Staying #Up2Date 🚨

1. Which triple therapy is best?

This cohort study of 40,776 COPD patients compared Breztri Aerosphere and Trelegy Ellipta for exacerbation prevention and safety. Breztri was associated with a 9% higher risk of moderate/severe COPD exacerbations (HR 1.09, 95% CI 1.04–1.14, NNH 38) and a 29% higher risk of severe exacerbations (HR 1.29, 95% CI 1.12–1.48, NNH 97) compared to Trelegy. Pneumonia-related hospitalizations were similar between groups (HR 1.00, 95% CI 0.91–1.10). With its better exacerbation prevention and lower environmental impact, Trelegy may be a preferred choice for COPD patients needing triple therapy.

2. Contraceptives & venous thromboembolism (VTE) 

This study analyzed (VTE) risk in over 1.3 million women in Denmark. Combined pills had the highest VTE rate ratios, with a 4.6-fold increase compared to nonuse, while third-generation progestin pills had the highest excess VTE rate of 14.2 per 10,000 person-years. Patches and implants showed moderate risks, with rate ratios of 5.0 and 2.4, respectively, and progestin-only pills had a lower VTE risk (rate ratio of 1.8). The study found that IUDs carried no increased VTE risk (rate ratio of 1.0), emphasizing the importance of personalized contraceptive counseling.

3. GLP1 RA in alcohol use disorder (AUD)

In this RCT, compared to placebo, semaglutide significantly reduced alcohol consumption in a laboratory self-administration test (β, -0.48; 95% CI, -0.85 to -0.11; P = .01) and decreased peak breath alcohol concentration (β, -0.46; 95% CI, -0.87 to -0.06; P = .03). While semaglutide did not affect total drinking days, it significantly reduced drinks per drinking day (β, -0.41; 95% CI, -0.73 to -0.09; P = .04) and weekly alcohol craving (β, -0.39; 95% CI, -0.73 to -0.06; P = .01). These findings support further clinical trials to assess GLP-1 receptor agonists as a potential treatment for AUD.

Human Pin Cushion

How a pain clinic made millions off of their injured patients.

What happened: Pain MD, a pain management company, is under fire after it was proven to be a part of a decade-long scheme that profited off of patients’ dependency on opioids.

Why it’s interesting: 3 former patients testified in court that the company’s injections didn’t treat their pain but instead made it worse. If they refused to get the shots, Pain MD would cut off their prescriptions.

Pain MD, known as Mid-South Pain Management, ran about 20 clinics in Tennessee, Virginia, and North Carolina in the 2010s. Some clinics had each patient take 12 injections per month, while a few received 500 shots in total.

That’s not all. During its years of operation, Pain MD billed Medicaid and Tricare and charged about $111 per injection. According to court documents, Pain MD pocketed more than $5 million from the government. Even private insurance companies were hit with Pain MD, charging them about $40 million for more than 300,000 injections. 

But, it gets worse: An expert on spine care testified that to treat inflamed joints, a doctor must inject steroids or platelet-rich plasma into the tendon. Yet it was revealed that Pain MD used needles that were too short to reach back tendons. A former Pain MD employee testified against the company and said his colleagues were following the advice of an anatomy professor who only ever worked on cadavers. 

Bottom line: Since the company’s bankruptcy in 2019, a broader conversation has begun on how to stop the pill mill problem while still helping patients find relief.

Hot Off The Press

1: 💉 President Trump has ordered that federal funding stop going to schools and universities requiring students to be vaccinated against COVID-19. Currently, no schools from K-12 expect students to be vaccinated, and only 15 colleges still ask before enrolling.

2: 🇺🇸 Protests are intensifying over Elon Musk’s influence in the Trump administration — specifically his push to cut federal health, education, and human services — with Congress on recess. Activists are targeting Tesla dealerships and congressional offices. They say these cuts threaten essential services like cancer research and veterans’ care.

3: 💊 RFK Jr is officially the country’s health secretary and his first order of business? Look into the “threat” SSRIs and antipsychotics have on children. The executive order is a part of his “Make America Healthy Again” plan, as he’s falsely stated that SSRIs are linked to school shootings. Many people took to social media to share this frustration with the order, saying that antidepressants and other mood-stabilizing drugs have “saved their lives.”

4: ⌚️ Apple continues to expand its push into healthcare, launching a new research study tapping into the health data of its 2.2 billion active devices. The study, which includes users of iPhones, Apple Watches, and AirPods, aims to explore both physical and mental health, and the potential to develop new health features. CEO Tim Cook believes Apple’s greatest legacy could be its contributions to healthcare.

Notable Numbers 🔢

8.7 million: how many new HIV infections could arise by 2029 due to the 90-day freeze on US foreign aid. UNAIDS warns this suspension could also result in 6.3 million AIDS-related deaths. 550 HIV workers have already been laid off, and the distribution of Lenacapavir (a promising twice-yearly shot) is in jeopardy. So far, no other countries have stepped in.

170 million: how many American users TikTok is back to serving, after nearly a month-long hiatus from the US app stores. The popular app, owned by Chinese firm ByteDance, was removed in January due to a law mandating its divestment or a ban. Thanks to Trump’s delay, TikTok avoided a mass migration to RedNote, where users dubbed themselves “TikTok refugees.”

300: the number of people Panama City is holding in a hotel because of Trump’s deportation order, and 40% say they won’t return to their homeland because it’s unsafe. The migrants are mostly from Asian countries, including Iran, India, Nepal, and Pakistan.

Postcall Picks

📺 Watch: this highlight video for SNL’s 50th anniversary episode, including performances from Adam Sandler and skits from comedy legends.

😂Laugh: This seems about right?

🤑 Save: Who says you can’t be stylish in the winter? Free People’s got what you need during their sale no matter the climate you live in.

Relax

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