HIV Prevention, Ancient Armadillos, and Direct-to-Consumer Drug Ads

IRA FLATOW: This is Science Friday. I’m Ira Flatow. This hour, we’re going to be tackling diseases, new ways to treat them, how to prevent them from becoming pandemic. We’re even going to dip into the wayback machine to 1994.

And we begin with HIV, the virus responsible for AIDS. 35 million people worldwide are living with HIV or AIDS according to the World Health Organization. HIV still does not have a cure. But anti-retroviral therapies have been a welcome tool in the treatment of the virus. And work continues at looking for ways to prevent transmission.

You may have heard of Truvada. Two studies presented this week at a conference in Boston look at another possible HIV preventive. Here to tell us about the story and a few other picks this week is Azeen Ghorayshi.

She’s a science reporter for Buzzfeed News here in New York. Welcome. Welcome back.

AZEEN GHORAYSHI: Thanks for having me.

IRA FLATOW: Let’s talk about it. A preventable, this drug makes it a preventable [INAUDIBLE].

AZEEN GHORAYSHI: Right. So, as you said, right now all we have– and it’s an amazing tool– but all we have is the daily pill Truvada, which works upwards of 92% of the time in preventing the transmission of HIV. But scientists are looking for obviously more tools in the tool kit for prevention to sort of tackle the epidemic all together. This is two studies, which are looking at the possibility of using a vaginal ring.

It’s much like the contraceptive NuvaRing to prevent HIV transmission in women specifically. So it’s a silicone ring. And you put it in once per month. And it should offer protection.

IRA FLATOW: Work? Does it work?

AZEEN GHORAYSHI: Well, so this looked at 5,000 women in 5 African countries. And it uses this drug Dapivirine that prevents HIV from being able to replicate. And it sort of worked. It’s certainly optimistic results.

But both of the studies had roughly 30% lower rates of transmission, which is admittedly not great. But when they took out the sort of the younger women from the study, they interestingly saw that it prevented transmission roughly 60% of the time. So they’re still figuring it out.

There are plenty of follow-up studies to do to figure out exactly what’s going on here and how effective this could be. But they do think that it probably boils down to how well people were using it.

IRA FLATOW: There was a case of a patient on Truvada contracting HIV.

AZEEN GHORAYSHI: Right. So this also came out of this conference this week in Boston, which it’s the first ever case of someone who was taking the daily pill and still contracted the virus. And the reason is because he actually came into contact with the virus that was resistant to both of the drugs in Truvada. And the reason for that is that the drugs that we’re using on the prevention side right now are the same drugs we’re using on the treatment side. So there can be that crossover. HIV is a very clever virus.

IRA FLATOW: Yeah, well, one case. We’ll have to wait for a few more I think.

AZEEN GHORAYSHI: Yeah, no cause for worry yet.

IRA FLATOW: Yeah. We’ve heard now that climate change is affecting coral reefs. We have known about that. But now there’s a new study giving out more proof about that?

AZEEN GHORAYSHI: Yeah. So this is a new one. It was published in Nature. And it’s the first experimental evidence in the natural reef environment showing that rising CO2 emission rates are taking a toll on coral reefs. So scientists from Stanford used this alkaline substance to basically alter the pH in a small patch of the Great Barrier Reef off the coast of Australia.

And this changed the pH to pre-industrial levels. And they showed that the rate of the coral grew actually increased by roughly 7%. So the ocean acidification that we’ve seen as a byproduct of rising CO2 emissions has very likely slowed.

IRA FLATOW: Wow. And this is not I’m saying, hey, let’s just sprinkle baking soda all over the ocean and raise the pH a little more and you get the corals to grow back. But it’s just a proof of concept.

AZEEN GHORAYSHI: Exactly. Exactly. And so as sea water is becoming more acidic, it can slow or even dissolve the calcium carbonate shells of coral. And we’re already seeing that oceans are roughly 30% more acidic than in the pre-industrial revolution times.

So the scientists were saying if the current trends continue, we might see corals shift into a permanent state of decline by the middle of this century, which is terrifying.

IRA FLATOW: I already know scuba places. I’ve been scuba diving for almost 40 years. The coral’s gone.

AZEEN GHORAYSHI: Oh God.

IRA FLATOW: I go back to the places and the coral is gone. Let’s move on to something a little more hopeful and that is NASA. This is interesting. NASA put out an open sort of a casting call for astronauts and the deadline closed last week. And they had tremendous response.

AZEEN GHORAYSHI: Yeah. So apparently people are getting more and more into the idea of space travel because more than 18,300 people applied to be in NASA’s 2017 astronaut class, which has 14 openings. So this is three times the number of people that applied last time they put on an open call, which was in 2012. And it’s way more than their previous record of 8,000 applicants in 1978.

And, yeah, applications opened in mid-December. They closed last Thursday. And they’re going to announce who the winners are basically in mid-2017. And the qualifications are pretty broad, which is probably why so many people applied.

You just need to have a STEM bachelor’s degree and like three years of experience in the field or 1,000 logged hours in piloting jet craft. But it’s probably the case that way more people besides that applied who just wanted to be astronauts.

IRA FLATOW: And obviously they’re not looking for those citizen passengers anymore.

AZEEN GHORAYSHI: Yeah. I think at this rate, point 0.8% of the applicants are going to be accepted. So you’re going to have to be pretty damn good. But, yeah, there’s a lot of speculation as to why so many applied.

And it was a big year for space. We had the Pluto flyby. The Martian came out.

IRA FLATOW: Great stuff. I want to know what that interview is going to be like for all those–

AZEEN GHORAYSHI: God, yeah, very unnerving I’m guessing.

IRA FLATOW: How are you going to impress the person over the other 18,000 people? What are you going to do?

AZEEN GHORAYSHI: No idea.

IRA FLATOW: Let’s go on to finally scientists, this is kind of interesting, they have uncovered the ancient ancestor of the armadillo. And it’s not a tiny little animal, is it?

AZEEN GHORAYSHI: No, not at all. So this is a new study published this week. And it confirmed that this family of ancient animals called glyptodonts are the long lost relatives of armadillos. So they looked at a specific species called doedicurus. It’s also armored but instead of the modern-day armadillo, the plates that you see is one complete plate.

But the biggest difference is that they were about the size of a car. And they have these spiked club-like tails that they probably used in pretty intense combat they’re guessing. The last of the doedicurus died about 11,000 years ago. So they had to basically excavate pieces of DNA from a 12,000 year old fossil and reassemble this mitochondrial DNA.

And they showed that the subfamily probably diverged about 35 million years ago. This is 30 million years before the development of the modern armadillo, before it emerged. And at the time, it was closer to 13 pounds. So it really evolved a lot in the course of its long stay here on earth.

IRA FLATOW: Described as the size of a Volkswagen. A lot of things are described as the size of– but that’s a big armadillo.

AZEEN GHORAYSHI: That is a big armadillo with a very big spiked club tail.

IRA FLATOW: Stay away. Thank you, Azeen.

AZEEN GHORAYSHI: Yeah. Thanks so much.

IRA FLATOW: You’re welcome. Azeen Ghorayshi is a senior science reporter for Buzzfeed News here in New York. And now it’s time to play good thing, bad thing.

[MUSIC PLAYING]

Because every story has a flip side and if you watch the evening news, the drug ads are everywhere.

SPOKESPERSON: Ask your health care provider for–

SPOKESPERSON: Talk to your doctor about prescription–

SPOKESPERSON: As your doctor about–

SPOKESPERSON: Ask your doctor.

SPOKESPERSON: Ask your pharmacist for Flomax–

SPOKESPERSON: –if Lunesta is good for you.

SPOKESPERSON: Ask your doctor–

SPOKESPERSON: Ask your doctor about Nasonex.

SPOKESPERSON: Talk to your doctor about Mirapex and RLS.

IRA FLATOW: Ask your doctor, of course, is preceded by a huge list of warnings and potential side effects that like half the length of the commercial. It’s called direct-to-consumer drug advertising, DTC, and it’s been running in the US for decades and has been controversial that whole time. And now a legislator has introduced a bill calling for limits on the practice.

Joining me now to talk about the potential side effects, get it, is Ed Silverman. He writes the Pharmalot blog for STAT. Welcome to the program.

ED SILVERMAN: Hi, how are you?

IRA FLATOW: All right. What are the good things about these ads?

ED SILVERMAN: Well, they can raise awareness. There are people who may not necessarily connect the dots and realize they have a condition or some disease that says they should take treatment and perhaps call their doctor and maybe discuss the problem, whether that leads to discussion of the medication is a related but somewhat separate issue. So there’s a benefit there because people might have an opportunity to pursue something they otherwise ignore.

IRA FLATOW: Hm-mm. And so the bad thing is?

ED SILVERMAN: Well, the contention is that in prompting people to do that, they may be unnecessarily contacting their doctor and as part of the discussion also insist or inquire and maybe insist on getting a particular medicine that they don’t need or maybe a medicine that simply isn’t appropriate for what they’re discussing. So and as an outgrowth of that, the contention also is that most of the medicines that advertise are newer medicines that cost more money than older certainly generic medicines. So as a result, consumer health care costs may go up.

IRA FLATOW: Aren’t we one of the very few countries in the whole world that allow these ads?

ED SILVERMAN: One of two, the other being New Zealand.

IRA FLATOW: Wow. So–

[LAUGHING]

That is very few, one of two. And last year, didn’t the AMA, the American Medical Association, call for a ban on these direct-to-consumer ads?

ED SILVERMAN: Right. Unlike the congressional lawmaker who wants a three-year moratorium on advertising, the AMA wants an outright ban, which is a much higher bar, as you can imagine, to achieve. But they are pursuing it nonetheless.

IRA FLATOW: So why would a group that represents the doctors want to ban this?

ED SILVERMAN: Because the doctors feel too often consumers, patients, come into their offices and start talking about medicines they may not need, as I mentioned a moment ago. And they feel pressured to write the prescriptions because in this environment they may lose the patients and therefore lose some business if the patients are adamant, want a prescription, but the doctor doesn’t comply. And the patient feels frustrated and figures, oh, I have a problem. I need to get that drug. I’ll go to another doctor to get the prescription.

IRA FLATOW: Yeah. And I’ve heard over the years– because we have been talking about this for years– on the flip side, the drug companies will say, you know, if patients go in and ask their doctor for anything, maybe they, as you say, they might discover an illness they hadn’t seen before.

ED SILVERMAN: Right. And that’s legitimate. I mean, whether we’re talking about our health, our houses, our cars, or anything else that we rely upon, we want to be informed. We want to know more. We want to connect dots.

We want to be able to address issues if they exist and be able to do so in a proper fashion. So if you have more information, that can be a good thing. The question is are we getting the right kind of information? Is it a balance between promotion and true scientific-based evidence? That’s the crux of the debate.

IRA FLATOW: Yeah. Well, and this being the American drug and health care system, that debate will go on for a while. Thanks, Ed.

ED SILVERMAN: Thank you for having me. Have a good day.

IRA FLATOW: You too. Ed Silverman writes the Pharmalot blog for STAT.

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