JUST OUT in @NEJM: Safety / Efficacy data for @novavax COVID-19 vaccine.
-89.7% efficacy against symptomatic COVID-19
-86.3% against alpha variant (B.1.1.7)
-96.4% against other variants
-NO hospitalizations, NO deaths in vaccine arm
DOI: 10.1056/NEJMoa2107659
Brief thread:
@NEJM@Novavax The @novavax vaccine is a (spike) protein-based vaccine, with an adjuvant that psychs up the immune system. This is older tech, like pertussis / Hep B vaccines - and may (?!) be more acceptable to those who are a bit nervous about mRNA vaccines.
@NEJM@Novavax This report is on the UK trial - 15,000 participants. Half got placebo, half the vaccine (which is 2 doses, 21 days apart).
UK means this is mostly white people, though US data seems similar.
@NEJM@Novavax Efficacy 7 days after dose two is solid at near 90%. Starting the clock after dose 1 is, as expected, not as good - 70% or so. We'll need both doses I think.
@NEJM@Novavax Trial was conducted at B.1.17 (Alpha) variant was kicking off in the UK. Efficacy very good here as well. Great news.
Don't get too excited about the high efficacy against "other variants" though - no Delta in the population at the time this trial was going.
@NEJM@Novavax On to safety...
Systemic adverse events worse in vaccine group, particularly after dose 2 which we've come to expect. Most not severe.
@NEJM@Novavax A bit of a different side-effect profile than the @pfizer and @moderna shots. Less fever here. But headache, fatigue, muscle pain pretty common. Feels like some folks might need to take a day off of work after this.
@NEJM@Novavax@pfizer@Moderna Digging into the supplement for details on the serious events. 44 in vax group, 44 in placebo group. Nothing standing out as a "signal" on my first pass. Here's the cardiac data for those worried about this:
@NEJM@Novavax@pfizer@Moderna People always ask about pregnancy. Pregnant women excluded (as ever) from this trial. Some women became pregnant, but I can't find a hard count. One miscarriage reported in the vax group.
@NEJM@Novavax@pfizer@Moderna Take home?
-Solid SOLID efficacy for this protein-based vaccine.
-No data on efficacy against delta though
-Side effect profile seems on par with mRNA vaccines
-No major safety signals.
@NEJM@Novavax@pfizer@Moderna I assume this will get an EUA. The big question is whether this more familiar vaccine tech will move the needle and get some folks into the vaccinated camp. I hope so.
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The GLP-1 receptor agonists (like Ozempic and Mounjaro) are wildly effective weight-loss agents. But are they COST-effective? That's a trickier question. And a new study just out in JAMA Health Forum provides an answer. A resounding "no."
(Thread)
For those of you who like reading articles in the traditional way, please check out my weekly column @Medscape. Good comments there too. buff.ly/4IhGleH
@Medscape I tend to evaluate a drug in terms of efficacy or effectiveness, not cost-effectiveness because I, like most doctors, find it incredibly difficult to know what a drug I may prescribe actually costs (yes, it's ridiculous. Yes, it's true)
If you were on social media during the pandemic, you came across #DiedSuddenly.
Stories of young people, healthy, suffering fatal cardiac arrest out of nowhere. The implication? Those evil vaccines.
It was all bullshit. But I want to talk about why it was so effective.
🧵
Before we dive in, I have a bit longer version of this thread @medscape: buff.ly/4keHNvW
@Medscape The reason I was thinking about this issue this week was because of this study, just published @jamanetworkopen, examining the rate of sudden cardiac arrest and sudden death in middle school, high school, and college athletes. buff.ly/4bkqcPk
NIH has announced a cut in the "indirect rate" to 15% across the board, in a move that appears to be retroactive to even existing grants. This is a bloodbath for research institutions throughout the country.
Brief explainer for those not in this world:
If I am awarded a grant for the NIH, it covers my budget for the research study. It ALSO awards a percentage of that budget (over what I need for the study) to Yale, my institution. That overage is called the indirect rate.
This money is used to pay for office space, electricity, internet, library, journal subscriptions, administrators, printer paper, etc. This stuff is EXPLICITLY not allowed in the main budget for a research study. I can't budget for printer paper. That is all in the "indirects".
This thing keeps happening with ultra-processed food research and it's very confusing to me. People seem to be searching for a link with bad health outcomes that is *independent* of caloric intake. Like... folks... that's the link. (brief 🧵)
I think I got on this kick with the JFK hearings. There was... a lot there. His thoughts about UPF actually come close to the mark though. Except he did this thing that a lot of people do - he blamed the health outcomes of UPF intake on the chemicals and additives and stuff.
The reason that's dangerous is the implication that if we got rid of that stuff, the food would be better for us. Like Doritos without preservatives would be good for us or something. It's really not true.
Every week, I see a new study talking about this or that effect of GLP-1 receptor agonists like #ozempic. FINALLY, we have a study evaluating all the outcomes (good and bad) in one dataset. There are some... surprises. 🧵
Kudos to @zalaly for this analysis, appearing in @NatureMedicine.
You can find the primary source here: buff.ly/4jm6iqC
And my (more in depth) @medscape column here: buff.ly/4gZtbyu
(Or stick with me on this thread).
@zalaly @NatureMedicine @Medscape This is discovery research. It's a shotgun approach to linking the exposure of interest (GLP1ra) to a slew of outcomes. Think the search for extra-terrestrial intelligence. You can point a telescope at some interesting planet or you can listen to the entire sky at once.
Data keeps emerging that suggests GLP-1RAs like #Ozempic curb all sorts of appetites... not just appetite for food. Brief thread on some new findings...
They aren't the splashiest articles, but studies keep suggesting Ozempic has these "off-target" effects. Here's one showing the drug reduces alcohol intake... nature.com/articles/s4159…