Please Don’t Take Prescription Drug Advice from Kim Kardashian
Kim Kardashian's recent Instagram post promoting a morning sickness medication she had never tried.
Where would you turn if you wanted the best advice about trying a new drug? A doctor with years of specialized training? A website with opinions from leading experts in the field? Maybe a review article by a trustworthy medical reporter. Or, maybe even go right to the source — an article about the drug in the peer-reviewed medical literature.
Or you could choose to get advice from someone whose education ended with high school and who almost certainly has had no training in pharmacology or scientific methodology. In America the answer is, sadly, the high school graduate if he or she is a huge celebrity.
Kardashian appears to have blessed a drug she never used and had no basis to endorse.
Drug manufacturers know this. They turn to celebrities, no matter how ignorant, ill-informed, money grubbing or air-headed, to pitch their goods directly to you on TV and the internet.
The latest example of this reliance on the utterly unqualified is the use of the surgically reengineered, reality show TV star Kim Kardashian to endorse a pill for women suffering from morning sickness during pregnancy. Kim, whose science training, whatever it was, ended when she graduated California's Marymount high school, recently offered this assessment of the medication:
"You know how sick I was while pregnant; I could barely get out of bed. That was before I found a safe & effective med to treat my morning sickness when diet & lifestyle changes didn't help. I hear there's a new formulation of the drug combination I took that's made to work faster & longer. If you're pregnant & feeling sick & changing your diet & lifestyle doesn't work, ask your doctor about Bonjesta® (doxylamine succinate/pyridoxine HCl). Most common side effect is drowsiness. Bonjesta.com for info."
She appears to have blessed a drug she never used and had no basis to endorse. And whether she got all the possible important side effects out there is not clear. In 2015, her internet post lauding another morning sickness drug, Diclegis, made by the same company, Duchesnay, now pushing Bonjesta, earned her $500,000 and Duchesnay a warning letter from the FDA for false and misleading advertising. Duchesnay dealt with the FDA and went on its merry way coming up with new meds relying on confirmation of their value by Kim.
Artificial demand creates more expense downstream for insurers, payer programs, and patients.
It seems pretty likely she was handsomely paid for her kind words about Bonjesta--payment that, if it occurred, is not disclosed in her endorsement or in most commercials in which celebrities tout drugs, vaccines and devices.
Legislators and patients often wonder why the cost of drugs in America is so high relative to the rest of the world. Well, one reason is the rest of the world does not tolerate direct-to-consumer ads aimed at ginning up demand when touted by actors, soap opera stars, sports stars, reality tv icons, quiz show hosts and others selling their fame so you will use a company's drug. Increasing the demand through celebrity endorsement allows companies to jack up their prices. Duchesnay did just that! Artificial demand creates more expense downstream for insurers, payer programs, and patients.
We treat marketing drugs on a par with marketing cosmetics, dishwashers, and fast food. And we get what Kim and other media celebs are paid for: useless information from unqualified sources who can grab eyeballs and get you to pester your doctor about what your idols say works.
Urinary tract infections account for more than 8 million trips to the doctor each year.
Few things are more painful than a urinary tract infection (UTI). Common in men and women, these infections account for more than 8 million trips to the doctor each year and can cause an array of uncomfortable symptoms, from a burning feeling during urination to fever, vomiting, and chills. For an unlucky few, UTIs can be chronic—meaning that, despite treatment, they just keep coming back.
But new research, presented at the European Association of Urology (EAU) Congress in Paris this week, brings some hope to people who suffer from UTIs.
Clinicians from the Royal Berkshire Hospital presented the results of a long-term, nine-year clinical trial where 89 men and women who suffered from recurrent UTIs were given an oral vaccine called MV140, designed to prevent the infections. Every day for three months, the participants were given two sprays of the vaccine (flavored to taste like pineapple) and then followed over the course of nine years. Clinicians analyzed medical records and asked the study participants about symptoms to check whether any experienced UTIs or had any adverse reactions from taking the vaccine.
The results showed that across nine years, 48 of the participants (about 54%) remained completely infection-free. On average, the study participants remained infection free for 54.7 months—four and a half years.
“While we need to be pragmatic, this vaccine is a potential breakthrough in preventing UTIs and could offer a safe and effective alternative to conventional treatments,” said Gernot Bonita, Professor of Urology at the Alta Bro Medical Centre for Urology in Switzerland, who is also the EAU Chairman of Guidelines on Urological Infections.
The news comes as a relief not only for people who suffer chronic UTIs, but also to doctors who have seen an uptick in antibiotic-resistant UTIs in the past several years. Because UTIs usually require antibiotics, patients run the risk of developing a resistance to the antibiotics, making infections more difficult to treat. A preventative vaccine could mean less infections, less antibiotics, and less drug resistance overall.
“Many of our participants told us that having the vaccine restored their quality of life,” said Dr. Bob Yang, Consultant Urologist at the Royal Berkshire NHS Foundation Trust, who helped lead the research. “While we’re yet to look at the effect of this vaccine in different patient groups, this follow-up data suggests it could be a game-changer for UTI prevention if it’s offered widely, reducing the need for antibiotic treatments.”
MILESTONE: Doctors have transplanted a pig organ into a human for the first time in history
A surgeon at Massachusetts General Hospital prepares a pig organ for transplant.
Surgeons at Massachusetts General Hospital made history last week when they successfully transplanted a pig kidney into a human patient for the first time ever.
The recipient was a 62-year-old man named Richard Slayman who had been living with end-stage kidney disease caused by diabetes. While Slayman had received a kidney transplant in 2018 from a human donor, his diabetes ultimately caused the kidney to fail less than five years after the transplant. Slayman had undergone dialysis ever since—a procedure that uses an artificial kidney to remove waste products from a person’s blood when the kidneys are unable to—but the dialysis frequently caused blood clots and other complications that landed him in the hospital multiple times.
As a last resort, Slayman’s kidney specialist suggested a transplant using a pig kidney provided by eGenesis, a pharmaceutical company based in Cambridge, Mass. The highly experimental surgery was made possible with the Food and Drug Administration’s “compassionate use” initiative, which allows patients with life-threatening medical conditions access to experimental treatments.
The new frontier of organ donation
Like Slayman, more than 100,000 people are currently on the national organ transplant waiting list, and roughly 17 people die every day waiting for an available organ. To make up for the shortage of human organs, scientists have been experimenting for the past several decades with using organs from animals such as pigs—a new field of medicine known as xenotransplantation. But putting an animal organ into a human body is much more complicated than it might appear, experts say.
“The human immune system reacts incredibly violently to a pig organ, much more so than a human organ,” said Dr. Joren Madsen, director of the Mass General Transplant Center. Even with immunosuppressant drugs that suppress the body’s ability to reject the transplant organ, Madsen said, a human body would reject an animal organ “within minutes.”
So scientists have had to use gene-editing technology to change the animal organs so that they would work inside a human body. The pig kidney in Slayman’s surgery, for instance, had been genetically altered using CRISPR-Cas9 technology to remove harmful pig genes and add human ones. The kidney was also edited to remove pig viruses that could potentially infect a human after transplant.
With CRISPR technology, scientists have been able to prove that interspecies organ transplants are not only possible, but may be able to successfully work long term, too. In the past several years, scientists were able to transplant a pig kidney into a monkey and have the monkey survive for more than two years. More recently, doctors have transplanted pig hearts into human beings—though each recipient of a pig heart only managed to live a couple of months after the transplant. In one of the patients, researchers noted evidence of a pig virus in the man’s heart that had not been identified before the surgery and could be a possible explanation for his heart failure.
So far, so good
Slayman and his medical team ultimately decided to pursue the surgery—and the risk paid off. When the pig organ started producing urine at the end of the four-hour surgery, the entire operating room erupted in applause.
Slayman is currently receiving an infusion of immunosuppressant drugs to prevent the kidney from being rejected, while his doctors monitor the kidney’s function with frequent ultrasounds. Slayman is reported to be “recovering well” at Massachusetts General Hospital and is expected to be discharged within the next several days.