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By Nancy Lapid, Health Science Editor

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! In the meantime, at the end of today’s issue we’ve included our editors’ and reporters’ picks for the most impactful health and pharmaceutical stories of 2023.  

In breaking news, see these stories from our Reuters journalists: WHO classifies JN.1 coronavirus strain as ‘variant of interest’; Planned Parenthood drops challenge to Kentucky abortion ban; Vaping grows fastest among UK groceries in 2023; and Mexico closes cantaloupe plant temporarily amid deadly salmonella outbreak.

Here, surgeons are extracting organs from a brain-dead patient for transplantation. Below we report on a study of outcomes when donor livers are stored at body temperature, rather than in ice chests as is normally the case. REUTERS/Fabrizio Bensch

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, 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.

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.)

NMP recipients had more often been waiting longer for an organ to become available and also were more often particularly ill.

Despite these differences, the percentage of functioning livers at one year after transplantation were virtually identical, researchers found.

Storage times averaged 3 to 4 hours longer with NMP than with cold storage. Longer storage times are safer for the organs with NMP than with cold storage, 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.

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.

Looking Back at 2023

We asked our Reuters colleagues for their favorite health-related stories of 2023. Here are some of their top choices.

Two that made the list covered the global scandal over contaminated cough syrup:

As African children died, doctors fought to get toxic Indian cough syrup banned.

Cough syrup killed scores of children. Why no one has been held to account.

New drugs for treating obesity were a major focus of coverage:

Maker of Wegovy, Ozempic showers money on U.S. obesity doctors.

Wegovy, other weight-loss drugs scrutinized over reports of suicidal thoughts.

Most patients using weight-loss drugs like Wegovy stop within a year, data show.

Demand for weight-loss drugs fuels global rise in counterfeits.

We kept a close eye on Alzheimer’s disease research:

Researchers return to Alzheimer’s vaccines, buoyed by recent drug success.

Insight: Promising new Alzheimer’s drugs may benefit whites more than Blacks.

Insight: ‘It totally backfired’: The pitfalls of Alzheimer’s genetic testing.

Down syndrome families’ fight for access to Alzheimer’s trials, treatments.

And we scrutinized worker safety, brain implants at Elon Musk’s companies:

At SpaceX, worker injuries soar in Elon Musk’s rush to Mars.

U.S. regulators rejected Elon Musk’s bid to test brain chips in humans.

At Musk’s brain-chip startup, animal-testing panel is rife with potential conflicts.

Happy holidays and best wishes for 2024, from the global healthcare and pharmaceuticals team at Reuters!

This newsletter was edited by Bill Berkrot.

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