“A good understanding of the diverse veteran populations is imperative if the VA is to genuinely resolve the inequities for those at high risk and with the most need,” says the introduction to the first-ever National Veteran Health Equity Report. The report, which contains demographic information on veterans who received VHA care in Fiscal Year (FY) 2013, is designed to provide that comparative information on minorities, women, and other veteran groups. For example:

• Although women represented only about 7% of patients in FY2013, their numbers in VHA have more than doubled since 2000—140% growth, far outstripping the 63% growth among men over the same period;
• In FY2013, 46% of veterans were aged ≥ 65 years;
• More than one-third of veterans lived in rural areas;
• Almost one-half of VHA patients had a service-connected disability. All racial/ethnic minority patient groups, compared with whites, were more likely to have a service-connected disability;

• A higher proportion of women had a service-connected disability, and women are twice as likely to be diagnosed with depression;
• Overall, 33% of VHA patients had ≥ 1 mental health diagnoses. Women and blacks/African Americans were “over-represented” among patients diagnosed with serious mental illness;

• Veterans with serious mental illness also had higher diagnosis rates for musculoskeletal disorders (60% vs 43%) and gastrointestinal conditions (48% vs 30%). In fact, among the top 20 diagnosed conditions, rates for the SMI group exceeded that for the veterans with no mental health diagnosis for 17 conditions by a margin of > 10% for 7. The largest disparities were in tobacco use disorder, psychosocial factors, spine disorders, and housing insufficiency; and
• The only condition in which the diagnosed rate in a racial/ethnic group exceeded that for whites by a margin of 10% was PTSD, diagnosed in 21% of American Indian/Alaska Natives, versus 11% of whites.

Although the report targeted  6 million veterans accessing VA care in FY13, the estimated number of living veterans is about 22 million. It is a “starting place,” the developers promise. Next iterations will continue to evolve to meet the unique needs of diverse veterans.

“A good understanding of the diverse veteran populations is imperative if the VA is to genuinely resolve the inequities for those at high risk and with the most need,” says the introduction to the first-ever National Veteran Health Equity Report. The report, which contains demographic information on veterans who received VHA care in Fiscal Year (FY) 2013, is designed to provide that comparative information on minorities, women, and other veteran groups. For example:

• Although women represented only about 7% of patients in FY2013, their numbers in VHA have more than doubled since 2000—140% growth, far outstripping the 63% growth among men over the same period;
• In FY2013, 46% of veterans were aged ≥ 65 years;
• More than one-third of veterans lived in rural areas;
• Almost one-half of VHA patients had a service-connected disability. All racial/ethnic minority patient groups, compared with whites, were more likely to have a service-connected disability;

• A higher proportion of women had a service-connected disability, and women are twice as likely to be diagnosed with depression;
• Overall, 33% of VHA patients had ≥ 1 mental health diagnoses. Women and blacks/African Americans were “over-represented” among patients diagnosed with serious mental illness;

• Veterans with serious mental illness also had higher diagnosis rates for musculoskeletal disorders (60% vs 43%) and gastrointestinal conditions (48% vs 30%). In fact, among the top 20 diagnosed conditions, rates for the SMI group exceeded that for the veterans with no mental health diagnosis for 17 conditions by a margin of > 10% for 7. The largest disparities were in tobacco use disorder, psychosocial factors, spine disorders, and housing insufficiency; and
• The only condition in which the diagnosed rate in a racial/ethnic group exceeded that for whites by a margin of 10% was PTSD, diagnosed in 21% of American Indian/Alaska Natives, versus 11% of whites.

Although the report targeted  6 million veterans accessing VA care in FY13, the estimated number of living veterans is about 22 million. It is a “starting place,” the developers promise. Next iterations will continue to evolve to meet the unique needs of diverse veterans.

“A good understanding of the diverse veteran populations is imperative if the VA is to genuinely resolve the inequities for those at high risk and with the most need,” says the introduction to the first-ever National Veteran Health Equity Report. The report, which contains demographic information on veterans who received VHA care in Fiscal Year (FY) 2013, is designed to provide that comparative information on minorities, women, and other veteran groups. For example:

• Although women represented only about 7% of patients in FY2013, their numbers in VHA have more than doubled since 2000—140% growth, far outstripping the 63% growth among men over the same period;
• In FY2013, 46% of veterans were aged ≥ 65 years;
• More than one-third of veterans lived in rural areas;
• Almost one-half of VHA patients had a service-connected disability. All racial/ethnic minority patient groups, compared with whites, were more likely to have a service-connected disability;

• A higher proportion of women had a service-connected disability, and women are twice as likely to be diagnosed with depression;
• Overall, 33% of VHA patients had ≥ 1 mental health diagnoses. Women and blacks/African Americans were “over-represented” among patients diagnosed with serious mental illness;

• Veterans with serious mental illness also had higher diagnosis rates for musculoskeletal disorders (60% vs 43%) and gastrointestinal conditions (48% vs 30%). In fact, among the top 20 diagnosed conditions, rates for the SMI group exceeded that for the veterans with no mental health diagnosis for 17 conditions by a margin of > 10% for 7. The largest disparities were in tobacco use disorder, psychosocial factors, spine disorders, and housing insufficiency; and
• The only condition in which the diagnosed rate in a racial/ethnic group exceeded that for whites by a margin of 10% was PTSD, diagnosed in 21% of American Indian/Alaska Natives, versus 11% of whites.

Although the report targeted  6 million veterans accessing VA care in FY13, the estimated number of living veterans is about 22 million. It is a “starting place,” the developers promise. Next iterations will continue to evolve to meet the unique needs of diverse veterans.

Stack of money

Reference pricing effectively encourages patients to spend significantly less on prescription drugs, according to research published in NEJM.

Under the reference pricing strategy, the insurer or employer establishes its maximum contribution toward the price of therapeutically similar drugs, and the patient must pay the remainder out of pocket.

The insurer/employer contribution is based on the price of the lowest-priced drug in the therapeutic class, called the reference drug.

“If the patient chooses a cheap or moderately priced option, the employer’s contribution will cover most of the cost,” said study author James C. Robinson, PhD, of the University of California at Berkeley.

“However, if the patient insists on a particularly high-priced option, he or she will need to make a meaningful payment from personal resources.”

It has been theorized that this policy would encourage patients to save money by selecting cheaper drugs. However, little is known about how the policy has actually influenced patient spending.

The new study showed that reference pricing was associated with significant changes in drug selection and spending for patients covered by employment-based insurance in the US.

Researchers analyzed changes in prescriptions and pricing for 1302 drugs in 78 therapeutic classes in the US, before and after an alliance of private employers began using reference pricing.

The trends were compared to a cohort without reference pricing. The study’s dataset included 1.1 million prescriptions reimbursed from 2010 to 2014.

Implementation of reference pricing was associated with a 7% increase in prescriptions filled for the low-price reference drug within its therapeutic class, a 14% decrease in average price paid, and a 5% increase in consumer cost-sharing.

In the first 18 months after implementation, employers’ spending dropped $1.34 million, and employees’ cost-sharing increased $120,000.

Based on these findings, Dr Robinson and his colleagues concluded that reference pricing may be one instrument for influencing patients’ drug choices and drug prices paid by employers and insurers. The team believes that, in the future, pharmaceutical companies charging “premium prices” may need to demonstrate that their drugs provide “premium performance.”

“There is huge and unjustified variation within and across geographic areas in the prices charged for almost every test and treatment, drug and device, office visit and hospitalization,” Dr Robinson said.

“It’s not a surprise when one considers that most patients are covered by health insurance and, hence, do not shop among competing providers on the basis of price. Some providers look at price-unconscious consumer demand and ask themselves, ‘Why don’t we raise our prices?’”

This research was funded by the US Agency for Healthcare Research and Quality and the Genentech Foundation.

Stack of money

Reference pricing effectively encourages patients to spend significantly less on prescription drugs, according to research published in NEJM.

Under the reference pricing strategy, the insurer or employer establishes its maximum contribution toward the price of therapeutically similar drugs, and the patient must pay the remainder out of pocket.

The insurer/employer contribution is based on the price of the lowest-priced drug in the therapeutic class, called the reference drug.

“If the patient chooses a cheap or moderately priced option, the employer’s contribution will cover most of the cost,” said study author James C. Robinson, PhD, of the University of California at Berkeley.

“However, if the patient insists on a particularly high-priced option, he or she will need to make a meaningful payment from personal resources.”

It has been theorized that this policy would encourage patients to save money by selecting cheaper drugs. However, little is known about how the policy has actually influenced patient spending.

The new study showed that reference pricing was associated with significant changes in drug selection and spending for patients covered by employment-based insurance in the US.

Researchers analyzed changes in prescriptions and pricing for 1302 drugs in 78 therapeutic classes in the US, before and after an alliance of private employers began using reference pricing.

The trends were compared to a cohort without reference pricing. The study’s dataset included 1.1 million prescriptions reimbursed from 2010 to 2014.

Implementation of reference pricing was associated with a 7% increase in prescriptions filled for the low-price reference drug within its therapeutic class, a 14% decrease in average price paid, and a 5% increase in consumer cost-sharing.

In the first 18 months after implementation, employers’ spending dropped $1.34 million, and employees’ cost-sharing increased $120,000.

Based on these findings, Dr Robinson and his colleagues concluded that reference pricing may be one instrument for influencing patients’ drug choices and drug prices paid by employers and insurers. The team believes that, in the future, pharmaceutical companies charging “premium prices” may need to demonstrate that their drugs provide “premium performance.”

“There is huge and unjustified variation within and across geographic areas in the prices charged for almost every test and treatment, drug and device, office visit and hospitalization,” Dr Robinson said.

“It’s not a surprise when one considers that most patients are covered by health insurance and, hence, do not shop among competing providers on the basis of price. Some providers look at price-unconscious consumer demand and ask themselves, ‘Why don’t we raise our prices?’”

This research was funded by the US Agency for Healthcare Research and Quality and the Genentech Foundation.

Stack of money

Reference pricing effectively encourages patients to spend significantly less on prescription drugs, according to research published in NEJM.

Under the reference pricing strategy, the insurer or employer establishes its maximum contribution toward the price of therapeutically similar drugs, and the patient must pay the remainder out of pocket.

The insurer/employer contribution is based on the price of the lowest-priced drug in the therapeutic class, called the reference drug.

“If the patient chooses a cheap or moderately priced option, the employer’s contribution will cover most of the cost,” said study author James C. Robinson, PhD, of the University of California at Berkeley.

“However, if the patient insists on a particularly high-priced option, he or she will need to make a meaningful payment from personal resources.”

It has been theorized that this policy would encourage patients to save money by selecting cheaper drugs. However, little is known about how the policy has actually influenced patient spending.

The new study showed that reference pricing was associated with significant changes in drug selection and spending for patients covered by employment-based insurance in the US.

Researchers analyzed changes in prescriptions and pricing for 1302 drugs in 78 therapeutic classes in the US, before and after an alliance of private employers began using reference pricing.

The trends were compared to a cohort without reference pricing. The study’s dataset included 1.1 million prescriptions reimbursed from 2010 to 2014.

Implementation of reference pricing was associated with a 7% increase in prescriptions filled for the low-price reference drug within its therapeutic class, a 14% decrease in average price paid, and a 5% increase in consumer cost-sharing.

In the first 18 months after implementation, employers’ spending dropped $1.34 million, and employees’ cost-sharing increased $120,000.

Based on these findings, Dr Robinson and his colleagues concluded that reference pricing may be one instrument for influencing patients’ drug choices and drug prices paid by employers and insurers. The team believes that, in the future, pharmaceutical companies charging “premium prices” may need to demonstrate that their drugs provide “premium performance.”

“There is huge and unjustified variation within and across geographic areas in the prices charged for almost every test and treatment, drug and device, office visit and hospitalization,” Dr Robinson said.

“It’s not a surprise when one considers that most patients are covered by health insurance and, hence, do not shop among competing providers on the basis of price. Some providers look at price-unconscious consumer demand and ask themselves, ‘Why don’t we raise our prices?’”

This research was funded by the US Agency for Healthcare Research and Quality and the Genentech Foundation.

Lab mouse

A 3-drug combination has demonstrated long-term efficacy against acute lymphoblastic leukemia (ALL) in mice, according to research published in Nature Communications.

Researchers found that when the production of nucleotides is stopped, a DNA replication stress response is activated, and this allows ALL cells to survive.

The team used these findings to devise a 3-drug regimen that blocks both of the nucleotide biosynthetic pathways and inhibits the replication stress response.

One of the drugs is triapine (3-AP), which inhibits ribonucleotide reductase (RNR) and enhances salvage nucleotide biosynthesis.

Another drug is DI-82, which inhibits the nucleoside salvage kinase deoxycytidine kinase (dCK).

And the third drug is VE-822, which inhibits the replication stress-sensing kinase ataxia telangiectasia and Rad3-related protein (ATR).

The researchers tested these 3 drugs in a mouse model of pre-B-ALL. Starting on day 7 after inoculation of pre-B-ALL, the mice received 3-AP and DI-82 twice a day and VE-822 once a day.

The team said mice in the control group succumbed to their disease within 17 days. However, all of the mice that received the 3-drug combination were still disease-free 442 days after they had stopped treatment (on day 42).

The researchers said the combination was well-tolerated, as mice maintained their body weight and enjoyed long-term survival without any detectable pathology.

The team also tested a dosing regimen in which all 3 drugs were given once a day.

Although this was less effective than the first regimen, 4 of 5 mice had no detectable disease 313 days after stopping treatment.

Two of the researchers involved in this study are co-founders and equity holders of Trethera Corp, a company developing a dCK inhibitor known as TRE-515.

The University of California (where most of the study authors work) has patented intellectual property for small-molecule dCK inhibitors, and it was licensed by Trethera.

Lab mouse

A 3-drug combination has demonstrated long-term efficacy against acute lymphoblastic leukemia (ALL) in mice, according to research published in Nature Communications.

Researchers found that when the production of nucleotides is stopped, a DNA replication stress response is activated, and this allows ALL cells to survive.

The team used these findings to devise a 3-drug regimen that blocks both of the nucleotide biosynthetic pathways and inhibits the replication stress response.

One of the drugs is triapine (3-AP), which inhibits ribonucleotide reductase (RNR) and enhances salvage nucleotide biosynthesis.

Another drug is DI-82, which inhibits the nucleoside salvage kinase deoxycytidine kinase (dCK).

And the third drug is VE-822, which inhibits the replication stress-sensing kinase ataxia telangiectasia and Rad3-related protein (ATR).

The researchers tested these 3 drugs in a mouse model of pre-B-ALL. Starting on day 7 after inoculation of pre-B-ALL, the mice received 3-AP and DI-82 twice a day and VE-822 once a day.

The team said mice in the control group succumbed to their disease within 17 days. However, all of the mice that received the 3-drug combination were still disease-free 442 days after they had stopped treatment (on day 42).

The researchers said the combination was well-tolerated, as mice maintained their body weight and enjoyed long-term survival without any detectable pathology.

The team also tested a dosing regimen in which all 3 drugs were given once a day.

Although this was less effective than the first regimen, 4 of 5 mice had no detectable disease 313 days after stopping treatment.

Two of the researchers involved in this study are co-founders and equity holders of Trethera Corp, a company developing a dCK inhibitor known as TRE-515.

The University of California (where most of the study authors work) has patented intellectual property for small-molecule dCK inhibitors, and it was licensed by Trethera.

Lab mouse

A 3-drug combination has demonstrated long-term efficacy against acute lymphoblastic leukemia (ALL) in mice, according to research published in Nature Communications.

Researchers found that when the production of nucleotides is stopped, a DNA replication stress response is activated, and this allows ALL cells to survive.

The team used these findings to devise a 3-drug regimen that blocks both of the nucleotide biosynthetic pathways and inhibits the replication stress response.

One of the drugs is triapine (3-AP), which inhibits ribonucleotide reductase (RNR) and enhances salvage nucleotide biosynthesis.

Another drug is DI-82, which inhibits the nucleoside salvage kinase deoxycytidine kinase (dCK).

And the third drug is VE-822, which inhibits the replication stress-sensing kinase ataxia telangiectasia and Rad3-related protein (ATR).

The researchers tested these 3 drugs in a mouse model of pre-B-ALL. Starting on day 7 after inoculation of pre-B-ALL, the mice received 3-AP and DI-82 twice a day and VE-822 once a day.

The team said mice in the control group succumbed to their disease within 17 days. However, all of the mice that received the 3-drug combination were still disease-free 442 days after they had stopped treatment (on day 42).

The researchers said the combination was well-tolerated, as mice maintained their body weight and enjoyed long-term survival without any detectable pathology.

The team also tested a dosing regimen in which all 3 drugs were given once a day.

Although this was less effective than the first regimen, 4 of 5 mice had no detectable disease 313 days after stopping treatment.

Two of the researchers involved in this study are co-founders and equity holders of Trethera Corp, a company developing a dCK inhibitor known as TRE-515.

The University of California (where most of the study authors work) has patented intellectual property for small-molecule dCK inhibitors, and it was licensed by Trethera.

Photo by Bill Branson

The US Food and Drug Administration (FDA) has granted orphan drug designation to SENS-401 to be used for the prevention of platinum-induced ototoxicity in pediatric patients.

Platinum-based chemotherapies, particularly cisplatin, can induce severe hearing loss in cancer patients, but there is no pharmaceutical agent approved to treat this side effect.

“Hearing loss in pediatric oncology patients is one of the most frequent side effects of cisplatin treatment and may disable them for the rest of their lives,” said Nawal Ouzren, CEO of Sensorion, the company developing SENS-401.

“Based on its unique profile and the data generated to date, we believe SENS-401 has the potential to be a safe and effective treatment for this serious medical condition where a significant unmet need exists. As such, we look forward to working with the FDA and EMA [European Medicines Agency] to set up an IND [investigational new drug application] and design a phase 2 clinical trial in order to evaluate SENS-401 in this indication.”

About SENS-401

SENS-401 (R-azasetron besylate) is a small molecule intended to protect and preserve inner ear tissue when lesions cause progressive or sequelar hearing impairments. The drug can be taken orally or via an injection.

SENS-401 is one of the two enantiomer forms of SENS-218 (azasetron), a racemic molecule belonging to the family of setrons marketed in Asia under the name Serotone. Pharmacological and pharmacokinetic tests have shown a superior profile for SENS-401 compared with the other enantiomer or the racemic form.

Healthy subjects demonstrated a “very good clinical tolerance” to SENS-401 in a phase 1 study, according to Sensorion. The company is planning to launch a phase 2 trial of the drug for platinum-induced ototoxicity in 2018.

About orphan designation

The FDA grants orphan designation to products intended to treat, diagnose, or prevent diseases/disorders that affect fewer than 200,000 people in the US.

The designation provides incentives for sponsors to develop products for rare diseases. This may include tax credits toward the cost of clinical trials, prescription drug user fee waivers, and 7 years of market exclusivity if the product is approved.

Photo by Bill Branson

The US Food and Drug Administration (FDA) has granted orphan drug designation to SENS-401 to be used for the prevention of platinum-induced ototoxicity in pediatric patients.

Platinum-based chemotherapies, particularly cisplatin, can induce severe hearing loss in cancer patients, but there is no pharmaceutical agent approved to treat this side effect.

“Hearing loss in pediatric oncology patients is one of the most frequent side effects of cisplatin treatment and may disable them for the rest of their lives,” said Nawal Ouzren, CEO of Sensorion, the company developing SENS-401.

“Based on its unique profile and the data generated to date, we believe SENS-401 has the potential to be a safe and effective treatment for this serious medical condition where a significant unmet need exists. As such, we look forward to working with the FDA and EMA [European Medicines Agency] to set up an IND [investigational new drug application] and design a phase 2 clinical trial in order to evaluate SENS-401 in this indication.”

About SENS-401

SENS-401 (R-azasetron besylate) is a small molecule intended to protect and preserve inner ear tissue when lesions cause progressive or sequelar hearing impairments. The drug can be taken orally or via an injection.

SENS-401 is one of the two enantiomer forms of SENS-218 (azasetron), a racemic molecule belonging to the family of setrons marketed in Asia under the name Serotone. Pharmacological and pharmacokinetic tests have shown a superior profile for SENS-401 compared with the other enantiomer or the racemic form.

Healthy subjects demonstrated a “very good clinical tolerance” to SENS-401 in a phase 1 study, according to Sensorion. The company is planning to launch a phase 2 trial of the drug for platinum-induced ototoxicity in 2018.

About orphan designation

The FDA grants orphan designation to products intended to treat, diagnose, or prevent diseases/disorders that affect fewer than 200,000 people in the US.

The designation provides incentives for sponsors to develop products for rare diseases. This may include tax credits toward the cost of clinical trials, prescription drug user fee waivers, and 7 years of market exclusivity if the product is approved.

Photo by Bill Branson

The US Food and Drug Administration (FDA) has granted orphan drug designation to SENS-401 to be used for the prevention of platinum-induced ototoxicity in pediatric patients.

Platinum-based chemotherapies, particularly cisplatin, can induce severe hearing loss in cancer patients, but there is no pharmaceutical agent approved to treat this side effect.

“Hearing loss in pediatric oncology patients is one of the most frequent side effects of cisplatin treatment and may disable them for the rest of their lives,” said Nawal Ouzren, CEO of Sensorion, the company developing SENS-401.

“Based on its unique profile and the data generated to date, we believe SENS-401 has the potential to be a safe and effective treatment for this serious medical condition where a significant unmet need exists. As such, we look forward to working with the FDA and EMA [European Medicines Agency] to set up an IND [investigational new drug application] and design a phase 2 clinical trial in order to evaluate SENS-401 in this indication.”

About SENS-401

SENS-401 (R-azasetron besylate) is a small molecule intended to protect and preserve inner ear tissue when lesions cause progressive or sequelar hearing impairments. The drug can be taken orally or via an injection.

SENS-401 is one of the two enantiomer forms of SENS-218 (azasetron), a racemic molecule belonging to the family of setrons marketed in Asia under the name Serotone. Pharmacological and pharmacokinetic tests have shown a superior profile for SENS-401 compared with the other enantiomer or the racemic form.

Healthy subjects demonstrated a “very good clinical tolerance” to SENS-401 in a phase 1 study, according to Sensorion. The company is planning to launch a phase 2 trial of the drug for platinum-induced ototoxicity in 2018.

About orphan designation

The FDA grants orphan designation to products intended to treat, diagnose, or prevent diseases/disorders that affect fewer than 200,000 people in the US.

The designation provides incentives for sponsors to develop products for rare diseases. This may include tax credits toward the cost of clinical trials, prescription drug user fee waivers, and 7 years of market exclusivity if the product is approved.

New studies raise doubts on the reliability of physical exam findings in suspected pediatric community-acquired pneumonia cases and on the value of blood cultures in hospitalized pediatric CAP cases.

In one study, 128 cases of suspected CAP in children aged 3 months to 18 years presenting to an ED from July 2013 to May 2016 underwent paired assessments within 20 minutes of each other. Only 3 of 19 exam findings used to diagnose CAP – wheezing, retractions, and respiratory rate – had acceptable levels of inter-rater reliability, with the lower end of the 95% confidential interval at a Fleiss’ kappa value of 0.4 or higher.

CDC/Amanda Mills

Both studies were funded by the National Institutes of Health. For the physician exam study, additional funding was provided by individual grants from the Gerber Foundation, the National Center for Research Resources and the National Center for Advancing Translational Sciences, the National Institute for Allergy and Infectious Diseases and the National Institutes of Health, and a Trustee Award from Cincinnati Children’s Hospital Medical Center. For the blood cultures study, individual researchers received funding from the National Institute of Allergy and Infectious Diseases and the Agency for Healthcare Research and Quality. For the physician exam study, no financial disclosures were reported. For the blood cultures study, Anne Blaschke, MD, PhD, reported receiving research funding from and other financial relationships with BioFire Diagnostics.

New studies raise doubts on the reliability of physical exam findings in suspected pediatric community-acquired pneumonia cases and on the value of blood cultures in hospitalized pediatric CAP cases.

In one study, 128 cases of suspected CAP in children aged 3 months to 18 years presenting to an ED from July 2013 to May 2016 underwent paired assessments within 20 minutes of each other. Only 3 of 19 exam findings used to diagnose CAP – wheezing, retractions, and respiratory rate – had acceptable levels of inter-rater reliability, with the lower end of the 95% confidential interval at a Fleiss’ kappa value of 0.4 or higher.

CDC/Amanda Mills

Both studies were funded by the National Institutes of Health. For the physician exam study, additional funding was provided by individual grants from the Gerber Foundation, the National Center for Research Resources and the National Center for Advancing Translational Sciences, the National Institute for Allergy and Infectious Diseases and the National Institutes of Health, and a Trustee Award from Cincinnati Children’s Hospital Medical Center. For the blood cultures study, individual researchers received funding from the National Institute of Allergy and Infectious Diseases and the Agency for Healthcare Research and Quality. For the physician exam study, no financial disclosures were reported. For the blood cultures study, Anne Blaschke, MD, PhD, reported receiving research funding from and other financial relationships with BioFire Diagnostics.

New studies raise doubts on the reliability of physical exam findings in suspected pediatric community-acquired pneumonia cases and on the value of blood cultures in hospitalized pediatric CAP cases.

In one study, 128 cases of suspected CAP in children aged 3 months to 18 years presenting to an ED from July 2013 to May 2016 underwent paired assessments within 20 minutes of each other. Only 3 of 19 exam findings used to diagnose CAP – wheezing, retractions, and respiratory rate – had acceptable levels of inter-rater reliability, with the lower end of the 95% confidential interval at a Fleiss’ kappa value of 0.4 or higher.

CDC/Amanda Mills

Both studies were funded by the National Institutes of Health. For the physician exam study, additional funding was provided by individual grants from the Gerber Foundation, the National Center for Research Resources and the National Center for Advancing Translational Sciences, the National Institute for Allergy and Infectious Diseases and the National Institutes of Health, and a Trustee Award from Cincinnati Children’s Hospital Medical Center. For the blood cultures study, individual researchers received funding from the National Institute of Allergy and Infectious Diseases and the Agency for Healthcare Research and Quality. For the physician exam study, no financial disclosures were reported. For the blood cultures study, Anne Blaschke, MD, PhD, reported receiving research funding from and other financial relationships with BioFire Diagnostics.

I provided an update on existing, new, and upcoming medical therapies for Crohn’s disease (CD) and ulcerative colitis (UC), with a focus on studies presented at Digestive Disease Week^® 2017.

In one study of over 13,000 inflammatory bowel disease (IBD) patients in Medicare/Medicaid databases, it was found that among those treated with corticosteroids in the previous year, patients started on a tumor necrosis factor (TNF) inhibitor within the next year had mortality rates that were at least 22% lower than those of patients treated with prolonged corticosteroids over the next 12 months (Gastroenterology. 2017;152[5 Suppl 1]:S65-5). Initial results of the CALM study were presented, comparing a treat-to-target (T2T) algorithmic medical escalation approach in moderate to severe CD to a more conventional approach. Medical therapy was primarily adalimumab based and was escalated based on “success criteria,” which included not only symptomatic remission but also normalization of serum C-reactive protein and fecal calprotectin. At week 48, the rate of endoscopic remission was significantly higher (45.9%) in the T2T group than in conventionally managed patients (30.3%, P = .01), thus demonstrating the superiority of a T2T approach (Gastroenterology 2017;152[5 Suppl 1]:S155).

Dr. Loftus is professor of medicine, Mayo Clinic College of Medicine, director of the Inflammatory Bowel Disease Interest Group, the division of gastroenterology and hepatology, Rochester, Minn. He made his comments during the AGA Institute Presidential Plenary at the Annual Digestive Disease Week.

I provided an update on existing, new, and upcoming medical therapies for Crohn’s disease (CD) and ulcerative colitis (UC), with a focus on studies presented at Digestive Disease Week^® 2017.

In one study of over 13,000 inflammatory bowel disease (IBD) patients in Medicare/Medicaid databases, it was found that among those treated with corticosteroids in the previous year, patients started on a tumor necrosis factor (TNF) inhibitor within the next year had mortality rates that were at least 22% lower than those of patients treated with prolonged corticosteroids over the next 12 months (Gastroenterology. 2017;152[5 Suppl 1]:S65-5). Initial results of the CALM study were presented, comparing a treat-to-target (T2T) algorithmic medical escalation approach in moderate to severe CD to a more conventional approach. Medical therapy was primarily adalimumab based and was escalated based on “success criteria,” which included not only symptomatic remission but also normalization of serum C-reactive protein and fecal calprotectin. At week 48, the rate of endoscopic remission was significantly higher (45.9%) in the T2T group than in conventionally managed patients (30.3%, P = .01), thus demonstrating the superiority of a T2T approach (Gastroenterology 2017;152[5 Suppl 1]:S155).

Dr. Loftus is professor of medicine, Mayo Clinic College of Medicine, director of the Inflammatory Bowel Disease Interest Group, the division of gastroenterology and hepatology, Rochester, Minn. He made his comments during the AGA Institute Presidential Plenary at the Annual Digestive Disease Week.

I provided an update on existing, new, and upcoming medical therapies for Crohn’s disease (CD) and ulcerative colitis (UC), with a focus on studies presented at Digestive Disease Week^® 2017.

In one study of over 13,000 inflammatory bowel disease (IBD) patients in Medicare/Medicaid databases, it was found that among those treated with corticosteroids in the previous year, patients started on a tumor necrosis factor (TNF) inhibitor within the next year had mortality rates that were at least 22% lower than those of patients treated with prolonged corticosteroids over the next 12 months (Gastroenterology. 2017;152[5 Suppl 1]:S65-5). Initial results of the CALM study were presented, comparing a treat-to-target (T2T) algorithmic medical escalation approach in moderate to severe CD to a more conventional approach. Medical therapy was primarily adalimumab based and was escalated based on “success criteria,” which included not only symptomatic remission but also normalization of serum C-reactive protein and fecal calprotectin. At week 48, the rate of endoscopic remission was significantly higher (45.9%) in the T2T group than in conventionally managed patients (30.3%, P = .01), thus demonstrating the superiority of a T2T approach (Gastroenterology 2017;152[5 Suppl 1]:S155).

Dr. Loftus is professor of medicine, Mayo Clinic College of Medicine, director of the Inflammatory Bowel Disease Interest Group, the division of gastroenterology and hepatology, Rochester, Minn. He made his comments during the AGA Institute Presidential Plenary at the Annual Digestive Disease Week.

PARK CITY, UTAH – Copper IUDs really do increase the risk of bacterial vaginosis (BV), according to a longitudinal study of 234 women in Harare, Zimbabwe.

This notion has “always been a little bit controversial; it’s commonly believed by some and refuted by others,” but the findings from the new research “are real and generalizable,” said Sharon Hillier, PhD, the study’s senior investigator and the director of reproductive infectious disease research at Magee-Womens Hospital of the University of Pittsburgh.

[email protected]

PARK CITY, UTAH – Copper IUDs really do increase the risk of bacterial vaginosis (BV), according to a longitudinal study of 234 women in Harare, Zimbabwe.

This notion has “always been a little bit controversial; it’s commonly believed by some and refuted by others,” but the findings from the new research “are real and generalizable,” said Sharon Hillier, PhD, the study’s senior investigator and the director of reproductive infectious disease research at Magee-Womens Hospital of the University of Pittsburgh.

[email protected]

PARK CITY, UTAH – Copper IUDs really do increase the risk of bacterial vaginosis (BV), according to a longitudinal study of 234 women in Harare, Zimbabwe.

This notion has “always been a little bit controversial; it’s commonly believed by some and refuted by others,” but the findings from the new research “are real and generalizable,” said Sharon Hillier, PhD, the study’s senior investigator and the director of reproductive infectious disease research at Magee-Womens Hospital of the University of Pittsburgh.

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In 1992, the AGA Research Foundation issued the first AGA-R. Robert and Sally D. Funderburg Research Award in Gastric Cancer to support research into this previously underfunded area. There have been 26 recipients of the AGA-Funderburg award to date, comprising an honor role of distinguished national leaders in gastroenterology. Each recipient has addressed different aspects of the disease, providing a dramatic improvement in the understanding and treatment of gastric cancer.

The AGA Research Foundation is thankful for the continuous funding from the Funderburg family, which has provided the opportunity for gastric cancer research discoveries that otherwise would not have been funded. Learn more about the Funderburgs and the impact of this award in AGA Perspectives, http://agaperspectives.gastro.org/reflecting-25-years-groundbreaking-gastric-cancer-research.

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In 1992, the AGA Research Foundation issued the first AGA-R. Robert and Sally D. Funderburg Research Award in Gastric Cancer to support research into this previously underfunded area. There have been 26 recipients of the AGA-Funderburg award to date, comprising an honor role of distinguished national leaders in gastroenterology. Each recipient has addressed different aspects of the disease, providing a dramatic improvement in the understanding and treatment of gastric cancer.

The AGA Research Foundation is thankful for the continuous funding from the Funderburg family, which has provided the opportunity for gastric cancer research discoveries that otherwise would not have been funded. Learn more about the Funderburgs and the impact of this award in AGA Perspectives, http://agaperspectives.gastro.org/reflecting-25-years-groundbreaking-gastric-cancer-research.

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In 1992, the AGA Research Foundation issued the first AGA-R. Robert and Sally D. Funderburg Research Award in Gastric Cancer to support research into this previously underfunded area. There have been 26 recipients of the AGA-Funderburg award to date, comprising an honor role of distinguished national leaders in gastroenterology. Each recipient has addressed different aspects of the disease, providing a dramatic improvement in the understanding and treatment of gastric cancer.

The AGA Research Foundation is thankful for the continuous funding from the Funderburg family, which has provided the opportunity for gastric cancer research discoveries that otherwise would not have been funded. Learn more about the Funderburgs and the impact of this award in AGA Perspectives, http://agaperspectives.gastro.org/reflecting-25-years-groundbreaking-gastric-cancer-research.

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Talking to your patients about PPIs

AGA has developed talking points about research released associating PPIs with dementia, chronic kidney disease, and the latest research associating PPI use with all-cause mortality. These resources can help you educate your patients on the data and on the risks and benefits of using PPIs in their care.

• • PPIs and dementia: http://www.gastro.org/news_items/2017/07/20/how-to-talk-with-your-patients-about-ppis-and-dementia.
• • PPIs and chronic kidney disease: http://www.gastro.org/news_items/how-to-talk-with-patients-about-ppis-and-chronic-kidney-disease.
• • PPIs and all-cause mortality: http://www.gastro.org/news_items/a-guide-to-conversations-about-the-latest-ppi-research-results.

Talking to your colleagues about PPIs

AGA members have been discussing this new data linking PPIs to death. Weigh in by visiting the AGA Community, www.community.gastro.org.

Talking to your patients about PPIs

AGA has developed talking points about research released associating PPIs with dementia, chronic kidney disease, and the latest research associating PPI use with all-cause mortality. These resources can help you educate your patients on the data and on the risks and benefits of using PPIs in their care.

• • PPIs and dementia: http://www.gastro.org/news_items/2017/07/20/how-to-talk-with-your-patients-about-ppis-and-dementia.
• • PPIs and chronic kidney disease: http://www.gastro.org/news_items/how-to-talk-with-patients-about-ppis-and-chronic-kidney-disease.
• • PPIs and all-cause mortality: http://www.gastro.org/news_items/a-guide-to-conversations-about-the-latest-ppi-research-results.

Talking to your colleagues about PPIs

AGA members have been discussing this new data linking PPIs to death. Weigh in by visiting the AGA Community, www.community.gastro.org.

Talking to your patients about PPIs

AGA has developed talking points about research released associating PPIs with dementia, chronic kidney disease, and the latest research associating PPI use with all-cause mortality. These resources can help you educate your patients on the data and on the risks and benefits of using PPIs in their care.

• • PPIs and dementia: http://www.gastro.org/news_items/2017/07/20/how-to-talk-with-your-patients-about-ppis-and-dementia.
• • PPIs and chronic kidney disease: http://www.gastro.org/news_items/how-to-talk-with-patients-about-ppis-and-chronic-kidney-disease.
• • PPIs and all-cause mortality: http://www.gastro.org/news_items/a-guide-to-conversations-about-the-latest-ppi-research-results.

Talking to your colleagues about PPIs

AGA members have been discussing this new data linking PPIs to death. Weigh in by visiting the AGA Community, www.community.gastro.org.