Health Rounds: Schizophrenia drug using new approach shows promise in trial

Karuna Therapeutics

19/12/2023 20:05

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    By Nancy Lapid
       Dec 19 (Reuters) - Hello Health Rounds readers! For our
last newsletter of the year we feature an experimental drug that
could represent the most significant advance in schizophrenia
treatment in decades, and a body-temperature method for storing
donated livers that may lead to more organs being available for
transplant. We also report on an analysis that found simply
regularly brushing the teeth of hospitalized critically ill
patients may save lives. We'll be back in 2024 with more cutting
edge health science and medicine.    

    Experimental drug takes new approach to schizophrenia
    For the first time in more than seven decades, a new type of
antipsychotic medicine for treating schizophrenia may be close
to commercial availability, researchers said, based on a
successful clinical trial.
    The experimental drug, KarXT from Karuna Therapeutics
 KRTX.O , activates proteins called muscarinic receptors in the
central nervous system, which have recently been shown to play a
role in psychosis. All existing antipsychotic drugs act by
blocking proteins called dopamine receptors.
    The trial detailed in The Lancet involved 252 hospitalized
patients with schizophrenia who received either KarXT or a
placebo over five weeks.
    By the end of the study, patients receiving the drug had
“statistically significant and clinically meaningful” reductions
in all outcome measures, without many of the adverse events
typically associated with current antipsychotic treatments, such
as sleepiness, weight gain and involuntary movement.
    KarXT contains a combination of two drugs: xanomeline and
trospium. Karuna is presently testing it in longer-term studies
in non-hospitalized patients.
    With roughly one in three patients resistant to treatment
with currently available antipsychotic drugs, and with existing
drugs all having disabling side effects, “there is clearly a
major need for more efficacious and safer medications,”
according to a commentary published with the study. 
    Karuna has filed seeking approval of KarXT with the U.S.
Food and Drug Administration with a decision expected in
September 2024.
        
  
        New storage machines improve liver transplantation
    Transplant surgeons are slowly switching over from storing
donated livers in ice to preserving them at normal body
temperatures using an approach that is providing significant
benefits, according to a new analysis.
    From 2016 through 2022, more than 52,000 liver transplants
were performed in the United States, including 742 more recent
cases in which livers were preserved with so-called normothermic
machine perfusion (NMP) between removal from the donor and
implantation in the recipient, researchers reported in the
Journal of the American College of Surgeons. 
    Compared to the cases done with standard cold storage,
surgeons employing NMP were more often able to use livers deemed
to be “marginal”, meaning that some of the donor’s
characteristics increased the risk that the organ might not work
perfectly. 
    Increased use of marginal livers means fewer donated livers
are discarded, the researchers noted. 
    In addition, NMP recipients had more often been waiting
longer for an organ to become available and also were more often
particularly ill.
    Storage times averaged three to four hours longer with NMP
than with cold storage.
    Despite these differences, the percentage of functioning
livers at one year after transplantation were virtually
identical, researchers found.
    Longer storage times are safer for the organs with NMP than
using ice, previous research has shown. In the current study,
significantly more transplant surgeries could be done during
daytime when NMP was employed, whereas standard cases more often
had to be performed in the middle of the night in order to
minimize cold-storage time.  
    Preserving livers at normal temperatures prior to
transplantation has “noteworthy benefits for both patients and
providers,” the researchers concluded.
    
    Toothbrushing in the hospital can save lives
    Daily toothbrushing among hospitalized patients,
particularly those who are critically ill, is associated with
lower rates of hospital-acquired pneumonia and other adverse
outcomes, a new study has found.
    “It’s rare in the world of hospital preventative medicine to
find something like this that is both effective and cheap,”
study leader Dr. Michael Klompas at Brigham and Women’s Hospital
in Boston said in a statement. “Instead of a new device or drug,
our study indicates that something as simple as brushing teeth
can make a big difference.” 
    Klompas and a colleague pooled and analyzed data from 15
randomized trials involving more than 2,700 hospitalized
patients. They found lower pneumonia rates – and fewer
associated deaths - among patients who received daily
toothbrushing compared to those who did not, particularly among
patients on mechanical ventilation. 
    Hospital-acquired pneumonia occurs when bacteria in the
mouth enter a patient’s airways and infect their lungs. Daily
toothbrushing can decrease the amount of bacteria in the mouth,
potentially lowering the risk, the researchers explained on
Monday in JAMA Internal Medicine.
    Toothbrushing was also associated with shorter duration of
mechanical ventilation, shorter intensive care unit (ICU) length
of stay, and lower ICU mortality.
    “The signal that we see here towards lower mortality is
striking. It suggests that regular toothbrushing in the hospital
may save lives,” Klompas said. 


 (Reporting by Nancy Lapid; Editing by Bill Berkrot)
 ((nancy.lapid@thomsonreuters.com))