solved only when generations of physicians and researchers continue to work on them.
A mentor, just like a parent, helps mentees recognize their potentials — passion, strengths, and weaknesses — and to set ambitious yet realistic goals. A very important role of a mentor is to help mentees determine their short- and long-term goals by guiding them to leverage their strengths and passion toward areas and niches that are important and attainable.
Each goal must be accompanied by a plan on how to get there based on resources available. Here is where tough love comes into play. Because there are so many distractions in life, mentees can veer off and be lost. Research projects (and life) never go exactly as planned, and it is difficult to keep going when projects hit a roadblock and papers and grants are rejected. A mentor must help mentees accept and learn from failures and persevere with renewed commitment or find an alternative path (when it is clear the original path is doomed). The most important role of the mentor is to continue to believe in the mentee. Project failure must not be equated to mentee failure though there are times when it is clear some mentees have their interests and talents in other areas. Helping mentees find an alternative path to success and fulfillment can be a blessing. Indeed, two of my mentees who were successful researchers during their early careers have now become successful chief medical officers of major hospitals. They are happy, and I am very proud of them. Times have changed, so my coauthor, who has been faculty for 3.5 years, will share his journey from mentee to mentor.
Dr. Chen: Early Mentor’s Perspective
I (VLC) completed training in 2020 and have mentored only people who are early in their careers, i.e., medical students, residents, and fellows. My transition from mentee to mentor was primarily motivated by gratitude to my past mentors. Watching my own former trainees move on to the next stages of their careers has been hugely fulfilling. It is important that mentee-mentor relationships are mutually beneficial, and I offer a few points to junior faculty considering taking on trainees as mentees.
Taking on a mentee is a commitment. Take it seriously. While a mentee’s success is ultimately their responsibility, mentors are implicitly agreeing to give them opportunities commensurate to their skills and motivation. If you are not in a position to offer such opportunities, do not accept mentees.
Mentorship takes time. Explaining and reviewing research protocols, reading abstract or manuscript drafts, and meeting with mentees to plan for next steps take more time than one might expect.
Understand what potential mentees want. Most trainees are looking for help making it to the next stage of their career (college to medical school, residency to fellowship, etc.) and need abstracts and/or publications to get there. When I work with residents applying to GI fellowship, the goal is that by the time fellowship applications are submitted (early in third year of residency), they have at a minimum presented an abstract at Digestive Diseases Week (DDW) in their second year and submitted an abstract to the American College of Gastroenterology and/or American Association for the Study of Liver Diseases meetings in their third year. This requires planning to ensure they start working early enough to meet conference abstract deadlines. In my opinion, it is reasonable to give the trainee a less ambitious project or a piece of a larger project (i.e., middle authorship on a paper).
By contrast, for trainees who are seriously interested in a research career, the goal is not superfluous abstracts. Rather it is crucial to ensure that the trainee leads a meaningful project that will be a steppingstone to their future career and/or provide preliminary data to support grant applications. Similarly, training in research methodology should be more rigorous for these mentees.
Recognize the limitations of your circumstances. Early-stage faculty often operate on a shoestring budget and little protected time. Even those with 50% or more protected research time and excellent nursing support will find that the time they spend on patient care extends far beyond the time spent in endoscopy units and clinics. Time management and discipline — including not getting bogged down on low-impact research studies — are essential skills.
Be (slightly) selfish. Make sure that you get something out of the mentee as well. Ask yourself:
Do I have work they can help me with? Avoid creating projects simply to give a trainee something to do. It is much better to have them work on a project that you want to do anyway.
How do the trainee’s skills fit in with the type of work that I do? A trainee with no background in statistics may not be able to conduct analyses but may be able to do chart reviews.
Consider “testing” a potential mentee by assigning a limited, straightforward task. If the mentee completes this quickly and to a high standard, then move on to progressively more important or high-stakes projects.
Set concrete and realistic expectations, keeping in mind that trainees have other commitments such as classes and clinical rotations.
Serving as a mentor to the next generation of gastroenterologists is a privilege that junior faculty should not take lightly, and an opportunity for a symbiotic relationship.
Dr. Chen and Dr. Lok are with the Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan. They have no financial conflicts related to this article.
Mentoring is universally recognized as a key contributor to a successful career in academic medicine. Most of those who recently transitioned from fellow to faculty got to their current positions with the help of one or more mentors. While many will still need mentoring, coaching, and sponsoring, many are also eager to give back and wonder when and how to make that transition from mentee to mentor.
Dr. Lok: Senior Mentor’s Perspective
I (ASL) completed my hepatology fellowship training in London under Professor Dame Sheila Sherlock. I did not realize how fortunate I was until Dame Sheila’s retirement celebration (2 months before the end of my fellowship) when more than 200 former mentees flew in from all over the world to express their appreciation. Dame Sheila had always embraced all of us as part of the Sherlock family. I benefited tremendously not only from clinical and research training with Dame Sheila and her motherly love that continued well after I completed my fellowship but also the connections and support from my “siblings” who were the Who’s Who in Hepatology.
My transition from mentee to mentor occurred insidiously after my return to Hong Kong, coaching and collaborating with residents, fellows, and early career faculty in their research projects. A key tip I shared with them was the importance of establishing a robust database and sample repository — a vital element to success as a clinical investigator. Working in a busy clinical environment with no protected time and limited resources, we began by identifying clinical dilemmas that we faced in clinics each day and determined which ones were “solvable” if we dove deep. Through keen observations, protocolized clinical care, and robust data recording, we published in Gastroenterology one of the first prospective studies of hepatitis B reactivation in patients receiving chemotherapy, and it continues to be cited. Many principles in mentoring apply universally. Indeed, one of my most accomplished mentees in Hong Kong is a nephrologist with whom I continue to coauthor topics in UpToDate. This is an example of how mentee-mentor relationship can evolve and last, and how each can learn from the other to provide guidance on multi-disciplinary care of complex medical problems.
I became more involved in mentoring after I moved to the United States. I was first hired as Hepatology Program Director at Tulane University and then at the University of Michigan. These roles gave me a sense of responsibility not just to mentor one resident, fellow, or faculty on a research project but to have a holistic approach, providing the necessary guidance and support to help mentees make the best of their potentials and build successful careers, which in turn allows me to build a world-class program.
Over the years, I have mentored more than 60 trainees from all over the world, some of whom have now become division chiefs, department chairs, and chief medical officers of hospitals. Every mentor has a different style, and I had been criticized for being a “Tiger Mom.” I have mellowed over the years, and I hope I am no longer perceived as a “tiger,” though tough love is crucial in mentoring. I hope I am still considered a “mom,” because I see the role of a mentor as that of a parent, providing unconditional love and support with the only expectation that the mentees try to do their best to maximize their potentials and reach their goals. Mentoring is a time investment. It can be exhausting, frustrating, and heart-breaking. It is rarely recognized, and the time and effort rarely compensated. Thus, one should take on mentoring as a calling, a desire to pay it forward, and an understanding that problems can be solved only when generations of physicians and researchers continue to work on them.
A mentor, just like a parent, helps mentees recognize their potentials — passion, strengths, and weaknesses — and to set ambitious yet realistic goals. A very important role of a mentor is to help mentees determine their short- and long-term goals by guiding them to leverage their strengths and passion toward areas and niches that are important and attainable.
Each goal must be accompanied by a plan on how to get there based on resources available. Here is where tough love comes into play. Because there are so many distractions in life, mentees can veer off and be lost. Research projects (and life) never go exactly as planned, and it is difficult to keep going when projects hit a roadblock and papers and grants are rejected. A mentor must help mentees accept and learn from failures and persevere with renewed commitment or find an alternative path (when it is clear the original path is doomed). The most important role of the mentor is to continue to believe in the mentee. Project failure must not be equated to mentee failure though there are times when it is clear some mentees have their interests and talents in other areas. Helping mentees find an alternative path to success and fulfillment can be a blessing. Indeed, two of my mentees who were successful researchers during their early careers have now become successful chief medical officers of major hospitals. They are happy, and I am very proud of them. Times have changed, so my coauthor, who has been faculty for 3.5 years, will share his journey from mentee to mentor.
Dr. Chen: Early Mentor’s Perspective
I (VLC) completed training in 2020 and have mentored only people who are early in their careers, i.e., medical students, residents, and fellows. My transition from mentee to mentor was primarily motivated by gratitude to my past mentors. Watching my own former trainees move on to the next stages of their careers has been hugely fulfilling. It is important that mentee-mentor relationships are mutually beneficial, and I offer a few points to junior faculty considering taking on trainees as mentees.
Taking on a mentee is a commitment. Take it seriously. While a mentee’s success is ultimately their responsibility, mentors are implicitly agreeing to give them opportunities commensurate to their skills and motivation. If you are not in a position to offer such opportunities, do not accept mentees.
Mentorship takes time. Explaining and reviewing research protocols, reading abstract or manuscript drafts, and meeting with mentees to plan for next steps take more time than one might expect.
Understand what potential mentees want. Most trainees are looking for help making it to the next stage of their career (college to medical school, residency to fellowship, etc.) and need abstracts and/or publications to get there. When I work with residents applying to GI fellowship, the goal is that by the time fellowship applications are submitted (early in third year of residency), they have at a minimum presented an abstract at Digestive Diseases Week (DDW) in their second year and submitted an abstract to the American College of Gastroenterology and/or American Association for the Study of Liver Diseases meetings in their third year. This requires planning to ensure they start working early enough to meet conference abstract deadlines. In my opinion, it is reasonable to give the trainee a less ambitious project or a piece of a larger project (i.e., middle authorship on a paper).
By contrast, for trainees who are seriously interested in a research career, the goal is not superfluous abstracts. Rather it is crucial to ensure that the trainee leads a meaningful project that will be a steppingstone to their future career and/or provide preliminary data to support grant applications. Similarly, training in research methodology should be more rigorous for these mentees.
Recognize the limitations of your circumstances. Early-stage faculty often operate on a shoestring budget and little protected time. Even those with 50% or more protected research time and excellent nursing support will find that the time they spend on patient care extends far beyond the time spent in endoscopy units and clinics. Time management and discipline — including not getting bogged down on low-impact research studies — are essential skills.
Be (slightly) selfish. Make sure that you get something out of the mentee as well. Ask yourself:
Do I have work they can help me with? Avoid creating projects simply to give a trainee something to do. It is much better to have them work on a project that you want to do anyway.
How do the trainee’s skills fit in with the type of work that I do? A trainee with no background in statistics may not be able to conduct analyses but may be able to do chart reviews.
Consider “testing” a potential mentee by assigning a limited, straightforward task. If the mentee completes this quickly and to a high standard, then move on to progressively more important or high-stakes projects.
Set concrete and realistic expectations, keeping in mind that trainees have other commitments such as classes and clinical rotations.
Serving as a mentor to the next generation of gastroenterologists is a privilege that junior faculty should not take lightly, and an opportunity for a symbiotic relationship.
Dr. Chen and Dr. Lok are with the Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan. They have no financial conflicts related to this article.
FDA Approves Topical Gel For Wounds Associated With JEB and DEB
The FDA has approved a topical gel containing birch triterpenes for the treatment of partial thickness wounds in patients 6 months and older with junctional epidermolysis bullosa (JEB) and dystrophic epidermolysis bullosa (DEB).
The gel is marketed under the name Filsuvez. It is the first approved treatment for wounds associated with JEB and the second for patients with DEB, following the approval of Vyjuvek (Krystal Biotech), a topical gene therapy gel, in May 2023.
First developed by Amryt Pharma and intended for home use, Filsuvez is now marketed by Chiesi Global Rare Diseases, which acquired Amryt in January 2023. The gel is applied topically to the wound at each dressing change.
The approval of Filsuvez is based on results from the Efficacy and Safety Study of Oleogel-S10 in Epidermolysis Bullosa (EASE), a randomized, placebo-controlled study of 223 people, the largest-ever phase 3 clinical trial for the treatment of EB, according to the Chiesi news release. The gel was well tolerated and met the primary endpoint with statistical significance, with 41.3% of patients achieving first complete target wound closure within 45 days (compared with 28.9% on placebo).
“I am so excited to say that this is another hurdle cleared and milestone achieved for the EB Community,” Brett Kopelan, executive director at debra of America said in a blog post. “We are now on the road to being able to treat EB more effectively, and to make the worst disease you’ve never heard of chronic, but livable, by making use of multiple therapeutic options in conjunction with each other.”
The FDA has approved a topical gel containing birch triterpenes for the treatment of partial thickness wounds in patients 6 months and older with junctional epidermolysis bullosa (JEB) and dystrophic epidermolysis bullosa (DEB).
The gel is marketed under the name Filsuvez. It is the first approved treatment for wounds associated with JEB and the second for patients with DEB, following the approval of Vyjuvek (Krystal Biotech), a topical gene therapy gel, in May 2023.
First developed by Amryt Pharma and intended for home use, Filsuvez is now marketed by Chiesi Global Rare Diseases, which acquired Amryt in January 2023. The gel is applied topically to the wound at each dressing change.
The approval of Filsuvez is based on results from the Efficacy and Safety Study of Oleogel-S10 in Epidermolysis Bullosa (EASE), a randomized, placebo-controlled study of 223 people, the largest-ever phase 3 clinical trial for the treatment of EB, according to the Chiesi news release. The gel was well tolerated and met the primary endpoint with statistical significance, with 41.3% of patients achieving first complete target wound closure within 45 days (compared with 28.9% on placebo).
“I am so excited to say that this is another hurdle cleared and milestone achieved for the EB Community,” Brett Kopelan, executive director at debra of America said in a blog post. “We are now on the road to being able to treat EB more effectively, and to make the worst disease you’ve never heard of chronic, but livable, by making use of multiple therapeutic options in conjunction with each other.”
The FDA has approved a topical gel containing birch triterpenes for the treatment of partial thickness wounds in patients 6 months and older with junctional epidermolysis bullosa (JEB) and dystrophic epidermolysis bullosa (DEB).
The gel is marketed under the name Filsuvez. It is the first approved treatment for wounds associated with JEB and the second for patients with DEB, following the approval of Vyjuvek (Krystal Biotech), a topical gene therapy gel, in May 2023.
First developed by Amryt Pharma and intended for home use, Filsuvez is now marketed by Chiesi Global Rare Diseases, which acquired Amryt in January 2023. The gel is applied topically to the wound at each dressing change.
The approval of Filsuvez is based on results from the Efficacy and Safety Study of Oleogel-S10 in Epidermolysis Bullosa (EASE), a randomized, placebo-controlled study of 223 people, the largest-ever phase 3 clinical trial for the treatment of EB, according to the Chiesi news release. The gel was well tolerated and met the primary endpoint with statistical significance, with 41.3% of patients achieving first complete target wound closure within 45 days (compared with 28.9% on placebo).
“I am so excited to say that this is another hurdle cleared and milestone achieved for the EB Community,” Brett Kopelan, executive director at debra of America said in a blog post. “We are now on the road to being able to treat EB more effectively, and to make the worst disease you’ve never heard of chronic, but livable, by making use of multiple therapeutic options in conjunction with each other.”
SCLC Imaging
DEI and C
You’re familiar with DIY and DUI, but what associations do the initials DEI trigger in your thought processor? Your college is probably influenced by it. So is your medical school, as are many of the businesses whose advertisements bombard you on television and the internet. Your professional association is definitely involved with it.
In the words of one newspaper columnist, DEI is an “ideological framework” whose most recognizable buzz words are “diversity,” “equity,” and “inclusion.” In the case of the American Academy of Pediatrics (AAP), DEI has taken the form of a hiring philosophy that accepts and respects its responsibility to create a workplace “where each person can fully contribute to the shared mission without discrimination or intimidation and each person is respected, supported, and provided the equal opportunity, regardless of race, ethnicity, ancestry, national origin, religion, gender, marital status, sexual orientation, gender identity, or expression age, veteran status, immigration status, or disability.”.
As an organization representing its members, the AAP has issued a statement: “Celebrating the diversity of children and families and promoting nurturing, inclusive environments means actively opposing intolerance, bigotry, bias and discrimination” Further, ”. Included in its recommendations to fulfill this commitment are efforts to diversify the pediatric workforce and eliminate race-based medicine.
For the AAP, its commitment to diversity, equity, and inclusion seems to be a good fit. The first line of its mission statement — “to attain optimal physical, mental, and social health and well-being for all infants, children, adolescents and young adults” — is well focused and one that its members can agree upon. However, we are beginning to see and hear that on some college and university campuses DEI has worn out its welcome.
In academia, the decision to include a broad mix of students and faculty with diverse backgrounds and at the same time provide opportunities equitably has hit some serious bumps in the road. It’s unclear how much the chaos in the Middle East is to blame, However, for several years there have been unfortunate campus incidents when the invitation of controversial guest speakers has laid bare the widely different interpretations of exactly what “free speech” means.
From its hazy inception, DEI has been missing one key ingredient — commonality. If we are going to actively seek to include individuals from a variety of backgrounds, encourage them to celebrate their diversity, and offer them equitable opportunities, then at the same time we must make it clear that our overriding goal is to seek and encourage the civil discussion of what we all have in common. Neglecting this additional step of promoting commonality is a grave mistake.
One mustn’t be surprised that a group of individuals from diverse backgrounds will have differing opinions. Finding common ground will predictably be a challenge, but it can be done. It requires compromise and a commitment to civil discussion. Regrettably, DEI as a framework places so much emphasis on the individual and diversity that the critical concept of commonality has been lost. Ironically, true inclusion and equity can’t occur without a reverence for commonality.
The AAP has done a good job of folding DEI into fulfilling the first sentence of its mission statement. However, it must not lose sight of the critical ingredient of commonality as it seeks to “support the professional needs of its members” (the second sentence of its mission). Despite a general agreement on the goal of providing care for all children, there are differences of opinion among its members when it comes to some of the details. The confusing topic of gender-affirmative care comes to mind. I am confident that as a group of thoughtful professionals, even in the face of wide differences, we can see the way to civil and productive discussions in the search for commonality.
Dr. Wilkoff practiced primary care pediatrics in Brunswick, Maine, for nearly 40 years. He has authored several books on behavioral pediatrics, including “How to Say No to Your Toddler.” Other than a Littman stethoscope he accepted as a first-year medical student in 1966, Dr. Wilkoff reports having nothing to disclose. Email him at [email protected].
You’re familiar with DIY and DUI, but what associations do the initials DEI trigger in your thought processor? Your college is probably influenced by it. So is your medical school, as are many of the businesses whose advertisements bombard you on television and the internet. Your professional association is definitely involved with it.
In the words of one newspaper columnist, DEI is an “ideological framework” whose most recognizable buzz words are “diversity,” “equity,” and “inclusion.” In the case of the American Academy of Pediatrics (AAP), DEI has taken the form of a hiring philosophy that accepts and respects its responsibility to create a workplace “where each person can fully contribute to the shared mission without discrimination or intimidation and each person is respected, supported, and provided the equal opportunity, regardless of race, ethnicity, ancestry, national origin, religion, gender, marital status, sexual orientation, gender identity, or expression age, veteran status, immigration status, or disability.”.
As an organization representing its members, the AAP has issued a statement: “Celebrating the diversity of children and families and promoting nurturing, inclusive environments means actively opposing intolerance, bigotry, bias and discrimination” Further, ”. Included in its recommendations to fulfill this commitment are efforts to diversify the pediatric workforce and eliminate race-based medicine.
For the AAP, its commitment to diversity, equity, and inclusion seems to be a good fit. The first line of its mission statement — “to attain optimal physical, mental, and social health and well-being for all infants, children, adolescents and young adults” — is well focused and one that its members can agree upon. However, we are beginning to see and hear that on some college and university campuses DEI has worn out its welcome.
In academia, the decision to include a broad mix of students and faculty with diverse backgrounds and at the same time provide opportunities equitably has hit some serious bumps in the road. It’s unclear how much the chaos in the Middle East is to blame, However, for several years there have been unfortunate campus incidents when the invitation of controversial guest speakers has laid bare the widely different interpretations of exactly what “free speech” means.
From its hazy inception, DEI has been missing one key ingredient — commonality. If we are going to actively seek to include individuals from a variety of backgrounds, encourage them to celebrate their diversity, and offer them equitable opportunities, then at the same time we must make it clear that our overriding goal is to seek and encourage the civil discussion of what we all have in common. Neglecting this additional step of promoting commonality is a grave mistake.
One mustn’t be surprised that a group of individuals from diverse backgrounds will have differing opinions. Finding common ground will predictably be a challenge, but it can be done. It requires compromise and a commitment to civil discussion. Regrettably, DEI as a framework places so much emphasis on the individual and diversity that the critical concept of commonality has been lost. Ironically, true inclusion and equity can’t occur without a reverence for commonality.
The AAP has done a good job of folding DEI into fulfilling the first sentence of its mission statement. However, it must not lose sight of the critical ingredient of commonality as it seeks to “support the professional needs of its members” (the second sentence of its mission). Despite a general agreement on the goal of providing care for all children, there are differences of opinion among its members when it comes to some of the details. The confusing topic of gender-affirmative care comes to mind. I am confident that as a group of thoughtful professionals, even in the face of wide differences, we can see the way to civil and productive discussions in the search for commonality.
Dr. Wilkoff practiced primary care pediatrics in Brunswick, Maine, for nearly 40 years. He has authored several books on behavioral pediatrics, including “How to Say No to Your Toddler.” Other than a Littman stethoscope he accepted as a first-year medical student in 1966, Dr. Wilkoff reports having nothing to disclose. Email him at [email protected].
You’re familiar with DIY and DUI, but what associations do the initials DEI trigger in your thought processor? Your college is probably influenced by it. So is your medical school, as are many of the businesses whose advertisements bombard you on television and the internet. Your professional association is definitely involved with it.
In the words of one newspaper columnist, DEI is an “ideological framework” whose most recognizable buzz words are “diversity,” “equity,” and “inclusion.” In the case of the American Academy of Pediatrics (AAP), DEI has taken the form of a hiring philosophy that accepts and respects its responsibility to create a workplace “where each person can fully contribute to the shared mission without discrimination or intimidation and each person is respected, supported, and provided the equal opportunity, regardless of race, ethnicity, ancestry, national origin, religion, gender, marital status, sexual orientation, gender identity, or expression age, veteran status, immigration status, or disability.”.
As an organization representing its members, the AAP has issued a statement: “Celebrating the diversity of children and families and promoting nurturing, inclusive environments means actively opposing intolerance, bigotry, bias and discrimination” Further, ”. Included in its recommendations to fulfill this commitment are efforts to diversify the pediatric workforce and eliminate race-based medicine.
For the AAP, its commitment to diversity, equity, and inclusion seems to be a good fit. The first line of its mission statement — “to attain optimal physical, mental, and social health and well-being for all infants, children, adolescents and young adults” — is well focused and one that its members can agree upon. However, we are beginning to see and hear that on some college and university campuses DEI has worn out its welcome.
In academia, the decision to include a broad mix of students and faculty with diverse backgrounds and at the same time provide opportunities equitably has hit some serious bumps in the road. It’s unclear how much the chaos in the Middle East is to blame, However, for several years there have been unfortunate campus incidents when the invitation of controversial guest speakers has laid bare the widely different interpretations of exactly what “free speech” means.
From its hazy inception, DEI has been missing one key ingredient — commonality. If we are going to actively seek to include individuals from a variety of backgrounds, encourage them to celebrate their diversity, and offer them equitable opportunities, then at the same time we must make it clear that our overriding goal is to seek and encourage the civil discussion of what we all have in common. Neglecting this additional step of promoting commonality is a grave mistake.
One mustn’t be surprised that a group of individuals from diverse backgrounds will have differing opinions. Finding common ground will predictably be a challenge, but it can be done. It requires compromise and a commitment to civil discussion. Regrettably, DEI as a framework places so much emphasis on the individual and diversity that the critical concept of commonality has been lost. Ironically, true inclusion and equity can’t occur without a reverence for commonality.
The AAP has done a good job of folding DEI into fulfilling the first sentence of its mission statement. However, it must not lose sight of the critical ingredient of commonality as it seeks to “support the professional needs of its members” (the second sentence of its mission). Despite a general agreement on the goal of providing care for all children, there are differences of opinion among its members when it comes to some of the details. The confusing topic of gender-affirmative care comes to mind. I am confident that as a group of thoughtful professionals, even in the face of wide differences, we can see the way to civil and productive discussions in the search for commonality.
Dr. Wilkoff practiced primary care pediatrics in Brunswick, Maine, for nearly 40 years. He has authored several books on behavioral pediatrics, including “How to Say No to Your Toddler.” Other than a Littman stethoscope he accepted as a first-year medical student in 1966, Dr. Wilkoff reports having nothing to disclose. Email him at [email protected].
Lower olanzapine dose just as effective for chemotherapy-induced nausea, vomiting
SAN ANTONIO —
Although it’s highly effective in combination with standard antiemetic therapy, olanzapine at the standard dose of 10 mg makes people too drowsy. “This has prevented its widespread use in clinical practice,” medical oncologist Jyoti Bajpai, DM, of Tata Memorial Cancer Centre, Mumbai, India, explained at the San Antonio Breast Cancer Symposium.
She and her colleagues had a simple idea: Reduce the dose to 2.5 mg instead of 10 mg to prevent the problem. In a randomized trial with 267 patients that Dr. Bajpai presented at the meeting, they found that the lower dose was just as effective for nausea and vomiting prophylaxis, and it greatly reduced daytime somnolence.
“This merits consideration as an antiemetic regimen of choice for highly emetogenic chemotherapy.” The findings are “practice changing,” Dr. Bajpai, the lead investigator, said.
Laura Huppert, MD, a breast oncologist at the University of California, San Francisco, wasn’t surprised by the finding.
She said she and her colleagues at UCSF use a lot of olanzapine for nausea and vomiting prophylaxis. Like the team in India, they have found that 2.5 mg is effective and causes far less sleepiness. Some patients require 5 mg, but the full 10-mg dose is rarely needed.
Although the approach is familiar at UCSF, Dr. Huppert said she doesn’t think a lot of oncologists outside of academic centers know that olanzapine is “really helpful” and that “you don’t need a high dose.” It’s “a very good clinical pearl” and “definitely a new message for some,” she said in an interview.
Over 90% of the subjects in the study were women with breast cancer. Other cancers included sarcoma, germ cell tumors, and head and neck cancer. Subjects were scheduled for their first chemotherapy session with anthracycline-cyclophosphamide and high-dose cisplatin.
The trial randomized 135 patients to 10 mg of olanzapine and 132 to 2.5mg for 5 days, starting the day of their session. They were also on standard triple-antiemetic therapy (selective serotonin receptor (5-HT3) antagonist, neurokinin-1 receptor antagonist, and single-dose dexamethasone).
There were no significant differences between the two arms regarding nausea and vomiting, which patients tracked in daily journals using symptom severity and visual analog scales.
For instance, 44.7% in the 2.5-mg arm and 43.7% in the 10-mg arm reported no vomiting, no use of rescue medications, and no or only mild nausea (P = .87). Results were similar in the first 24 hours as well as on subsequent days.
There was also no difference in the proportion of patients who did have an emetic episode or needed rescue medication: 49.2% in the 2.5-mg arm versus 48.9% with 10 mg (P = .954).
Where the two groups split was on the incidence of daytime somnolence, which was reported by 65.2% of patients in the low-dose arm but 89.6% in the standard-dose group (P < .001). During the first 24 hours, 4.5% of low-dose patients reported severe somnolence versus 40% with 10-mg dosing (P < .001).
The overall incidence declined over the remaining study days, but the differences between the two groups were comparable. On day 5, for instance, 0.8% of low-dose patients but 8.1% of standard-dose patients reported severe somnolence (P = .004).
Low-dose patients also reported less appetite suppression.
The work was supported by the Progressive Ladies Welfare Association. Dr. Bajpai didn’t have any disclosures. Dr. Huppert is an adviser for AstraZeneca.
SAN ANTONIO —
Although it’s highly effective in combination with standard antiemetic therapy, olanzapine at the standard dose of 10 mg makes people too drowsy. “This has prevented its widespread use in clinical practice,” medical oncologist Jyoti Bajpai, DM, of Tata Memorial Cancer Centre, Mumbai, India, explained at the San Antonio Breast Cancer Symposium.
She and her colleagues had a simple idea: Reduce the dose to 2.5 mg instead of 10 mg to prevent the problem. In a randomized trial with 267 patients that Dr. Bajpai presented at the meeting, they found that the lower dose was just as effective for nausea and vomiting prophylaxis, and it greatly reduced daytime somnolence.
“This merits consideration as an antiemetic regimen of choice for highly emetogenic chemotherapy.” The findings are “practice changing,” Dr. Bajpai, the lead investigator, said.
Laura Huppert, MD, a breast oncologist at the University of California, San Francisco, wasn’t surprised by the finding.
She said she and her colleagues at UCSF use a lot of olanzapine for nausea and vomiting prophylaxis. Like the team in India, they have found that 2.5 mg is effective and causes far less sleepiness. Some patients require 5 mg, but the full 10-mg dose is rarely needed.
Although the approach is familiar at UCSF, Dr. Huppert said she doesn’t think a lot of oncologists outside of academic centers know that olanzapine is “really helpful” and that “you don’t need a high dose.” It’s “a very good clinical pearl” and “definitely a new message for some,” she said in an interview.
Over 90% of the subjects in the study were women with breast cancer. Other cancers included sarcoma, germ cell tumors, and head and neck cancer. Subjects were scheduled for their first chemotherapy session with anthracycline-cyclophosphamide and high-dose cisplatin.
The trial randomized 135 patients to 10 mg of olanzapine and 132 to 2.5mg for 5 days, starting the day of their session. They were also on standard triple-antiemetic therapy (selective serotonin receptor (5-HT3) antagonist, neurokinin-1 receptor antagonist, and single-dose dexamethasone).
There were no significant differences between the two arms regarding nausea and vomiting, which patients tracked in daily journals using symptom severity and visual analog scales.
For instance, 44.7% in the 2.5-mg arm and 43.7% in the 10-mg arm reported no vomiting, no use of rescue medications, and no or only mild nausea (P = .87). Results were similar in the first 24 hours as well as on subsequent days.
There was also no difference in the proportion of patients who did have an emetic episode or needed rescue medication: 49.2% in the 2.5-mg arm versus 48.9% with 10 mg (P = .954).
Where the two groups split was on the incidence of daytime somnolence, which was reported by 65.2% of patients in the low-dose arm but 89.6% in the standard-dose group (P < .001). During the first 24 hours, 4.5% of low-dose patients reported severe somnolence versus 40% with 10-mg dosing (P < .001).
The overall incidence declined over the remaining study days, but the differences between the two groups were comparable. On day 5, for instance, 0.8% of low-dose patients but 8.1% of standard-dose patients reported severe somnolence (P = .004).
Low-dose patients also reported less appetite suppression.
The work was supported by the Progressive Ladies Welfare Association. Dr. Bajpai didn’t have any disclosures. Dr. Huppert is an adviser for AstraZeneca.
SAN ANTONIO —
Although it’s highly effective in combination with standard antiemetic therapy, olanzapine at the standard dose of 10 mg makes people too drowsy. “This has prevented its widespread use in clinical practice,” medical oncologist Jyoti Bajpai, DM, of Tata Memorial Cancer Centre, Mumbai, India, explained at the San Antonio Breast Cancer Symposium.
She and her colleagues had a simple idea: Reduce the dose to 2.5 mg instead of 10 mg to prevent the problem. In a randomized trial with 267 patients that Dr. Bajpai presented at the meeting, they found that the lower dose was just as effective for nausea and vomiting prophylaxis, and it greatly reduced daytime somnolence.
“This merits consideration as an antiemetic regimen of choice for highly emetogenic chemotherapy.” The findings are “practice changing,” Dr. Bajpai, the lead investigator, said.
Laura Huppert, MD, a breast oncologist at the University of California, San Francisco, wasn’t surprised by the finding.
She said she and her colleagues at UCSF use a lot of olanzapine for nausea and vomiting prophylaxis. Like the team in India, they have found that 2.5 mg is effective and causes far less sleepiness. Some patients require 5 mg, but the full 10-mg dose is rarely needed.
Although the approach is familiar at UCSF, Dr. Huppert said she doesn’t think a lot of oncologists outside of academic centers know that olanzapine is “really helpful” and that “you don’t need a high dose.” It’s “a very good clinical pearl” and “definitely a new message for some,” she said in an interview.
Over 90% of the subjects in the study were women with breast cancer. Other cancers included sarcoma, germ cell tumors, and head and neck cancer. Subjects were scheduled for their first chemotherapy session with anthracycline-cyclophosphamide and high-dose cisplatin.
The trial randomized 135 patients to 10 mg of olanzapine and 132 to 2.5mg for 5 days, starting the day of their session. They were also on standard triple-antiemetic therapy (selective serotonin receptor (5-HT3) antagonist, neurokinin-1 receptor antagonist, and single-dose dexamethasone).
There were no significant differences between the two arms regarding nausea and vomiting, which patients tracked in daily journals using symptom severity and visual analog scales.
For instance, 44.7% in the 2.5-mg arm and 43.7% in the 10-mg arm reported no vomiting, no use of rescue medications, and no or only mild nausea (P = .87). Results were similar in the first 24 hours as well as on subsequent days.
There was also no difference in the proportion of patients who did have an emetic episode or needed rescue medication: 49.2% in the 2.5-mg arm versus 48.9% with 10 mg (P = .954).
Where the two groups split was on the incidence of daytime somnolence, which was reported by 65.2% of patients in the low-dose arm but 89.6% in the standard-dose group (P < .001). During the first 24 hours, 4.5% of low-dose patients reported severe somnolence versus 40% with 10-mg dosing (P < .001).
The overall incidence declined over the remaining study days, but the differences between the two groups were comparable. On day 5, for instance, 0.8% of low-dose patients but 8.1% of standard-dose patients reported severe somnolence (P = .004).
Low-dose patients also reported less appetite suppression.
The work was supported by the Progressive Ladies Welfare Association. Dr. Bajpai didn’t have any disclosures. Dr. Huppert is an adviser for AstraZeneca.
AT SABCS 2023
PsA Imaging
COVID Strain JN.1 Is Now a ‘Variant of Interest,’ WHO Says
the global health agency has announced.
JN.1 was previously grouped with its relative, BA.2.86, but has increased so much in the past 4 weeks that the WHO moved it to standalone status, according to a summary published by the agency. The prevalence of JN.1 worldwide jumped from 3% for the week ending November 5 to 27% for the week ending December 3. During that same period, JN.1 rose from 1% to 66% of cases in the Western Pacific, which stretches across 37 countries, from China and Mongolia to Australia and New Zealand.
In the United States, JN.1 has been increasing rapidly. The variant accounted for an estimated 21% of cases for the 2-week period ending December 9, up from 8% during the 2 weeks prior.
SARS-CoV-2 is the virus that causes COVID, and like other viruses, it evolves over time, sometimes changing how the virus affects people or how well existing treatments and vaccines work against it.
The WHO and CDC have said the current COVID vaccine appears to protect people against severe symptoms due to JN.1, and the WHO called the rising variant’s public health risk “low.”
“As we observe the rise of the JN.1 variant, it’s important to note that while it may be spreading more widely, there is currently no significant evidence suggesting it is more severe or that it poses a substantial public health risk,” John Brownstein, PhD, chief innovation officer at Boston Children’s Hospital, told ABC News.
In its recent risk analysis, the WHO did acknowledge that it’s not certain whether JN.1 has a higher risk of evading immunity or causing more severe symptoms than other strains. The WHO advised countries to further study how much JN.1 can evade existing antibodies and whether the variant results in more severe disease.
The latest CDC data show that 11% of COVID tests reported to the agency are positive, and 23,432 people were hospitalized with severe symptoms within a 7-day period. The CDC urgently asked people to get vaccinated against respiratory illnesses like the flu and COVID-19 ahead of the holidays as cases rise nationwide.
“Getting vaccinated now can help prevent hospitalizations and save lives,” the agency advised.
A version of this article originally appeared on WebMD.com.
the global health agency has announced.
JN.1 was previously grouped with its relative, BA.2.86, but has increased so much in the past 4 weeks that the WHO moved it to standalone status, according to a summary published by the agency. The prevalence of JN.1 worldwide jumped from 3% for the week ending November 5 to 27% for the week ending December 3. During that same period, JN.1 rose from 1% to 66% of cases in the Western Pacific, which stretches across 37 countries, from China and Mongolia to Australia and New Zealand.
In the United States, JN.1 has been increasing rapidly. The variant accounted for an estimated 21% of cases for the 2-week period ending December 9, up from 8% during the 2 weeks prior.
SARS-CoV-2 is the virus that causes COVID, and like other viruses, it evolves over time, sometimes changing how the virus affects people or how well existing treatments and vaccines work against it.
The WHO and CDC have said the current COVID vaccine appears to protect people against severe symptoms due to JN.1, and the WHO called the rising variant’s public health risk “low.”
“As we observe the rise of the JN.1 variant, it’s important to note that while it may be spreading more widely, there is currently no significant evidence suggesting it is more severe or that it poses a substantial public health risk,” John Brownstein, PhD, chief innovation officer at Boston Children’s Hospital, told ABC News.
In its recent risk analysis, the WHO did acknowledge that it’s not certain whether JN.1 has a higher risk of evading immunity or causing more severe symptoms than other strains. The WHO advised countries to further study how much JN.1 can evade existing antibodies and whether the variant results in more severe disease.
The latest CDC data show that 11% of COVID tests reported to the agency are positive, and 23,432 people were hospitalized with severe symptoms within a 7-day period. The CDC urgently asked people to get vaccinated against respiratory illnesses like the flu and COVID-19 ahead of the holidays as cases rise nationwide.
“Getting vaccinated now can help prevent hospitalizations and save lives,” the agency advised.
A version of this article originally appeared on WebMD.com.
the global health agency has announced.
JN.1 was previously grouped with its relative, BA.2.86, but has increased so much in the past 4 weeks that the WHO moved it to standalone status, according to a summary published by the agency. The prevalence of JN.1 worldwide jumped from 3% for the week ending November 5 to 27% for the week ending December 3. During that same period, JN.1 rose from 1% to 66% of cases in the Western Pacific, which stretches across 37 countries, from China and Mongolia to Australia and New Zealand.
In the United States, JN.1 has been increasing rapidly. The variant accounted for an estimated 21% of cases for the 2-week period ending December 9, up from 8% during the 2 weeks prior.
SARS-CoV-2 is the virus that causes COVID, and like other viruses, it evolves over time, sometimes changing how the virus affects people or how well existing treatments and vaccines work against it.
The WHO and CDC have said the current COVID vaccine appears to protect people against severe symptoms due to JN.1, and the WHO called the rising variant’s public health risk “low.”
“As we observe the rise of the JN.1 variant, it’s important to note that while it may be spreading more widely, there is currently no significant evidence suggesting it is more severe or that it poses a substantial public health risk,” John Brownstein, PhD, chief innovation officer at Boston Children’s Hospital, told ABC News.
In its recent risk analysis, the WHO did acknowledge that it’s not certain whether JN.1 has a higher risk of evading immunity or causing more severe symptoms than other strains. The WHO advised countries to further study how much JN.1 can evade existing antibodies and whether the variant results in more severe disease.
The latest CDC data show that 11% of COVID tests reported to the agency are positive, and 23,432 people were hospitalized with severe symptoms within a 7-day period. The CDC urgently asked people to get vaccinated against respiratory illnesses like the flu and COVID-19 ahead of the holidays as cases rise nationwide.
“Getting vaccinated now can help prevent hospitalizations and save lives,” the agency advised.
A version of this article originally appeared on WebMD.com.