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Jun 26 • 22 tweets • 7 min read • Read on X
The medical community has cured a mountain of diseases in the past several decades.

Diseases cured threadđź§µ

In 2013, hepatitis C was cured by direct-acting antivirals. Image
Peptic ulcers are now curable in more than 90% of patients via antibiotic triple/quad therapy (1994). Image
Sickle cell anemia was cured in 2023 for >96% of patients. Image
Ph+ leukemia was once a death sentence, but due to progressive improvements in treatment, most people are able to survive it now. Image
Hemgenix and Roctavian are cures for large numbers of the patients who have hemophilia B and hemophilia A. Image
Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis were very recently cured for the vast majority of patients (~90%). Image
Hereditary ATTR amyloidosis can now be halted with patisiran/inotersen, tafamidis, and vutrisiran.

It used to be fatal within ~ten years of onset. Image
Advanced Hodgkin Lymphoma used to have an extreme fatality rate, but thanks to brentuximab vedotin and nivolumab, ~90% now survive. Image
Hereditary angioedema used to cause unpredictable laryngeal attacks that were often fatal, but after lanadelumab and berotralstat, we now have a near-perfect prophylactic. Image
Paroxysmal nocturnal hemoglobinuria is so serious that ~35% of those who have it die within five years.

Eculizumab makes it so people with the condition can survive just as well as other members of the general population. Image
HER2+ breast cancer used to be the worst subtype, but thanks to trastuzumab (+ pertuzumab, T-DM1, T-DXd), it now has a ~95% survival rate if detected early (and we're increasingly detecting it early). Image
Chronic myeloid leukemia used to kill ~70-80% of people with it within five years, but thanks to 2nd/3rd-gen TKIs, 82% of people now survive 10 years with it.

Most people are functionally cured! Image
Hereditary tyrosinemia type 1 was almost uniformly fatal in childhood, but nitisinone has made it possible for totally normal survival for almost everyone with the condition who has it detected in youth. Image
Gaucher disease type 1 used to shorten and worsen lifespans dramatically, but enzyme replacement therapies have made it possible for people with it to live practically normally. Image
Diffuse large B-cell lymphoma used to kill most with it, but rituximab + CHOP made it so ~65% of people with it could be cured. Image
A repeated theme in cures is that they work for most people. There are, for example, several people who've been cured of HIV via bone marrow transplants.

But this doesn't apply to the majority, because the disease is complex. Complexity will always be true for all diseases.
Many of the cures we receive are functional ones.

We don't figure out how to completely get rid of a disease like we have for, e.g., hairy cell leukemia (1993) or acute promyelocytic leukemia (1995), but instead, we learn how to control disease, like we did with HIV/AIDS: Image
Similar successes have been reached with conditions like cystic fibrosis, where people can now take a drug and live normal lives.

Other treatments like those for SMA type 1 make it so the overwhelming majority survive, although only a majority—not overwhelming—do so healthfully. Image
I can keep listing diseases that have been cured for most, from metastatic GIST to infantile Pompe disease to relapsed/refractory pediatric B-ALL to homozygous familial hypercholesterolemia to... the list goes on.

But I doubt this person really cares.
Medicine actually delivers cures all the time, and it's increasingly delivering them today.

The number of gene therapies that we know work, and which are in the pipeline has exploded. We're entering the era of abundant cures!

And we're *in* an era where plenty has been cured! Image
And who could forget?

With drugs like semaglutide (pictured, from the SELECT trial), tirzepatide (even more effective), and retatrutide (even MORE effective!), almost everyone can now lose weight, and large amounts of it! Image
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More from @cremieuxrecueil

Jun 9
Because America has made the wise decision to compensate blood donors, it has ended up supplying some 70% of the world's blood plasma.

This is one of America's top exports, and each year, America saves hundreds of thousands of lives because it does this. Image
Some people argue against plasma donation on the basis of it being disproportionately used by poorer people

They say it's exploitative: they feel that selling something your body makes is wrong if disparate in ways they care about

But it's a lifesaver!

There's also research indicating that plasma donation can be healthy!

(And there's more indicating that, with compensation, it might reduce crime in the local area.)

Read 4 tweets
Jun 7
It's Pride Month, so let's talk about why San Francisco is so incredibly gay.

Military policy.

đź§µ Image
In 1982, Randy Shilts published his biography of Harvey Milk, entitled "The Mayor of Castro Street".

For those who don't know, Harvey Milk was the first open homosexual to be voted into public office in the state of California.

He was on the San Francisco Board of Supervisors. Image
The biography contains a fair bit of background, not just about Harvey Milk, but about San Francisco's gay community more generally.

In its early years, San Francisco attracted large waves of mainly male migrants motivated by the promise of gold in California. Image
Read 18 tweets
Jun 1
My Uber driver says

- His license is suspended
- He was once a soldier for a Mafia family
- He's telling me about his time in Rikers
- He's showing me YouTube videos
- He's telling me his theories about Jews
He's telling me about gang wars he was in ad a kid.

He's wondering why all the Chinese girls are lined up - for an audition?

He says to go to Mother's Ruin for latin prostitutes.

All of this entirely unprompted.
"Yeah, these African guys, yeesh"

"I couldn't fuck that whore because I got the erectile dysfunction."

He just keeps going.
Read 6 tweets
May 29
This is just not true and it's sad that people believe it.

It's also indicting, when it's so obviously false if you just look out into the world. What you see should match what the statistics clearly show:

Estimated marriage effects for men and women are almost always similarđź§µ Image
In that chart, I used the GSS and found something many people replicate:

1. Cross-sectionally, there's a relationship between being married and life satisfaction. It's similar for men and women.

2. Within persons—causally!—marriage boosts life satisfaction, but more for women.
Leveraging the same within-person design, we can use the Add Health dataset to look at stress and depression.

For both sexes, the effects are indistinguishable.

But they're also mostly not real: it's just that people who get married tend to be less stressed and depressed! Image
Read 10 tweets
May 26
As a recap on my appearance, Eli Lilly is pursuing:

- A one-dose drug for preventing most heart disease
- A vaccine for chlamydia
- A vaccine for gonorrhea
- A vaccine for Epstein-Barr
- A drug that lets you stay awake longer and feel more rested

It's a golden age of pharma! Image
And remember, Eli Lilly's big break historically was the University of Toronto licensing them to produce insulin.

They started off by giving it out for free, saving the world's diabetics at a time when there was no treatment available.

They've always been a force for good. Image
I think

- The heart disease drug will succeed
-- Will it commercialize? It can, easily. But I'm 50/50 due to the competition
- Chlamydia and gonorrhea vax will succeed, but I don't see much commercial potential with Lilly
- EBV vaccine will fail with Lilly, succeed eventually
Read 5 tweets
May 25
Eli Lilly has done it.

They've gone and made what seems to be a powerful, permanent gene therapy for LDL cholesterol.

That means they'll be able to effectively prevent most heart disease with a single infusion! Image
Almost all of the side effects were just things you see with any infusion. Some people react poorly to needles and having to sit for a while🤷‍♀️

And that's what we expect, because the people with good PCSK9 genes naturally are totally fine. This therapy catches the rest of us up!
This is amazing stuff, beating drug administration because it's permanent, and it only gets better from here.

We are going to get so healthy, so fast. Our grandkids are going to hear about heart attacks and have never actually seen one.

Source: nejm.org/doi/full/10.10…
Read 5 tweets

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