The health news of 2019 is a mixed bag. There were significant developments in cystic fibrosis and exciting news about breast cancer testing. The opioid epidemic took a significant turn with major settlements being awarded, but suicide rates in young girls are on the rise. Take a look back at the most inspiring—and most troubling—health stories from 2019.
Best: Groundbreaking cystic fibrosis treatment approved by the FDA
In November, the US Food and Drug Administration (FDA) approved a new treatment for cystic fibrosis (CF)—a devastating lung disease that compromises breathing. This is the first new treatment developed in decades. The medication, called Trikafta, can be used to treat patients 12 years and older who have at least one particular genetic mutation connected to CF (officially, an F508 mutation in the transmembrane conductance regulator—CFTR—gene). What that means is that while there are over 2,000 known mutations of the CFTR gene, this is the most common mutation and this is the first approved treatment that is effective for these patients, and they make up about 90 percent of those with the disease.
The Cystic Fibrosis Foundation hailed the FDA’s approval of the treatment as “the single greatest therapeutic advancement in the history of CF.”
Best: Intermittent fasting research looks promising
While fasting itself has reportedly been used therapeutically since the 5th century BCE, this weight-loss plan hit the headlines in October when actors Jennifer Aniston and Reese Witherspoon revealed they are both fans, and eschew solid food for 16 hours a day. Using an “eating window” of eight to 10 hours a day is one approach to intermittent fasting (IF); another is to fast a couple of days a week, and eat normally on the other days.)
“The science is so fascinating that supports it,” says Darria Long Gillespie, MD, clinical assistant professor, University of Tennessee School of Medicine, who follows a version of the plan herself. She points out that in animal studies, IF prevented weight gain in mice eating the same number of calories as mice on a regular feeding schedule. Human studies have also been promising: A review of IF research found it could help people lose as much weight as they would on a regular diet, but without feeling as hungry or suffering the dip in metabolism that occurs when you restrict calories throughout the day. A study of 2001 heart patients presented at the American Heart Association’s Scientific Sessions in November found that people who regularly fasted had a greater survival rate than heart patients who didn’t intermittent fast.
Best: Opioid settlement reached with three major drug companies
Three major drug distributors and an opioid manufacturer reached a $260 million dollar settlement in the first federal opioid trial in October. The landmark settlement could become a model for thousands of similar cases brought in an attempt to hold the industry responsible for the addiction epidemic that has killed hundreds of thousands of Americans—and devastated countless more lives.
“There are many variables that play a part in this epidemic, but I feel the recent opioid settlements reflect a changing of the tide in this epidemic, which is a good thing,” says Jen Caudle, DO, family physician, associate professor, Rowan University SOM. “Families need to heal. Communities need to heal.”
According to Dr. Gillespie: “While the settlement is little consolation to people who have developed addictions or died from overdoses as a result, I do find it encouraging to realize that people are now starting to understand this. Several years ago a lot more of my patients were demanding pain medications, and now I’ll have a patient and I will always have a candid conversation with them about opioids. I always tell my patients if you take these continually for five days, that’s all it takes to develop a dependence.”
Worst: Suicide rates in girls aged 10 to 14 years old are on the rise
Suicide rates for young girls are rising at a faster pace than that of boys, according to an alarming report released in May (published in the JAMA: The Journal of the American Medical Association). For the first time, research showed that rates of suicide peaked in 1993 and had been on the decline until 2007, when they again started to climb.
“As we struggle to figure out what is the cause, or what is driving this, I think there are too many key things, but two that come up are, one is the competition with a false perfection that we see on social media,” says Dr. Gillespie. “Another one is the anonymous bullying. When you see somebody face to face, you see the pain you’re causing and our brains are wired to stop—unless you’re a sociopath. But when you don’t see them face to face, they are a face behind a screen. You don’t get that negative feedback when people can be mean. And then, I think it’s the isolation. We spend our time behind our phones with our 6,000 friends, and not spending time with our tribe.”
Best: Second HIV patient goes into remission after stem cell treatment
For only the second time in medical history, doctors say they have sent a second HIV patient into what might be permanent remission using a stem cell transplant, according to a paper published in Nature. The patient was first diagnosed in 2003, and as of March 2019 had been off his medication and still in remission for 18 months, according to his medical team at the University College London, in England.
The news came nearly 12 years to the day after the first patient known to be cured, a feat that researchers have long tried, and failed, to duplicate. Both resulted from bone-marrow transplants given to infected patients. However, the transplants were intended to treat cancer, not HIV. And while bone marrow transplants might not be realistic for all HIV patients, rearming the body with immune cells similarly modified to resist HIV. might well succeed as a practical treatment.
Best: A new way to test for breast cancer early
According to new research presented at the 2019 NCRI Cancer Conference in November, breast cancer can be detected up to five years before there are any clinical signs of it using a blood test that identifies the body’s immune response to substances produced by tumor cells.
Breast cancer is the most common cancer among women in the United States, and early detection is key. In fact, over the past 25 years, more than 2.6 million breast cancer deaths have been avoided in part due to people finding out about it sooner.
“We need to develop and further validate this test,” says Daniyah Alfattani, a PhD student in the group presenting the research. “However, these results are encouraging and indicate that it’s possible to detect a signal for early breast cancer. Once we have improved the accuracy of the test, then it opens the possibility of using a simple blood test to improve early detection of the disease.”
Worst: The growing EVALI epidemic
As of November 20, 2019, 2,290 cases of lung injury have been linked to vaping according to the US Centers for Disease Control and Prevention. And the impacts are horrifying. Doctors at Detroit’s Henry Ford Hospital revealed that they have performed the first double lung transplant on a teenage patient with a vaping-related illness—a major development in the growing EVALI (e-cigarette or vaping product use associated lung injury) crisis.
What’s troubling, says Dr. Gillespie, is people were misled about the impact of e-cigarettes. “The initial message was, oh, it’s safer than cigarette smoking. And in the process, we have created this kind of monster where we’re now having teenagers and people who never smoked before are using these vape pens with the false pretense that it is safe.”
Best: EPA to begin phasing out animal testing
In September, Environmental Protection Agency administrator Andrew Wheeler signed a directive prioritizing efforts to reduce animal testing, and completely eliminate testing on animals by 2035. “Today’s memo directs the agency to aggressively reduce animal testing, including reducing mammal study requests and funding 30 percent by 2025 and completely eliminating them by 2035,” Wheeler said in a statement.
Any studies on mammals after 2035 will need administrator approval on a case-by-case basis, and, in accordance with the memo, the EPA will hold an annual conference on new approach methods beginning this year.
Best: The FDA approved the first CBD-based drug
CBD (Cannabidiol) products are seemingly everywhere, from oils and lotions you can buy at the drugstore, to drops you can add in a smoothie or even a cocktail. People swear by its pain-relieving effects, but while the hype is real, the effects and long-term impacts are still murky.
While CBD is one of the hundreds of components of marijuana, it does not cause a “high.” According to a report from the World Health Organization, “In humans, CBD exhibits no effects indicative of any abuse or dependence potential…. To date, there is no evidence of public health-related problems associated with the use of pure CBD.”
Claims around CBD include that it helps with anxiety, insomnia, and pain. However, the strongest scientific evidence for its effectiveness is in treating childhood epilepsy—specifically Dravet syndrome and Lennox-Gastaut syndrome, which typically don’t respond to anti-seizure medications. Recently the FDA approved the first-ever cannabis-derived medicine for these conditions, Epidiolex, which contains CBD.
Best: Copper hospital beds harbor 95 percent less bacteria
You’ve probably read hospital-acquired infections sicken over a million people in the US each year, but there’s finally some good news. A new study, published in November in the Applied and Environmental Microbiology, found that copper hospital beds in the intensive care unit (ICU) harbored an average of 95 percent fewer bacteria than the conventional hospital bed.
The study compared the relative contamination of ICU beds outfitted with copper rails, footboards, and bed controls to traditional hospital beds with plastic surfaces. Nearly 90 percent of the bacterial samples taken from the tops of the plastic rails had concentrations of bacteria that exceed levels considered safe. The evidence is compelling but so recent that there isn’t yet a plan in place to replace beds.
Worst: Rise in measles outbreaks
This is a serious problem, according to Caudle, who pleads everyone to vaccinate their children. “According to the CDC, 1,261 cases of the measles were confirmed from January 1 to November 7, 2019, which is the largest number of cases reported in the United States since 1992,” says Caudle. “Most of these cases were in people who were unvaccinated. As a physician, this is not only disappointing, it’s dangerous. Measles can have very serious complications: pneumonia, swelling of the brain, even death. Vaccination is key for reducing the number of measles infections, as well as other diseases. It’s imperative that parents, children and all people eligible for vaccination, get vaccinated.” Check out the things doctors wish you knew about vaccinations.
Best: New antiviral drug is effective in treating flu
A new antiviral drug could be a huge advance in influenza treatment and therapy, as it is highly effective in treating the influenza infection in animals and human airway tissue by inducing mutations in the actual genetic material of the influenza virus, according to a study published in Science Translational Medicine.
“It’s orally available, it’s broad spectrum against all influenza virus strains tested, and most important, it establishes a high barrier against viral escape from inhibition,” says Richard Plemper, PhD, senior author of the study and a professor in the Institute for Biomedical Sciences.
In the study from the Institute for Biomedical Sciences at Georgia State University, researchers showed that the antiviral drug blocks RNA polymerase, the enzyme that plays a central role in replicating the genome of an influenza virus, causing mutations in the viral genome. The study showed that enough mutations occur, the genome becomes nonfunctional and the virus cannot replicate.
Although the drug is still a few years away from making it to market, its impact could be significant: According to the National Institutes of Health, every year in the US, influenza viruses pose remarkable impacts on socio-economy, costs of medical care, loss of productivity, and even deaths.