Breaking Health News: GLP-1 Drugs for Parkinson’s, Asthma Treatment, and Maternal Mistreatment in US Hospitals

2024-04-04 18:50:26

Hello Health Rounds readers! GLP-1 drugs are in the news once more, and not because of weight loss. It might be that drugs in this class can slow the progression of Parkinson’s disease. We also report a potentially important discovery in asthma that might lead to new treatment options, and a survey of the prevalence of mistreatment of many mothers during childbirth in U.S. hospitals.

Diabetes drug might slow progression of Parkinson’s disease

A diabetes drug from the same class of drugs used to treat obesity appears to slow the progression of early Parkinson’s disease, but with a potentially unacceptable rate of gastrointestinal side effects.

In the French study, 156 patients who had Parkinson’s disease for less than three years and were taking stable doses of medications to treat symptoms received either daily injections of Sanofi’s GLP-1 agonist lixisenatide SAN or a placebo.

After 12 months, the lixisenatide group had essentially no change in scores on a validated instrument for assessing Parkinson’s movement disorders, while the placebo group had a 3-point worsening of symptoms on a 199-point scale, according to an am Report published Wednesday in The New England Journal of Medicine (link).

The 3-point advantage in the treated patients was still evident two months later, the researchers said. However, 46 percent of participants treated with lixisenatide reported nausea and 13 percent reported vomiting.

“The occurrence of side effects may be a barrier to broader use of lixisenatide in Parkinson’s disease,” wrote Dr. David Standaert of the University of Alabama at Birmingham in an editorial (link) published alongside the study.

The drug, originally sold under the brand name Adlyxin, will no longer be sold by Sanofi in the United States starting in early 2023.

If a three-point improvement is the most that can be achieved, the evaluation of lixisenatide may be limited, especially given the adverse effects, Standaert said.

However, if the drug keeps patients stable while untreated patients deteriorate by three points per year, “over a period of 5 to 10 years or more, then this might be a truly transformative treatment,” Standaert said.

Asthma attacks damage the lining of the airways

New evidence shows that asthma attacks actually damage the airways, and preventing that damage might be the focus of new treatments, researchers say.

Although asthma is primarily considered an inflammatory disease in which the immune system attacks tissues, leading to inflammation and mucus production, it is also known to be associated with bronchoconstriction – the narrowing of the smooth muscle surrounding the airways.

By studying human lung tissue as well as mice with asthma, researchers at King’s College London discovered that muscle constriction compresses and destroys the epithelial cells that form the lining of the airways. This damage, in turn, promotes the inflammation and mucus production that often accompany an asthma attack, they explained in a report published Thursday in Science (link).

The usual standard treatment for asthma – albuterol to open the airways and inhaled corticosteroids to control inflammation – does not prevent damage to the airway epithelium or the resulting inflammation following an asthma attack, researchers say.

However, blocking the crushing process and subsequent destruction of epithelial cells counteracted the airway damage and significantly reduced the inflammatory response, the researchers said.

“These results not only demonstrate that bronchoconstriction is a pro-inflammatory stimulus, but also point to the potential for new research approaches” that would prevent a vicious cycle of damage caused by mechanical injury and inflammation, another team of authors wrote in a commentary (link) , which was published alongside the study.

1 in 8 mothers in the US report mistreatment during childbirth

Various forms of mistreatment during childbirth are widespread in U.S. hospitals, a study published Thursday in JAMA Network Open (link) shows.

The researchers surveyed a representative sample of around half a million people who gave birth to a live child in New York City and the states of Kansas, Michigan, New Jersey, Pennsylvania, Utah and Virginia in 2020. Almost 14 percent of the 4,458 study participants reported abuse during labor and birth in a validated questionnaire.

The most common forms of abuse were “ignoring, refusing requests for help, or failing to respond in a timely manner” ((7.6 percent)), “yelling at or swearing at” by medical staff ((4.1 percent)), and threatening the medical staff Personals “withhold treatment from you or force you to undergo treatment that you do not want” ((2.3 percent)).

Such treatment was most commonly reported by unmarried women insured under the Medicaid program for the poor, who identified as LGBTQ people, who were considered obese, who had a history of substance use, mood disorders, or intimate partner violence, and in the family, as well as women who had an unplanned cesarean birth.

“Birth abuse has been widely documented in low- and middle-income countries, but this study shows that respectful maternity care is an important measure of quality that we should pursue in the United States as well,” said study leader Jamie Daw of the Mailman School of Public Health at Columbia University in New York City in a statement.

Her team only examined abuse during childbirth. The new mothers in the sample may also have been abused during pregnancy or following birth, the researchers said.

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