News in Circulation 1.31.2024

Biogen pivots away from Aduhelm, an obesity "bill of rights", and some good insights from The Atlantic.

Happy end of January readers! Can you believe one month is already down? Boy, I bet the holidays will be just around the corner at this rate…

Anyways, here are a few stories that caught my attention that are pertinent to this Substack.

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Biogen ends development of controversial Alzheimer’s Immunotherapy Aduhelm

Today Biogen announced that it will no longer continue its clinical trials and development of its controversial drug Aduhelm intended to target the amyloid plaques suspected of being related to the pathology of Alzheimer’s dementia.

The announcement comes after a long, expansive list of issues regarding the fast-tracking of this drug, its high cost, and concerning safety and efficacy issues, and has been covered several times on this Substack, including the fact that a congressional committee reviewed and scrutinized the FDA and Biogen’s approval process which didn’t follow typical guidance:

More articles can be found on this Substack for those interested.

Funnily, Biogen’s press release seems to obfuscate many of these prior controversies, and instead of announcing a discontinuation of Aduhelm have remarked that they will focus their attention on their other FDA-approved Alzheimer’s immunotherapy Leqembi, which has also been covered extensively on this Substack.

The press release makes the following remarks:

CAMBRIDGE, Mass., Jan. 31, 2024 (GLOBE NEWSWIRE) -- Biogen Inc. (Nasdaq: BIIB) today announced plans to reprioritize its resources in Alzheimer’s disease (AD), a strategic therapeutic area expected to drive near and long-term growth. The company will continue to advance LEQEMBI^® (lecanemab-irmb), the first anti-amyloid beta treatment with FDA traditional approval in the United States, and will accelerate development of potential new treatment modalities, including its ASO targeting tau (BIIB080) and an oral small molecule inhibitor of tau aggregation (BIIB113). The company will discontinue the development and commercialization of ADUHELM^® (aducanumab-avwa) 100 mg/mL injection for intravenous use and will terminate the ENVISION clinical study. This decision is not related to any safety or efficacy concerns. A large portion of the resources released resulting from termination of the ADUHELM program will be redeployed in Biogen’s AD franchise.

“As a pioneer in Alzheimer’s disease, Biogen is reprioritizing resources to build a leading franchise to address the multiple pathologies of the disease and patient needs. We plan to further advance the launch of LEQEMBI, together with Eisai, and continue to bolster innovation with the development of the other assets in our pipeline,” said Christopher A. Viehbacher, President and Chief Executive Officer of Biogen. “When searching for new medicines, one breakthrough can be the foundation that triggers future medicines to be developed. ADUHELM was that groundbreaking discovery that paved the way for a new class of drugs and reinvigorated investments in the field.”

It seems that Biogen is returning the rights of Aduhelm to Neurimmune from which it licensed the therapy.

Either way, the remarks here seem to be representative of a more insidious nature of Big Pharma, where companies may seek out and “invest” or “buy” various drugs in development, seeing what sticks, and moving forward with such projects.

I wouldn’t be surprised if Biogen wanted to forego of all the controversies surrounding Aduhelm in favor of Leqembi, even though these drugs seem to act similar in nature and both come with serious side effects.

There’s far less heat around Leqembi, and like a bad date Biogen seems as if it is dropping all baggage and making off as doing good by bringing people something that they so desperately need.

All this to say, don’t let this pivot by Biogen and pharmaceutical manufacturers obfuscate clear concerns over the process of drug approval.

Obese individuals want a “Bill of Rights”

In an ongoing example of modern day’s ridiculousness, USA Today produced an article regarding a supposed “bill of rights” for obese individuals.

The bill seems to want to tackle supposed injustices obese people face, especially when visiting the doctor where any of these individuals’ maladies may be traced back to their weight rather than other sources.

USA Today uses the example of Patty Nece, who had ongoing hip pain even after losing weight, appearing to be related to scoliosis.

The story has an air of something many people may find familiar, in that their health issues may go unrecognized or downplayed by physicians until the disease, especially in the case of cancer, may progress further than would be treatable.

In that regard, stories such as Patty’s may garner a bit of sympathy for those who have difficulty maneuvering the difficult landscape that is healthcare, and yet at the same time Patty’s story is emblematic of a larger cultural issue in which we pretend that our actions and behaviors don’t play at least some part in our overall health.

Even if we consider that Patty’s diagnosis of scoliosis was unrelated to her weight, it doesn’t seem fair to suggest that weight may not be the cause of her hip pain to begin with given that obesity and higher BMI are correlated with a host of issues.

It would be ridiculous for doctors to not consider a cough from a smoker to not be related to smoking, or for an alcoholic with poor kidney/liver function to not be related to the alcohol consumption.

In many cases, it would be within the interest of doctors to start with what may seem the most likely/obvious and work from there, and for those who are obese it wouldn’t be far-fetched to assume an initial concern over weight regarding any symptom that may be presented- doctors do have to start from somewhere when diagnosing.

There’s a real issue regarding how obese the world is becoming, and although it may be true that many people may be underdiagnosed or misdiagnosed for their maladies, it is also true that there are clear factors that are related to health issues that can’t go unrecognized.

And it’s this newfound contradiction that seems to overcorrect and coddle obese individuals while disregarding the serious issues of being obese.

Consider how USA Today frames Patty’s story:

For decades, people with obesity have dreaded interacting with their health care providers.

Take Patty Nece.

When she was in third grade, the school nurse wheeled in a scale and lined up the kids. After weighing the straight-A student, who loved to swim, skate, bike and do gymnastics, the nurse turned to her and announced in front of her classmates: "You're fat and you need to lose weight."

Nece, whose parents and grandparents all carried extra weight, got larger with age.

A successful career as an attorney with the Department of Labor provided plenty of evidence that Nece had self-control, but she blamed herself for every pound gained.

Finally, nearing retirement, she saw a doctor who helped her lose 70 pounds and feel healthier than she had in years. But persistent hip pain sent her to an orthopedist.

The specialist wouldn't listen to her long enough for Nece to share that she has lost weight. "You need to lose weight," he insisted. Then, when he saw her tears, the doctor blamed it on the pain from her excess weight.

"I didn't have the courage to say 'I'm crying because you're being such a jerk,'" Nece, of Alexandria, Virginia, told USA TODAY in a video call. A different doctor later found her hip pain was caused by scoliosis, an inherited curvature of the spine that had nothing to do with her weight.

“People with obesity”? Is this the same as POC? Is obese people now derogatory?

And take how Patty is framed as a very active child who was also overweight. I’m not sure what the intent is here, but there are many people who are overweight or obese who exercise. It doesn’t mean that their weight is not still a concern, although part of me suspects that this wording is another move by fat activists to push how they are “otherwise healthy” despite their weight.

And it doesn’t help that the framing also insinuates some sort of genetic/familial explanation for her weight a la muh genetics.

There are some more nuggets there, including the fact that a doctor’s insistence on her losing weight even after Patty mentioned her prior weight-loss may have suggested something about how much she actually weighed (not indicated here). There’s also the fact that the author seems to suggest that a scoliosis diagnosis is completely independent of weight, when it’s quite likely that weight can be an exacerbating factor in scoliosis (along with other diseases).

Now, I am of the mindset that people shouldn’t go out of their way to harass or target obese people, but I also operate under the reality that obesity is a serious medical issue, and that being obese cannot coincide with being healthy. There’s clear, factual evidence that being obese is not good for individuals, no matter how much fat activists try to say otherwise.

But as to the actual bill, the USA Today article includes some points:

On Wednesday, a group of more than 35 advocacy, aging and health organizations seeking to change the way medical professionals view such patients issued an Obesity Bill of Rights. The bill, which resulted from years of effort, including diverse town hall events across the country, demands better treatment for people who weigh enough to meet the clinical definition for obesity.

The eight "rights" outlined in the declaration include:

The right to accurate, clear, trusted and accessible information.

The right to respect.

The right to accessible obesity treatment in settings that allow for privacy, using equipment and scans that fit patients' bodies.

Like with any modern-day ideology, it seems as if this bill of rights operates under the virtue that people must act according to what fat activists want, rather than obese individuals understanding the reality and gravity of being obese.

Respect is something that shouldn’t be dished out senselessly, and accessible obesity treatment isn’t something that can easily be done. It’s not as if MRI machines and other highly sensitive imaging instruments can just be upscaled easily. This again is an example of ideology that doesn’t have an understanding of how things work. It’s easy to say that these things should be enacted, but to consider costs and the actual R&D needed is something else entirely.

All of this feels like a growing push to coddle people rather than having them face reality. This doesn’t seem like a bill that would actually help people, but make obese people feel comfortable, and apparently at the cost of taxpayers and healthcare providers.

Because at the end of the day, even if your issue isn’t related to your obesity, it is still not healthy to be obese.

Sometimes The Atlantic can provide some food for thought

As much distrust and criticisms the mainstream press receives they still are able to put out a few decent pieces.

This time, The Atlantic put out a rather interesting one regarding how pessimistic the world has become.

There’s a few issues in the article, including the idea that the economy is doing well (my grocery bill says otherwise), but nonetheless the ideas provided by author David Brooks are some things that I have had circulating in my mind, and I wouldn’t be surprised if others had similar thoughts. It at least serves as a reminder that our own negative thoughts can induce more negativity and hysteria. In some regards, it’s sometimes easier to take for granted that many of us share similar values, or that there are many things to be happy for even if things can look rather bleak.

I’ll just leave readers with the article, and would like to see what people think regarding some of the topics discussed:

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