The Scan by 2 Minute Medicine®: Veozah for Hot Flashes, Affordable Care Act Mandate for Preventive Care, Pride Month, and RSV Drug for Infants

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Veozah for Hot Flashes

The Story: The Federal Drug Administration (FDA) recently approved a drug to treat some of the symptoms of menopause, including hot flashes and night sweats. The newly approved medication, Veozah, is a non-hormonal medication and the first of its kind for treatment in menopause. The new treatment option represents an exciting new development, especially for those who are unable to take the standard hormonal therapies.

What is Menopause?

Menopause is the changes that occur in middle-aged women that involve the end of menstrual periods. Menopause typically occurs anywhere between the ages of 45 and 55 and is defined as the 12 months following a woman’s last menstrual period. Although it is only these 12 months that define menopause, the menopausal transition, or perimenopause, which includes the onset of irregularities in menstrual cycles and symptoms, can last several years. Common symptoms of menopause are due to fluctuations in estrogen levels and can include changes in sexual function, mood swings, hot flashes, and night sweats. Although menopause is a normal part of life, there is a lot of stigma around the transition, with many women experiencing shame and embarrassment. In fact, a UK study showed that nearly half of menopausal women haven’t spoken to their doctor about menopausal symptoms because of the stigma. These feelings towards menopause affect the workplace as well, with studies showing that many women feel they need to suffer silently at work. As a result, there is a push for “menopause friendly” workplaces which educate workers about the stigma and employ policies that make the transition easier for women. Talking about menopause and recognizing it as a normal part of life can help reduce the social burden that is placed on women going through this transition.

Symptom Control

Managing menopause symptoms can also be a challenge. Studies show that nearly three quarters of menopausal women don’t seek treatment for their symptoms. Not only can poor symptom management lead to discomfort, but it can also have health implications. Studies show that an increased frequency of symptoms such as hot flashes and night sweats is correlated with weight gain, poorer cardiovascular health scores, and lower overall quality of life. The typical treatment for these symptoms is hormone therapy: either estrogen alone, or in combination with progesterone. These treatments are quite effective, but for those who are unable to use these therapies, such as past and present hormone-sensitive breast cancer patients, the options are quite limited. The new drug, Veozah. will hopefully serve as an important alternative to manage symptoms in those who are unable to take standard therapies.

Affordable Care Act Mandate for Preventive Care

The part of the Affordable Care Act that requires insurance companies to cover the cost of preventive care interventions has been restored after some uncertainty. Earlier this year, the mandate was ruled as unconstitutional in court, which put access to many preventive care options for Americans in jeopardy. However, deliberations on whether to remove this part of the act are ongoing.

Preventive medicine is the branch of medicine involved in preventing or stopping disease. Preventive medicine is often seen as the gold standard: making sure people don’t get sick, rather than treating them once they have already fallen ill. Things that fall under the umbrella for preventive medicine include cancer screening, HIV prevention with the pre-exposure prophylaxis (PrEP) pill, vaccinations, and more. These interventions are often very successful, with the PrEP pill alone reducing the risk of sexual transmission of HIV by nearly 99%. Not only does preventive medicine result in improved patient outcomes, but it also has a huge economic benefit. With so much money diverted to the management of chronic diseases, estimates suggest that finding and treating conditions early could result in significant cost savings. Unfortunately, if insurance companies are no longer required to pay for these preventive measures, they will become inaccessible for many Americans.

Pride Month

June is Pride Month — a time to celebrate the LGBTQ+ community! It is also a time to draw attention to the inequalities that exist in this community and advocate for equality. With regard to the healthcare system, LGBTQ+ folks face unique challenges. For example, LGBTQ+ youth are at higher risk for several conditions, including sexually transmitted infections, cancers, mental health struggles, and more. LGBTQ+ folks are also less likely to have a primary care provider, and youth in this community are less likely to access necessary medical care than non-LGBTQ+ youth. As a result, the LGBTQ+ community experiences worse health outcomes than the general population.

One of the reasons for these findings is because of discrimination and stigma. Studies show that over 50% of surveyed LGBTQ+ adults have been subjected to discrimination, and this is also prevalent in the healthcare system. Part of this stems from a lack of education: more than three quarters of medical school students in a 2018 survey reported that they feel not competent or only somewhat competent in providing medical care to sexual and gender minorities. Although medical school teaching on LGBTQ+ health is limited, some schools are focusing on including more of this teaching into their curriculum. Developing cultural competency in treating LGBTQ+ patients is one way to ensure the medical system is a safe space for all.

RSV Drug for Infants

Following a significant spike in respiratory syncytial virus (RSV) over the winter, an advisory committee for the FDA unanimously voted in favor of approving a drug to protect infants against RSV. If the FDA follows the advice of the advisory panel and approves the drug, Nirsevimab would be the first to protect infants from RSV.

RSV typically presents as an upper respiratory tract infection but can also infect the lower respiratory tract. Although very common in the general population, serious illness can ensue in infants. In fact, RSV is one of the most common causes of death in the first year of life globally, second only to malaria. This is because infection can lead to a number of complications, including pneumonia. Although RSV can infect someone at any age, infants are more susceptible to the harmful effects because of their limited exposure and immunity. Furthermore, RSV leads to an inflammation of the airways. Infants have smaller airways and are more susceptible to this inflammation, leading to more significant symptoms.

As a result, there is a huge push to protect infants from the potentially harmful effects of RSV. The drug up for debate, Nirsevimab, is an antibody that can help prevent severe symptoms of RSV in infants. The drug was found to reduce infant RSV hospitalizations by over 80%. After a difficult winter of surging RSV cases, the new medication may play an important role in the protection of infants next flu season.

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