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Managed Healthcare

Featured Articles

Explore a featured selection of my writing work below.

Stopping or Changing Biologics in Severe Asthma Leads to Worse Clinical Outcomes

Stopping or Changing Biologics in Severe Asthma Leads to Worse Clinical Outcomes Findings from research presented at the American College of Chest Physicians suggest the importance of selecting the right biologic from the start. For many with severe asthma, biologic therapy has changed the way they live with asthma. Biologics have been shown to reduce the frequency of asthma exacerbations, hospitalizations, emergency room visits, and the need for oral corticosteroids in individuals who once ha

Mindfulness-Based Stress Reduction Improves Asthma Control and Reduces Airway Inflammation

Studies have shown that individuals with asthma as well as mood or anxiety disorders and psychological distress tend to have poorer control of their asthma, more severe symptoms, and greater utilization of healthcare services than asthma patients without these conditions. Additionally, chronic stress aggravates asthma symptoms and promotes type 2 inflammatory responses, such as those seen in severe asthma. Mindfulness-based stress reduction (MBSR) is a nonpharmacological approach for treating c

Removing the CD47 ‘Do Not Eat Me’ Sign

Macrophages, which are cells that engulf or “eat” other cells, are key players in the body’s immune response. But they need some guidance. Checkpoints built into human cells keep macrophages and the immune response from going amiss. A protein called cluster of differentiation 47 (CD47) is a main checkpoint for macrophages. The presence of this marker on a cell acts as a “do not eat me” sign for macrophages. CD47 is ubiquitous in healthy cells and overexpressed in many myeloid malignancies, incl

Drugs on the Fast Track as Treatments for PTSD

Post-traumatic stress disorder (PTSD) is a chronic psychiatric condition that occurs in some people after experiencing or witnessing traumatic events, such as military combat trauma, childhood trauma and physical or sexual assault. PTSD is associated with several uncontrolled and debilitating symptoms typically triggered by trauma reminders, including nightmares, intrusive thoughts, flashbacks, hypervigilant behaviors, avoidance of traumatic reminders and sleep disruptions. People with PTSD are

Asthma Exacerbations Associated With Poor Lung Function

Exacerbations are believed to be a significant but potentially modifiable cause of declining lung function in some people.Loss of lung function over time is associated with comorbidities, including chronic shortness of breath and premature death. Asthma exacerbations can wreak havoc in patients’ lives. Difficulty breathing can result in frequent trips to the emergency room visits, absences from work and a host of other problems. Asthma exacerbations are also associated with healthcare costs, bu

Treatment for Hemophilia: Many Decisions, Some Difficult, All Should Be Shared

Treatment for Hemophilia: Many Decisions, Some Difficult, All Should Be Shared The hemophilia organization developed a shared decision-making tool for patients and providers. With the anticipated regulatory approval of novel hemophilia gene therapies, many in the hemophilia community have identified the need for and importance of people with hemophilia to fully participate in a shared decision-making process with healthcare professionals. In a paper published last June in the journal Patient P

Treatment for Hemophilia: Many Decisions, Some Difficult, All Should Be Shared

Treatment for Hemophilia: Many Decisions, Some Difficult, All Should Be Shared The hemophilia organization developed a shared decision-making tool for patients and providers. With the anticipated regulatory approval of novel hemophilia gene therapies, many in the hemophilia community have identified the need for and importance of people with hemophilia to fully participate in a shared decision-making process with healthcare professionals. In a paper published last June in the journal Patient P

Judging Up-and-Coming Hemophilia Treatments

Long-acting recombinant replacement factor gets favorable rating from multidisciplinary group. Gene therapy was viewed with some wariness. Anticipated agency approvals of emerging innovative hemophilia treatments are bound to disrupt healthcare organizations and patient care management. The pipeline includes subcutaneously administered coagulation factor replacements, treatments with a longer duration of action and potentially curative gene therapy. In a pilot study published in PLOS ONEin Sept

Asthma Education Program in a Hispanic Community Proves To Be Cost Effective

Asthma Education Program in a Hispanic Community Proves To Be Cost Effective Program in Hidalgo, Texas, cost less than $250 per family. A study found that the intervention saved each household an average of $36 per day. According to the U.S. Department of Health and Human Services, Hispanic people with asthma are twice as likely to have emergency room visits due to asthma-related events compared with non-Hispanic white individuals. Additionally, Hispanic children are 40% more likely to die fro

Predicting Loss of Lung Function in Children With Asthma

Children with nonsevere and severe asthma are more likely to have declining lung function throughout childhood and into adulthood. Yet predictors of which children will experience poor lung function in have not been thoroughly explored or identified In a study published in August 2022 in the Journal of Allergy and Clinical Immunology, researchers used data from the Severe Asthma Research Program (SARP) 3 pediatric cohort study to discover phenotypic factors that contribute to declining lung fun

Diabetes and HIV May Increase Risk of Hypertension in People with Hemophilia

Diabetes and HIV May Increase Risk of Hypertension in People with Hemophilia Findings suggest that screening people with hemophilia for diabetes and hypertension might have benefits. A study published in the journal Haemophilia in July 2022 found that diabetes and human immunodeficiency virus (HIV) infection increase the risk of hypertension in men with hemophilia. This is of concern in the hemophilia population because both diabetes and hypertension are associated with an increased risk of in

Gene Therapy for Severe Hemophilia B Could Be More Cost Effective Than Current Treatments

Gene Therapy for Severe Hemophilia B Could Be More Cost Effective Than Current Treatments An analysis found that a single dose of gene therapy would be more cost-effective than on-demand or prophylaxis factor replacement in 92% of cases. Hemophilia is a hereditary, lifelong, and life-threatening disorder that, until recently, has had no prospective cure. Gene therapy might change that, but the cost has been predicted to be in the millions. Individuals with hemophilia have a gene mutation that

An NIH Trial of Severe Asthma Treatment Tailored to Subtypes

An NIH Trial of Severe Asthma Treatment Tailored to Subtypes Repurposing Gleevec as an asthma drug is one of the possibilities that the PrecISE trial of severe asthma is examining. The trial has an adaptive design. Although severe asthma accounts for only 3% to 10% of the adult population with asthma, it makes up more than half of healthcare expenses related to asthma. Some of that cost includes the development of new and effective treatments. People with severe asthma have difficult-to-contro

A Possible Link Between Acid Reducers and Asthma

Acid suppressants, particularly proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2 blockers), are often prescribed to treat gastroesophageal reflux and gastroesophageal reflux disease (GERD) in infants. The PPIs include drugs such as lansoprazole, which is sold under the brand name Prevacid, and omeprazole, sold under the brand name Prilosec. The H2 blockers include cimetidine, sold as Tagamet, and famotidine, sold as Pepcid AC. Evidence of the efficacy of the acid blockers i

Gene Therapies for Hemophilia. Possibly Curative, Likely Ultraexpensive

Hemophilia is a rare, X-linked, hereditary bleeding disorder characterized by blood clotting factor deficiencies that affects mainly males. It results in excessive bleeding, particularly in the joints, soft tissues and muscles. The bleeding usually happens after internal or external trauma, but in rare cases, it occurs spontaneously. According to the CDC, up to 33,000 males in the United States live with hemophilia, but the condition can be fatal. Hemophilia is divided into subtypes, the two mos

Anxiety, Depression, and Diabetes Higher in Older Males with Hemophilia; Cardiovascular Disease Lower

Anxiety, Depression, and Diabetes Higher in Older Males with Hemophilia; Cardiovascular Disease Lower Lack of blood clotting may afford some protection against common cardiovascular disease events, such as ischemic stroke. People living with hemophilia now can expect a longer lifespan than those who had the disease decades ago. Thanks to new advances in treatment, people with hemophilia now have an average life expectancy close to that of people without hemophilia. However, living into older a

For Plaque Psoriasis Treatment, Abundance Gets More Company

Note: This story was updated on Aug. 19 People with plaque psoriasis have a number of treatment options: topical agents, phototherapy, oral treatments and biologics. And now drugmakers are vying to create even more. In front of the queue is Vtama (tapinarof) cream 1%, the first nonsteroidal topical agent approved to treat plaque psoriasis. Developed by Dermavant Sciences, a biotech company in Morristown, North Carolina, Vtama is a cream containing an aryl hydrocarbon receptor agonist. Aryl hyd

Why Steroids Don’t Work in Severe Asthma Patients

Over 25 million people in the United States live with asthma, and up to 10 percent of these hve severe asthma, according to the American Lung Association. In most people with asthma, inhaled corticosteroids are effective as rescue and maintenance therapy in decreasing airway swelling and irritation. However, people with severe asthma fail to respond to inhaled corticosteroids. Until recently, the reasons behind this poor response had been a perplexing mystery. In a study published earlier this

Cost Effectiveness Analysis of Biomarkers for Guiding Asthma Treatment in Children

Current Global Initiative for Asthma (GINA) guideline for asthma management recommends periodic evaluation of airway inflammation to prevent hospitalization in people with asthma. Additionally, monitoring airway inflammation provides a valuable tool for predicting asthma exacerbations, which in turn aids in optimizing the use of biologics and corticosteroid treatments. Although various methods exist to conduct this assessment, noninvasive procedures tend to be more feasible in pediatric patient

American Academy of Family Physicians Awarded $31 Million for Comparative Asthma Treatment Study

The Patient-Centered Outcomes Research Institute (PCORI) has approved an award for the American Academy of Family Physicians (AAFP) of $31 million to fund a large comparative study of asthma treatments. Penn State College of Medicine will partner with the AAFP, serving as the data coordinating center for the study. The Individualizing Treatment for Asthma in Primary Care (iTREAT-PC) study will enroll 3,200 adults and adolescents 12 to under 76 years of age who have asthma. The study will be con
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