There has been a lot in the news lately about aducanumab (Aduhelm), a new monoclonal antibody treatment for Alzheimer’s disease. 

Alzheimer’s disease is a neurological disease and is the most common cause of dementia. It causes destructive, progressive, and irreversible changes in the brain. A common feature is the accumulation of a protein called amyloid-β in the form of plaques and tau tangles. Both are thought to cause cell death, but they have not yet been shown to be the cause of Alzheimer’s disease.

Aducanumab (Aduhelm), a drug that reduces amyloid-β plaques, was approved by the FDA on June 7, 2021 for treatment of all stages of Alzheimer’s disease. The approval was quite controversial for several reasons.

  • Many experts are concerned that accelerated approval of aducanumab without convincing evidence is premature, especially since it was only tested on those with early Alzheimer’s disease but was approved for all stages. In fact, there is no evidence at all that aducanumab is effective in patients with advanced Alzheimer’s disease.
  • The government is now looking at the issue since Alzheimer’s disease primarily occurs in seniors and Medicare will be picking up most of the tab for a medication that may have little benefit.
  • The Boston Globe reported unofficial meetings between the manufacturer and an FDA director that may have influenced the decision. 

The reason for the controversy can be confusing, so I will try and explain the different sides of the issue to help you understand what the fuss is about. There are basically three perspectives to consider when breaking down this issue.

  1. Those who believe there was not enough good evidence that aducanumab improves patients with Alzheimer’s disease to approve the drug, especially for use in those with advanced disease.
  2. Those who feel that the fact that there are no other available treatments justifies the use of aducanumab without convincing evidence and despite the known side-effects.
  3. Those who are concerned that the healthcare system cannot afford the $58,000 yearly cost of medication, along with the cost of brain-imaging tests, infusions, and provider visits, especially if the benefits are only subtle.

The Evidence

Basing medical treatments on solid evidence is of major importance to healthcare providers. There are too many examples of unhelpful

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Transgender Pride Flag

Transgender Awareness Week falls between November 13-19 every year and is meant to help raise visibility of a vulnerable and underserved community.  ‘Transgender’ is an umbrella term for people whose gender identity is different from the sex assigned at birth; ‘gender identity’ is one’s innermost concept of self as male, female, a blend of both, or neither.

Transgender/gender non-conforming people experience gender dysphoria, a clinically significant distress recognized by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) caused by a person’s assigned birth gender differing from the one with which they identify. This leads to increased depression among the transgender community, which can be exacerbated by being rejected by family and friends, abuse/violence, or experiencing discrimination. Gender-affirming operations have shown to yield long-term mental health benefits for transgender people.

Transgender and gender-nonconforming people can face significant problems with accessing health care. Finding a healthcare provider who is

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The last week of March has been LGBT Health Awareness Week since 2003. We have explored some of the barriers to healthcare for the transgender community in previous blog posts, but it remains important to bring awareness to the unique healthcare needs of lesbian, gay, bisexual, and transgender people and the health disparities that continue to affect the lives of so many Americans.

Experts report that LGBT people often avoid seeking out medical care or refrain from “coming out” to their healthcare provider. This compromises an entire community of lesbian, gay, bisexual, and transgender individuals who are at increased risk for several health threats when compared to heterosexual or cisgender peer groups: Gay men are at higher risk of HIV and other sexually transmitted infections; lesbians are less likely to get cancer screenings; transgender individuals are among the least likely to have health insurance along with risks from hormone replacement and atypical cancers. Even as youths, LGBT people are at higher risk of violence, depression, substance abuse, homelessness, and other suicide-related behaviors.

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Transgender Pride Flag

Transgender Awareness Week falls between November 12-19 every year and is meant to help raise visibility of a vulnerable and underserved community.  ‘Transgender’ is an umbrella term for people whose gender identity is different from the sex assigned at birth; ‘gender identity’ is one’s innermost concept of self as male, female, a blend of both, or neither.

Transgender and gender-nonconforming people can face significant problems with accessing health care. Finding a healthcare provider who is knowledgeable of transgender health issues can be a hurdle itself; some healthcare professionals may believe that there is something wrong with someone because they are transgender—they are wrong. Even after finding a knowledgeable and sympathetic doctor, insurance may not cover the cost of treatment. Many transgender people are on a dosage of hormones which can affect one’s blood pressure, blood sugar, or in rare cases contribute to cancer. Some cancers found in transgender people can appear atypical—trans men are at risk for ovarian and cervical cancers, and trans women can be diagnosed with prostate cancer.

Transgender/gender

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Today is World Asthma Day, and we are in the midst of the time of year many know for seasonal allergies and asthma attack symptoms. Most spring allergies are caused by pollen released by trees, grass, weeds, and other plants and can cause runny nose, itchy eyes, and other uncomfortable symptoms. The rising temperatures can also negatively impact those with asthma.

While some of the symptoms are the same, allergies and asthma are two entirely different diseases, but there can be overlap. The primary difference is that allergies are a disease of the immune system whereas asthma is a disease of the lungs. Over 26 million Americans are affected by asthma. There are two types of asthma, allergic and non-allergic, with similar symptoms caused by airway obstruction and inflammation. The most common symptoms are shortness of breath, chest tightness, coughing and wheezing. The difference between the two is that non-allergic asthma is triggered by a variety of causes (such as cold air, exercise, smoke, or stress and anxiety) while

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