Latest news with #AOM
Medscape
14-07-2025
- Health
- Medscape
Can Nonresponders to Antiobesity Medicines Be Predicted?
Emerging research indicates that phenotype-based testing may help identify which biologic process is driving an individual's obesity, enabling clinicians to better tailor antiobesity medication (AOM) to the patient. Currently, patient response to AOMs varies widely, with some patients responding robustly to AOMs and others responding weakly or not at all. For example, trials of the GLP-1 semaglutide found that 32%-39.6% of people are 'super responders,' achieving weight loss in excess of 20%, and a subgroup of 10.2%-16.7% of individuals are nonresponders. Similar variability was found with other AOMs, including the GLP-1 liraglutide and tirzepatide, a dual GLP-1/glucose-dependent insulinotropic polypeptide receptor agonist. Studies of semaglutide suggest that people with obesity and type 2 diabetes (T2D) lose less weight on the drug than those without T2D, and men tend to lose less weight than women. However, little else is known about predictors of response rates for various AOMs, and medication selection is typically based on patient or physician preference, comorbidities, medication interactions, and insurance coverage. Although definitions of a 'nonresponder' vary, the Endocrine Society's latest guideline, which many clinicians follow, states that an AOM is considered effective if patients lose more than 5% of their body weight within 3 months. Can nonresponders and lower responders be identified and helped? Yes, but it's complicated. 'Treating obesity effectively means recognizing that not all patients respond the same way to the same treatment, and that's not a failure; it's a signal,' said Andres Acosta, MD, PhD, an obesity expert at Mayo Clinic, Rochester, Minnesota, and a cofounder of Phenomix Sciences, a biotech company in Menlo Park, California. 'Obesity is not a single disease. It's a complex, multifactorial condition driven by diverse biological pathways,' he told Medscape Medical News. 'Semaglutide and other GLP-1s primarily act by reducing appetite and slowing gastric emptying, but not all patients have obesity that is primarily driven by appetite dysregulation.' Phenotype-Based Profiling Figuring out what drives an individual's obesity is where a phenotype-based profiling test could possibly help. Acosta and colleagues previously used a variety of validated studies and questionnaires to identify four phenotypes that represent distinct biologic drivers of obesity: hungry brain (abnormal satiation), emotional hunger (hedonic eating), hungry gut (abnormal satiety), and slow burn (decreased metabolic rate). In their pragmatic clinical trial, phenotype-guided AOM selection was associated with 1.75-fold greater weight loss after 12 months than the standard approach to drug selection, with mean weight loss of 15.9% and 9%, respectively. 'If a patient's obesity isn't primarily rooted in the mechanisms targeted by a particular drug, their response will naturally be limited,' Acosta said. 'It's not that they're failing the medication; the medication simply isn't the right match for their biology.' For their new study, published online in Cell Metabolism , Acosta and colleagues built on their previous research by analyzing the genetic and nongenetic factors that influenced calories needed to reach satiation (Calories to Satiation [CTS]) in adults with obesity. They then used machine learning techniques to develop a CTS gene risk score (CTS-GRS) that could be measured by a DNA saliva test. The study included 717 adults with obesity (mean age, 41; 75% women) with marked variability in satiation, ranging from 140 to 2166 kcals to reach satiation. CTS was assessed through an ad libitum meal, combined with physiological and behavioral evaluations, including calorimetry, imaging, blood sampling, and gastric emptying tests. The largest contributors to CTS variability were sex and genetic factors, while other anthropometric measurements played lesser roles. Various analyses and assessments of participants' CTS-GRS scores showed that individuals with a high CTS-GRS, or hungry brain phenotype, experienced significantly greater weight loss when treated with phentermine/topiramate than those with a low CTS-GRS, or hungry gut, phenotype. After 52 weeks of treatment, individuals with the hungry brain phenotype lost an average of 17.4% of their body weight compared with 11.2% in those with the hungry gut phenotype. An analysis of a separate 16-week study showed that patients with the hungry gut phenotype responded better to the GLP-1 liraglutide, losing 6.4% total body weight, compared to 3.3% for those with the hungry brain phenotype. Overall, the CTS-GRS test predicted drug response with up to 84% accuracy (area under the curve, 0.76 in men and 0.84 in women). The authors acknowledged that these results need to be replicated prospectively and in more diverse populations to validate the test's predictive ability. 'This kind of phenotype-based profiling allows us to predict which patients are more likely to respond and who might need a different intervention,' Acosta said. 'It's a critical step toward eliminating trial-and-error in obesity treatment.' The test (MyPhenome test) is used at more than 80 healthcare clinics in the United States, according to Phenomix Sciences, which manufactures it. A company spokesperson said the test does not require FDA approval because it is used to predict obesity phenotypes to help inform treatment, but not to identify specific medications or other interventions. 'If it were to do the latter,' the spokesperson said, 'it would be considered a 'companion diagnostic' and subject to the FDA clearance process.' What to Do if an AOM Isn't Working? It's one thing to predict whether an individual might do better on one drug vs another, but what should clinicians do meanwhile to optimize weight loss for their patients who may be struggling on a particular drug? 'Efforts to predict the response to GLP-1 therapy have been a hot topic,' noted Sriram Machineni, MD, associate professor at Montefiore Medical Center, Bronx, New York, and founding director of the Fleischer Institute Medical Weight Center at Montefiore Einstein. Although the current study showed that genetic testing could predict responders, such as Acosta, he agreed that the results need to be replicated in a prospective manner. 'In the absence of a validated tool for predicting response to specific medications, we use a prioritization process for trialing medications,' Machineni told Medscape Medical News . 'The prioritization is based on the suitability of the side-effect profile to the specific patient, including contraindications; benefits independent of weight loss, such as cardiovascular protection for semaglutide; average efficacy; and financial accessibility for patients.' Predicting responders isn't straightforward, said Robert Kushner, MD, professor of medicine and medical education at the Feinberg School of Medicine at Northwestern University and medical director of the Wellness Institute at Northwestern Memorial Hospital in Chicago. 'Despite looking at baseline demographic data such as race, ethnicity, age, weight, and BMI, we are unable to predict who will lose more or less weight,' he told Medscape Medical News . The one exception is that women generally lose more weight than men. 'However, even among females, we cannot discern which females will lose more weight than other females,' he said. If an individual is not showing sufficient weight loss on a particular medication, 'we first explore potential reasons that can be addressed, such as the patient is not taking the medication or is skipping doses,' Kushner said. If need be, they discuss changing to a different drug to improve compliance. He also stresses the importance of making lifestyle changes in diet and physical activity for patients taking AOMs. Often patients who do not lose at least 5% of their weight within 3 months are not likely to respond well to that medication even if they remain on it. 'So, early response rates determine longer-term success,' Kushner said. Acosta said that if a patient isn't responding to one class of medication, he pivots to a treatment better aligned with their phenotype. 'That could mean switching from a GLP-1 to a medication like [naltrexone/bupropion] or trying a new method altogether,' he said. 'The key is that the treatment decision is rooted in the patient's biology, not just a reaction to short-term results. We also emphasize the importance of long-term follow-up and support.' The goal isn't just weight loss but also improved health and quality of life, Acosta said. 'Whether through medication, surgery, or behavior change, what matters most is tailoring the care plan to each individual's unique biology and needs.' The new study received support from the Mayo Clinic Clinical Research Trials Unit, Vivus Inc., and Phenomix Sciences. Acosta is supported by a National Institutes of Health grant. Acosta is a co-founder and inventor of intellectual property licensed to Phenomix Sciences Inc.; has served as a consultant for Rhythm Pharmaceuticals, Gila Therapeutics, Amgen, General Mills, Boehringer Ingelheim, Currax Pharmaceuticals, Nestlé, Bausch Health, and Rare Diseases; and has received research support or had contracts with Vivus Inc., Satiogen Pharmaceuticals, Boehringer Ingelheim, and Rhythm Pharmaceuticals. Machineni has been involved in semaglutide and tirzepatide clinical trials and has been a consultant to Novo Nordisk, Eli Lilly and Company, and Rhythm Pharmaceuticals. Kushner is on the scientific advisory board for Novo Nordisk.
Cision Canada
07-07-2025
- Health
- Cision Canada
Ontario Midwives president Althea Jones takes the stage at international symposium on Black reproductive justice
TORONTO, July 7, 2025 /CNW/ - President of the Association of Ontario Midwives (AOM) Althea Jones, RM, has been invited by the United Nations Population Fund (UNFPA) to speak at the Global Symposium for Bridging the Gap in Reproductive Health of Afro-Descendant Women, taking place July 8 to 11 in San José, Costa Rica. The symposium is a response to the urgent need to address the compounding effects of racism and sexism in sexual and reproductive health outcomes. The four-day gathering brings together Black leaders, researchers, midwives and other health professionals to collaborate on closing inequality gaps in perinatal mortality and contraception access in Black communities worldwide. The invitation to participate serves as a powerful acknowledgement of Althea Jones' leadership in of midwifery and reproductive justice in Ontario. A founding partner of Ancestral Hands Midwives in Scarborough, Jones has played a pivotal role in delivering culturally grounded care to clients who have been historically underserved by the health system. Since assuming the role of AOM President in 2024, Jones has championed equity and inclusion within Ontario's midwifery profession and health system more broadly. "Midwifery is more than a model of care—it's a tool for transformation," says Jones. "It's how we restore autonomy, rebuild trust and reimagine reproductive health systems that actually work for Afro-descendant communities." Jones' presence at the event reflects a broader recognition of Ontario midwifery's leadership in equity-driven care—and of the need for Black midwives to have a seat at every table where reproductive policies are being shaped. The AOM is proud to support Jones as she brings her voice, vision and commitment to this global platform. AOM will arrange interviews on request. Contact Elizabeth Brandeis, Director, Government, Labour & Public Relations, at [email protected] or (416) 568-4595. About the Association of Ontario Midwives: The AOM advances the clinical and professional practice of Indigenous and Registered midwives in Ontario. There are over one thousand midwives serving more than 250 communities across the province, funded by the Ministry of Health. Since midwifery became a regulated health profession in 1994, more than 400 000 babies have been born under midwifery care. Learn more:
Business Wire
22-05-2025
- Business
- Business Wire
May 2025 Meeting: Port Houston Announces $131 Million in USACE Workplan Designated for Houston Ship Channel Construction and Maintenance
HOUSTON--(BUSINESS WIRE)--On Tuesday, May 20, the Port Commission of the Port of Houston Authority met for its regular monthly meeting. Chairman Ric Campo opened the meeting with an update that the U.S. Army Corps of Engineers (USACE) released their FY25 workplan, which includes $33 million allocated to the Houston Ship Channel Expansion, known as Project 11, construction and $98 million to operations and maintenance to keep the Houston Ship Channel dredged. 'Thank you to everyone who pulled together to get this done, including our industry partners, customers, congressional delegation, and specifically Congressman Wesley Hunt and Congressman Brian Babin who worked around the clock to make sure we got what we needed,' said Chairman Campo. Port Houston reported strong volumes in April, which can be found in more detail via the press release issued on May 19. Operations reported nine blank sailings forecasted over the next six weeks at the container terminals. Despite this, Port Houston remains cautiously optimistic, noting that the number is significantly lower than during previous periods of market uncertainty, such as the COVID-19 pandemic. It was also announced that the USACE approved the federal Assumption of Maintenance (AOM) for Segment 1B of the Houston Ship Channel (Redfish Reef to Bayport Terminal), in addition to Segment 1C (Bayport to Barbours Cut Ship Channel), which was approved in 2022. This marks the successful conclusion of a nearly five-year group effort and with these approvals Port Houston will save a net present value of nearly $380 million over the next 50 years. The organization is on track to complete the dredging activities in Segment 1C by late Q2/early Q3 2025, completing the Port Houston-led portions of Project 11 dredging. Completion of Galveston Bay beneficial use features is scheduled for Q4 2025. As it relates to maintenance at the public terminals, Port Houston commissioned 20 clean diesel yard tractors at Barbours Cut Terminal and Bayport Terminal, removing 20 outdated, less efficient tractors from service. The organization is also actively collaborating with TxDOT (Texas Department of Transportation), Houston Pilots and PSEO (Port Security and Emergency Operations) to temporarily improve air draft markings on the Interstate 610 bridge. Additional Meeting Updates & Announcements Port Houston CEO Charlie Jenkins highlighted the Maritime Museum's upcoming grand opening at their new location next to Port Houston's Administrative Building at East River. Port Houston will be a sponsor for the new space. Chairman Campo also congratulated the 2025 maritime program graduates, noting that Port Houston's maritime education program and ongoing partnerships with industry and area schools and universities further bolsters the port's talent pipeline and contributes to the future maritime workforce. The Port Commission meets next on Tuesday, June 24, 2025. About Port Houston For more than 100 years, Port Houston has owned and operated the public wharves and terminals along the Houston Ship Channel, including the area's largest breakbulk facility and two of the most efficient container terminals in the country. Port Houston is the advocate and a strategic leader for the Channel. The Houston Ship Channel complex and its more than 200 private and eight public terminals is the nation's largest port for waterborne tonnage and an essential economic engine for the Houston region, the state of Texas and the U.S. The Port of Houston supports the creation of nearly 1.5 million jobs in Texas and 3.37 million jobs nationwide, and economic activity totaling $439 billion in Texas and $906 billion in economic impact across the nation. For more information, visit the website at
Yahoo
22-05-2025
- Business
- Yahoo
May 2025 Meeting: Port Houston Announces $131 Million in USACE Workplan Designated for Houston Ship Channel Construction and Maintenance
HOUSTON, May 22, 2025--(BUSINESS WIRE)--On Tuesday, May 20, the Port Commission of the Port of Houston Authority met for its regular monthly meeting. Chairman Ric Campo opened the meeting with an update that the U.S. Army Corps of Engineers (USACE) released their FY25 workplan, which includes $33 million allocated to the Houston Ship Channel Expansion, known as Project 11, construction and $98 million to operations and maintenance to keep the Houston Ship Channel dredged. "Thank you to everyone who pulled together to get this done, including our industry partners, customers, congressional delegation, and specifically Congressman Wesley Hunt and Congressman Brian Babin who worked around the clock to make sure we got what we needed," said Chairman Campo. Project 11 Updates & Operations Highlights Port Houston reported strong volumes in April, which can be found in more detail via the press release issued on May 19. Operations reported nine blank sailings forecasted over the next six weeks at the container terminals. Despite this, Port Houston remains cautiously optimistic, noting that the number is significantly lower than during previous periods of market uncertainty, such as the COVID-19 pandemic. It was also announced that the USACE approved the federal Assumption of Maintenance (AOM) for Segment 1B of the Houston Ship Channel (Redfish Reef to Bayport Terminal), in addition to Segment 1C (Bayport to Barbours Cut Ship Channel), which was approved in 2022. This marks the successful conclusion of a nearly five-year group effort and with these approvals Port Houston will save a net present value of nearly $380 million over the next 50 years. The organization is on track to complete the dredging activities in Segment 1C by late Q2/early Q3 2025, completing the Port Houston-led portions of Project 11 dredging. Completion of Galveston Bay beneficial use features is scheduled for Q4 2025. As it relates to maintenance at the public terminals, Port Houston commissioned 20 clean diesel yard tractors at Barbours Cut Terminal and Bayport Terminal, removing 20 outdated, less efficient tractors from service. The organization is also actively collaborating with TxDOT (Texas Department of Transportation), Houston Pilots and PSEO (Port Security and Emergency Operations) to temporarily improve air draft markings on the Interstate 610 bridge. Additional Meeting Updates & Announcements Port Houston CEO Charlie Jenkins highlighted the Maritime Museum's upcoming grand opening at their new location next to Port Houston's Administrative Building at East River. Port Houston will be a sponsor for the new space. Chairman Campo also congratulated the 2025 maritime program graduates, noting that Port Houston's maritime education program and ongoing partnerships with industry and area schools and universities further bolsters the port's talent pipeline and contributes to the future maritime workforce. The Port Commission meets next on Tuesday, June 24, 2025. About Port Houston For more than 100 years, Port Houston has owned and operated the public wharves and terminals along the Houston Ship Channel, including the area's largest breakbulk facility and two of the most efficient container terminals in the country. Port Houston is the advocate and a strategic leader for the Channel. The Houston Ship Channel complex and its more than 200 private and eight public terminals is the nation's largest port for waterborne tonnage and an essential economic engine for the Houston region, the state of Texas and the U.S. The Port of Houston supports the creation of nearly 1.5 million jobs in Texas and 3.37 million jobs nationwide, and economic activity totaling $439 billion in Texas and $906 billion in economic impact across the nation. For more information, visit the website at View source version on Contacts Lisa Ashley-Daniels, Director, Public RelationsOffice: 713-670-2644Mobile: 832-247-8179E-mail: lashley@ Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Miami Herald
07-03-2025
- Health
- Miami Herald
Miami lawmaker pushes for Medicaid, Medicare to cover anti-obesity medicine
For a state of over 23 million people, approximately 40% of the population has one thing in common — they are either Medicare or Medicaid beneficiaries. Across the Sunshine State, just shy of nine million people utilize government health insurance programs. With many individuals in Florida relying on these programs, ensuring they are as comprehensive as possible is key to improving health. For many beneficiaries of these programs, one of the biggest health issues they face is obesity and its various co-morbidities. But just 10% of people with obesity receive any treatment for the disease. In the Florida Legislature, which went into session this week, we're looking to change that. I've introduced legislation, Senate Bill 648, that would expand Medicaid treatment options for obesity, including covering the cost of the use of Food and Drug Administration (FDA) approved anti-obesity medications, known as AOMs. Now, I hope the federal government follows our lead. President Donald Trump has long fought for commonsense healthcare reform. Fortunately, he has a chance to deliver on it. He is reviewing a rule from the Centers for Medicare & Medicaid Services (CMS) which establishes or modifies what Medicare and Medicaid will cover. Only by finalizing this proposed CMS rule and expanding AOM can their full potential be realized in Florida and across the country. It's necessary that Trump finalize it. Obesity is the nation's second leading cause of death and raises an individual's mortality rate from anywhere from 22% to 91%. Not to mention, it's a significant risk factor for the leading cause of death: heart disease. Beyond that, it's connected to over 200 other serious chronic diseases ranging from diabetes to 13 of the most prevalent cancers to arthritis. All told, the impact of obesity on the human body is severe. For years, lifestyle changes, primarily diet and exercise, have been the primary treatment option for obesity. But it's clear that this alone is not the most effective treatment available. For patients who adopt lifestyle changes and nothing else, more than 95% of weight lost is regained within five years. That's where AOMs come into play. AOMs have been proven to be a highly effective tool in treating obesity. Over the last several years, a sizable body of research has shown their benefits, including reduced blood pressure, reduced sleep apnea, improved glycemic health and significant, sustained weight loss. They provide a pathway to weight loss that, in turn, reduces the risk of obesity-related complications. For our state's seniors, reducing obesity can mean a lessened risk of falls, better mental health and a lower chance of nursing home admission, all of which serve to enhance independence. But right now, far too few individuals have access to them. Of the 10% of people who receive any medical help for obesity, a minuscule 2% subset take AOMs. Annually, across the entire U.S. public and private healthcare system, hundreds of billions of dollars are spent on obesity and related illnesses. Looking at the Medicare and Medicaid programs alone, that figure is beginning to encroach on $100 billion a year. The link between obesity and other chronic diseases is clear and lead down the same path — more hospitalizations, more deaths and higher annual medical costs. On the flip side, the broader use of AOMs, particularly among Medicare and Medicaid recipients, has a clear line to fewer medical costs in treating obesity and related conditions. The more effective treatment of obesity through Medicare and Medicaid could lead to net savings of over $700 billion over the next 30 years. Obesity is one of our nation's biggest public health crises, and AOMs are a pivotal innovation in the healthcare space as we look to solve it. Only by finalizing this proposed CMS rule and expanding AOM coverage in Medicare and Medicaid can their full potential be realized. Ana Maria Rodriguez is a Republican state senator representing District 40, which includes parts of southern Miami-Dade and Monroe counties.
