Medical Bulletin 09/ July/ 2024

Here are the top medical news for the day:

Could Daily Sauna Sessions Prevent Menopausal Weight Gain? Study Sheds Light

New research, presented at NUTRITION 2024 — the annual meeting of the American Society for Nutrition— highlighted heat treatments as a method to encourage healthier ageing.

The study suggested that whole-body heat therapy could be an effective and non-invasive method for managing both age-related and menopause-related weight gain and insulin resistance.

The findings were published in the journal Current Developments in Nutrition.

Menopause, the natural biological process marking the end of a woman's reproductive years, typically occurs in the late 40s to early 50s. During menopause, hormonal changes, particularly the decrease in estrogen levels, can lead to various physical and emotional symptoms. One common issue is weight gain. This weight gain is often due to a slower metabolism, loss of muscle mass, and changes in fat distribution. Managing weight during menopause can be challenging but is crucial for overall health, as excess weight can increase the risk of heart disease, diabetes, and other conditions.

In a recent study, researchers investigated the effects of daily heat therapy on weight gain during menopause by using 10-month-old mice to model aging and mice with their ovaries removed to simulate postmenopausal conditions. To induce weight gain, the mice were fed a Western diet with 45% of calories from fat.

One group of mice underwent daily 30-minute heat therapy sessions in a chamber set to 40℃ (104°F) for 12 weeks, while the other group did not receive any heat treatment.

The results showed that the aging mice receiving heat therapy had significantly lower levels of lactate dehydrogenase, indicating reduced tissue damage related to aging.

Moreover, heat therapy effectively prevented weight gain caused by the high-fat diet in both aging mice and those with their ovaries removed. Compared to the untreated mice, those that received heat therapy exhibited notable improvements in insulin sensitivity and signaling, and decreased fat accumulation in critical areas like the liver and brown fat. Brown fat, unlike regular adipose tissue, is metabolically active and helps the body burn more energy.

“Our research shows that daily whole-body heat treatment (104-113°F) for 30 minutes can significantly reduce obesity and improve insulin sensitivity in older female mice and mouse models that simulate menopause. The 30-minute daily duration for heat treatment was chosen based on CDC guidelines, which recommend at least 150 minutes of moderate-intensity physical activity per week for adults,” said Rong Fan, author of the study.

Reference: Rong Fan, Sean Bannon, Judy Kim, Gwenael Layec, Soonkyu Chung; Hyperthermia Treatment Attenuates Diet-Induced Obesity and Insulin Resistance in Old Female and Ovariectomized Mice via TRPV1-Mediated Futile Calcium Cycling; Current Developments in Nutrition;2024; https://doi.org/10.1016/j.cdnut.2024.102231.

Acupuncture can help boost sleep quality in Parkinson’s disease: Study

Parkinson’s disease is a neurological disorder that impacts movement and can lead to cognitive changes. While there is no cure for Parkinson's, treatments are available to slow its progression and alleviate symptoms.

Parkinson’s disease worsens over time, but symptoms can be managed with medications, surgical treatments such as deep brain stimulation, and occupational or physical therapies.

While these therapies help with symptoms, they can also contribute to reducing sleep quality in people with Parkinson’s disease. Poor sleep can worsen Parkinson’s symptoms and overall contribute to a worsened quality of life.

To address this, researchers in China conducted a study to evaluate the effectiveness of acupuncture in improving sleep for Parkinson’s patients.

The study was published in JAMA Network Open.

In the study, researchers studied 78 participants aged 30 to 80 with moderate to severe sleep issues who were taking anti-Parkinson’s medication. Before treatment, participants completed the Parkinson’s Disease Sleep Scale (PDSS) questionnaire to assess their sleep quality.

Participants were randomly divided into two groups: one received real acupuncture, while the other received placebo acupuncture. Both groups underwent 30-minute acupuncture sessions three times a week for four weeks. They completed the PDSS again after four weeks and at an eight-week follow-up.

The real acupuncture group showed significant improvements in sleep quality, with a 29.65-point increase in PDSS scores after four weeks, compared to a 10.47-point increase in the sham group. The real acupuncture group continued to show improvement at the eight-week follow-up, while the sham group did not.

Additionally, the real acupuncture group experienced reductions in both motor and non-motor skill severity. No participants had adverse side effects, leading researchers to conclude that acupuncture is a safe and effective therapy for improving sleep quality and overall quality of life in people with Parkinson’s disease.

“Acupuncture offers significant, lasting improvements in sleep quality for patients with Parkinson’s disease. Notably, acupuncture has no side effects and does not interfere with existing medications, making this a groundbreaking discovery. While it should not replace traditional Parkinson’s disease treatments, acupuncture can serve as an effective complementary therapy,” said the authors.

Reference: Yan M, Fan J, Liu X, et al. Acupuncture and Sleep Quality Among Patients With Parkinson Disease: A Randomized Clinical Trial. JAMA Netw Open. 2024;7(6):e2417862. doi:10.1001/jamanetworkopen.2024.17862

Clinical Trial Shows Injection Twice a Year 100% Effective in HIV Treatment

Large-scale clinical trials conducted in Uganda and South Africa have revealed a groundbreaking advancement in HIV prevention. The trials demonstrated that a novel pre-exposure prophylaxis (PrEP) medication, administered twice a year, completely protects young women from HIV infection. This discovery offers a promising new method for managing the virus, especially for those who struggle with daily medication adherence.

The Purpose 1 trial, led by principal investigator Linda-Gail Bekker, tested the efficacy of two different drugs: daily pills and an injection of Lenacapavir.

Lenacapavir, also known as Len LA, is a fusion capsid inhibitor that interferes with the HIV capsid—a protein envelope that protects the virus's genetic material and essential replication enzymes. Administered subcutaneously once every six months, lenacapavir proved to be a formidable defense against HIV.

The randomized controlled trial included 5,000 participants across three locations in Uganda and 25 sites in South Africa. The trial had three primary objectives:

1. To determine if a six-monthly injection of lenacapavir was safe and more effective in preventing HIV infection among women aged 16 to 25 years compared to Truvada (F/TDF), a daily PrEP pill widely used for over a decade.

2. To assess whether Descovy (F/TAF), a newer daily pill with superior pharmacokinetic properties, was as effective as Truvada. Pharmacokinetics refers to how a drug moves into, through, and out of the body.

3. To evaluate the overall efficacy and safety of lenacapavir in comparison to the other medications.

The trial included three arms, with participants randomized in a double-blind manner in a 2:2:1 ratio (Len LA: Truvada oral: Descovy oral). This means that neither the participants nor the researchers knew which treatment was being administered until the trial concluded.

Remarkably, during the randomized phase of the trial, none of the 2,134 women who received lenacapavir contracted HIV, resulting in a 100% efficacy rate. In contrast, 16 of the 1,068 women (1.5%) who took Truvada (F/TDF) and 39 of the 2,136 women (1.8%) who received Descovy (F/TAF) contracted HIV.

“With zero infections and 100% efficacy, twice-yearly lenacapavir has demonstrated its potential as an important new tool to help prevent HIV infections. We look forward to additional results from the ongoing PURPOSE clinical program and continuing toward our goal of helping to end the HIV epidemic for everyone, everywhere,” said Merdad Parsey, MD, PhD, Chief Medical Officer, Gilead Sciences.

This breakthrough holds immense promise as a highly effective prevention tool to protect people from HIV. With 1.3 million new HIV infections globally in the past year—down from 2 million in 2010—it is evident that more needs to be done to meet the UNAIDS target of fewer than 500,000 new infections by 2025 and ultimately end AIDS by 2030.

In conclusion, the development of lenacapavir as a biannual injection for HIV prevention represents a significant advancement in the fight against the virus. By providing a reliable and effective alternative to daily medication, this innovation has the potential to transform HIV prevention strategies and significantly reduce the global incidence of HIV infections.

Reference: Gilead’s Twice-Yearly Lenacapavir Demonstrated 100% Efficacy and Superiority to Daily Truvada for HIV Prevention – First Phase 3 HIV Prevention Trial Ever to Show Zero Infections; Topline PURPOSE 1 data; June 20, 2024