|
The whole world's waiting on a vaccine, so here's to positive early signals. We've got the latest on mRNA phase 1.
|
|
|
mRNA Covid vaccines have brought the hype: after the genome for SARS-CoV-2 was posted publicly in January, Moderna's vaccine candidate mRNA-1273 underwent a first-in-human phase 1 trial 63 days later in March. The vaccine injects the Covid spike protein's RNA sequence into host cells, where the recipient then makes the antigen that triggers an immune response (see illustration). Good news: there's no live virus here. Bad news: the approach is new, so no one is quite sure if it will work.
|
|
You have to start at phase 1, and here researchers found that mRNA-1273 was safe in 45 healthy volunteers aged 18 - 55. Volunteers were given 2 injections 28 days apart in escalating doses per trial design. At day 47, every participant had serum neutralizing antibodies to the spike protein. People are raving about the speed of the endeavor: this was done in 6 months following the release of the SARS-CoV-2 genome, compared to a typical process of 3 to 9 years. The leap owes thanks to research from prior coronavirus outbreaks (SARS, MERS) and new mRNA vaccine tech.
NEJM
|
|
|
The usual phase 1 caveats apply, but there's a lot at play given how early we are in the process and the novel nature of the vaccine. Many concerns are around the elderly, who were not represented in the study (age < 55) and may need higher doses of a vaccine (as seen in flu) for effective protection. And while neutralizing antibodies are a good sign, researchers need to prove that the vaccine impacts clinical outcomes. Choosing the right endpoints in a large phase 3 trial will be tricky given the heterogeneity of Covid illness.
|
|
|
Phase 2 is in progress, and phase 3 with over 30,000 participants is set to begin July 27th. Remember that there are many other vaccine candidates in this race that are simultaneously undergoing rapid development.
|
|
When the waiting room has never been so empty
|
|
It's one thing for your clinic, another for the cath lab. Reports of patients avoiding the hospital for non-Covid (but still very serious) illnesses abound. An analysis of acute coronary syndrome (ACS) admissions from Britain's National Health Service found a 40% drop from 2019 levels in March 2020 as the pandemic took hold. And while numbers have improved, admissions in May remained down 16% from prior levels. That's a lot of untreated STEMIs and NSTEMIs.
Lancet
|
|
When a day of discharges means you'll get rocked on call
|
|
Some stuff is easy to predict, but rheumatoid arthritis (RA) flares can be subtle. Using a heavy dose of bioinformatics, researchers linked pre-symptomatic changes in immune cell gene expression (measured through RNA sequencing) to clinical flares 1 - 2 weeks later. The study was performed in 4 patients, but if results are proven generalizable a similar approach could be used to intervene on flares before symptoms.
NEJM
|
|
When all you read is the assessment and plan
|
|
A little goes a long way. Researchers evaluated the impact of a 90-second cartoon video (example stills here) on parents' interest in receiving an antibiotic for their child in a study of 1,000 English and Spanish speaking patients who presented with upper respiratory tract infections. Among parents who reported their interest in an antibiotic as 'high' before watching the video, about half of those who watched changed their interest level to low or neutral.
J Pediatr
|
|
What your comp sci friends are talking about
|
|
|
Health-tech hackathons used to have a different meaning. New reports link Russian hacking groups to efforts to steal vaccine research in the US, Canada, and Britain.
|
|
Send your interns something to look forward to
|
|
|
|
