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Michael Lin, MD PhD 🧬 Profile picture
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Mar 17 • 9 tweets • 4 min read
For Biogen, a funny thing happened on the way to issuing a press release...

Yesterday they announced "Peer-Reviewed Publication of ADUHELM® Phase 3 EMERGE and ENGAGE Data in The Journal of Prevention of Alzheimer’s Disease"

globenewswire.com/news-release/2…
The link in the PR for the Aduhelm paper is www-dot-jpreventionalzheimer-dot-com/category/articles-html. But this reveals an article not by Biogen and not about Aduhelm (true yesterday and now)

Alanko et al (Karolinska) are going to see incredible metrics for their paper! Image
Yesterday I searched JPAD for Biogen and Aduhelm and could not find the right link, so gave up. Was going to joke that Biogen's layoffs might have gone a bit too far if they were hiring low-wage workers for their press releases.
In the meantime, multiple articles such as from Stat and Fierce Pharma are uncritically using the same wrong link, sending even more traffic to Alanko et al and certainly confusing anyone with an interest in Biogen. For example,
fiercepharma.com/marketing/biog…
Or this one, where the wrong link makes the bad news seem even worse than it is
statnews.com/2022/03/16/bio…
Today, the mystery is solved. Biogen updated their press release (investors.biogen.com/news-releases/…) so the link now goes to an internet archive
web.archive.org/web/2022031616…
The wayback machine shows the URL www-dot-jpreventionalzheimer-dot-com/category/articles-html did at one time point to their article. More imoprtantly, we now get a title and DOI. They should have used the DOI to begin with. Image
But you *still* can't find their paper from the JPAD website if you search Aduhelm or by author names. So there is additional downside to publishing in a little-known journal: even something as vital as search may not work, or the journal is very slow to update their databases.
However the doi works and it gives you the Springer autogenerated full-text format

@statnews @FiercePharma you're welcome

link.springer.com/article/10.142…

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More from @michaelzlin

Michael Lin, MD PhD 🧬 Profile picture
Mar 20
Curious why Pfizer's 2-dose vax for <5yo failed and if Moderna will do better? I was too, so I looked into it.

It was a bit of a brainteaser, but basically Pfizer played it safe and got blindsided by Omicron but Moderna should do better if side effects are tolerable

a thread
Basic facts: Pfizer's 2-dose vax for 2 to <5yo is 3mcg, compared to 10mcg for 5 to <12yo and 30mcg for ≥12yo. It's also 3mcg for 0.5 to <2yo, by the way, which is an interesting clue in the failure analysis. Ph3 enrollment started in summer 2021.
pfizer.com/news/press-rel…
WSJ reported that the 2 to <5yo vax (going to write 2–4yo now) was not working well against Omicron. VE was ~50% for Delta and then dropped for Omicron. It was also reported that the vax induced lower Abs in 2-4yo than the approved 30mcg for adolescents.
wsj.com/articles/lower…
Read 26 tweets
Michael Lin, MD PhD 🧬 Profile picture
Mar 17
Probably a good thing that the new coronavirus "czar" (not my word choice) actually comes from the health sector.
nytimes.com/2022/03/17/us/…
Glad this article didn't try to hide Zients' failures in understanding the pandemic: 'The American Prospect, a liberal website, published an article titled “Fire Jeff Zients” that said he had “proven himself not up to the task, and Biden should relieve him of his duties.”' Image
The story gave a certain quotable person a chance to contradict himself. Credit for looking where the puck is going to be should be reserved for those who actually look at the correct place! Image
Read 10 tweets
Michael Lin, MD PhD 🧬 Profile picture
Mar 17
Nice study but the Novavax samples taken 55-191 days after vaccination, whereas RNA samples were taken 14 days at peak. You'd expect a 3- to 10-fold decay in that time. If you adjust for that, then Novavax looks similar on original and better on Omicron than RNA vax.
The imbalance in collection times is seen in this table. It also seems to show a recordkeeping problem with the Novavax samples; for each sample two possible collection times. It seems they don't know which is correct? That should disqualify the data actually. Image
I didn't want to conclude anything about Novavax from this paper as a result, but I was asked about it and I see it's being presented on twitter. So now I'm explaining why I think any comparison between Novavax and other vaccines is questionable.
Read 8 tweets
Michael Lin, MD PhD 🧬 Profile picture
Mar 15
Great news for SA. They relied heavily on J&J and provide much knowledge about J&J's lower efficacy vs other vaccines. They've now joined most of the world in recommending 2 boosters after J&J.

Meanwhile the USA is still stuck on 1 booster only for JnJers.
And despite having been one of J&J's most vocal supporters, South Africa's health ministry is allowing heterologous boosting. That heterologous boosting works better than homologous boosting for J&J is now common knowledge.
In case we needed another reminder, a paper just came out last week (one I had analyzed as a preprint) showing J&J + 1xPfizer was much better than J&J + J&J, and similar to 2xPfizer, finally
sciencedirect.com/science/articl…
Read 7 tweets
Michael Lin, MD PhD 🧬 Profile picture
Mar 14
In a recent thread, I analyzed Novavax vax data and hypothesized it might elicit broader antibodies than the RNA vaccines and thus be more protective vs. variants.

Now we'll explore differences between Novavax and RNA vaccines that could account for this

Novavax is S protein assembled with lipids in viral-like nanoparticles. These are taken up by APCs (DCs, macrophages), and S fragments presented on MHC2 to activate CD4+ T cells. B cells with surface Ig recognizing S and coactivation by CD4+ T cells via MHC2 then get expanded.
RNA vax deliver RNA to cells to express S. Some cells die with S at the ER-Golgi and surface. S-containing membranes are digested by APCs and S fragments presented on MHC2 to activate CD4+ T cells. B cells bind S on cells to get their 1st signal.
(Pic: doi.org/10.1038/s41541…)
Read 15 tweets
Michael Lin, MD PhD 🧬 Profile picture
Mar 8
Huge issue with Test2Treat is it's unknown if antiviral drugs is any use for vaxxed or previously infected, which is 90% of everyone now.

But Test2Treat is advertised as if for everyone. That encourages bad medicine. Topol should be against, not for, it.

washingtonpost.com/health/2022/03…
As I've said before, antivirals are merited in vaxxed cases of high-risk conditions or advanced age, who have more severe and longer-lasting breakthroughs. But this program is being promoted without those qualifications (they're not mentioned in the article for example)
About Topol's concerns that supply won't meet demand: would certainly be a problem if a bunch of people who didn't need it demanded it and answered questionnaires in a way to get it.

Thus worried by govt pushing this without better education. Could create unneeded run on drugs.
Read 5 tweets

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