[HN Gopher] New treatments give an example of how treating one p...
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New treatments give an example of how treating one patient can
benefit others
Author : jseliger
Score : 22 points
Date : 2023-09-21 14:59 UTC (8 hours ago)
(HTM) web link (randomactsofmedicine.substack.com)
(TXT) w3m dump (randomactsofmedicine.substack.com)
| uslic001 wrote:
| One of the great successes of modern medicine. When I first
| started treating Hepatitis C patients in 1995 our Hepatitis C
| treatments had terrible side effects and rarely worked after 48
| weeks of treatment. Now the treatments are 98% effective in 8-12
| weeks and have minimal side effects. People need to stop saying
| that big pharma doesn't find cures.
| spondylosaurus wrote:
| One caveat to "big pharma finds cures" is that, to my
| understanding, a lot of the _research_ is done via public
| institutions, big pharma just handles the manufacturing and
| distribution.
|
| I know adalimumab's discovery was funded (at least in part) by
| government grants, but Humira still made AbbVie richer than
| god.
| sudosysgen wrote:
| Big Pharma also often handles the clinical trials and
| approvals. I don't know if there is a mechanism for a public
| lab to get approval for a medicine? Probably if we found a
| way to drive down the cost of clinical trials, we'd be able
| to structure the system in a way to eliminate the middle-men
| here, but that's much easier said than done.
| spondylosaurus wrote:
| Ah, good point... are clinical trials expensive to run?
| sjducb wrote:
| A couple of billion per drug.
| PeterisP wrote:
| They are a bit more than half of the total drug R&D
| costs, so they cost more than all the research,
| experimental synthesis and pre-clinical experiments
| combined. If you've discovered a drug which works in
| vitro and on animals, and want to start clinical trials,
| you're not even halfway done.
| murphyslab wrote:
| There's a lot of literature in medicine of how often one small
| subset of patients consumes a disproportionate level of
| healthcare resources, i.e. the Pareto principle. It's fantastic
| seeing just how much providing _effective_ treatment for that
| small subset offers drastic benefits to everyone else. For liver
| transplants, it 's a very 1-to-1 situation, but for other
| resources such as hospital beds, the ripples probably go much
| farther.
| Herodotus38 wrote:
| This is a good article. One of the sad things is that the rates
| of NAFLD (non-alcoholic fatty liver disease) are increasing in
| proportion to the increase we see in morbid obesity, diabetes,
| etc... and this can also lead to cirrhosis and the need for liver
| transplantation.
|
| https://jamanetwork.com/journals/jamanetworkopen/fullarticle...
|
| However, with the newer GLP-1 agonists (like
| Ozempic/semaglutide), we might be seeing an ability to better
| treat NAFLD and its downstream cirrhosis.
| m463 wrote:
| I've been listening to "The glucose revolution" and I believe
| getting glucose monitors into the hands of the general public
| might prevent a lot of this.
|
| Right now continuous glucose monitoring requires an expensive
| patch, lasts for a finite time and is available to few people.
|
| The holy grail would be a non-invasive monitor such as a watch.
|
| It seems avoiding glucose spikes might be the key to preventing
| much nafld, diabetes, obesity, heart disease, etc.
| thimkerbell wrote:
| What is the most convenient and cost-effective spike-
| flattening food that you could take with your high-glycemic
| meal?
| m463 wrote:
| Haven't gotten through the whole thing, but it is
| enlightening in lots of ways, not just "eat this".
|
| For example, I like what it said about eating your food in
| a different order. With no change but the order - eating
| fiber first, then proteins and fats, and carbs last - your
| glucose spike will be minimized, by quite a lot.
|
| It also said we get cravings when our blood sugar drops.
| And it always drops after a spike.
|
| also, walking for 10 minutes after a meal helps lessen
| spike.
|
| EDIT: good summary someone prepared:
|
| https://www.believebig.org/wp-
| content/uploads/2022/12/Glucos...
| thimkerbell wrote:
| A restaurant should do this, rather than bringing out the
| bread first. And show how helpful/healthful it is.
| thimkerbell wrote:
| If a physician randomly hands these blood glucose monitors
| out to some motivated but non-health-nut people, has them try
| it for a week, do they develop long-term better eating
| patterns?
| m463 wrote:
| I believe that's basically what happened in the author's
| case.
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