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Brainstorm Health: Ovarian Cancer and Aspirin, Lilly Diabetes Data, Chemistry Nobel Prize

Hippocrates used it. As did Pliny the Elder—and then, too, Galen of Pergamon, perhaps the greatest physician-scientist of antiquity. Passed down from the Greeks and Romans, Sumerians, Assyrians, and Egyptians, the remedy drawn from the bark of a willow tree, was known to have extraordinary powers for reducing pain, swelling, and even fever. Pliny was said to have burned the bark and turned the ash into a paste, which he then used to remove corns.

In 1763, the good Reverend Edward Stone of Oxfordshire (who also went by Edmund), wrote a letter to the Right Honorable George Parker, Second Earl of Macclesfield (and, importantly, then, the president of the Royal Society), detailing the remarkable antipyretic powers of the substance, which he procured by drying willow bark for three months next to a baker’s oven and then pounding it into a fine powder.

(Fans of Monty Python will enjoy reading Stone’s original letter, which was published in the Royal Society’s Proceedings: “…About fix years ago, I accidentally tafted it, and was furprifed at its extraordinary bitternefs which immediately raifed me a fufpicion of its having the properties of the Peruvian bark.”)

A Frenchman named Charles Frédéric Gerhardt managed to synthesize the active chemical, acetylsalicylic acid—but never marketed it. Years later, though, a German chemist, working at Bayer, synthesized it anew. This time, in 1897, the 2,000-year-old natural remedy was reborn under the now-familiar name of “aspirin.”

Even then, it almost never made it to market. Colleagues at Bayer were more excited about pushing another drug synthesized at Bayer the very same year. (Called “heroin,” it was to be sold as a “cough remedy.”) Aspirin, though, ultimately survived the internal politicking at the company—and it’s a damn good thing it did.

Witness today, when not one, but two scientific papers published in the journal JAMA Oncology, unveiled yet more compelling evidence to support aspirin’s truly rare wonder-drug status.

In the first article, senior author Dr. Shelley Tworoger and colleagues, conducted a prospective analysis using data from 205,498 women followed over some three and a half decades in two ongoing epidemiological studies (the famed Nurses’ Health Studies I and II). In short, the investigators asked women about their use of aspirin and other non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) over time, and then followed those women to see who developed ovarian cancer.

The results are striking. Women who regularly (more than two times per week) took low-dose aspirin (under 100 milligrams) had a 23% lower risk of getting ovarian cancer, the research team found. Ovarian cancer, which most often is a silent killer—progressing without notice in the body for years before it is caught—is the fifth-leading cause of cancer death among U.S. women. This year, according the American Cancer Society, an estimated 22,240 new cases of the disease will be diagnosed in the U.S., and 14,070 women will die from it. (For more, see the special section that begins on page 28 of the organization’s latest Cancer Facts & Figures.)

Notably, those taking standard doses of aspirin on a regular basis had no reduction in risk—and other types of NSAIDs, when used frequently, seemed to have an opposite effect to low-dose aspirin. “We actually saw a suggestion that there might be an increased risk with very long-term and high-frequency use of non-aspirin NSAIDs,” Tworoger, a senior researcher at the Moffitt Cancer Center, told me in an interview by phone this afternoon.

The study, importantly, builds on previous work Tworoger and others have done suggesting that aspirin might help protect against ovarian cancer—as well as the huge body of work showing that aspirin might play a similar chemopreventive role in the case of colorectal cancer, other malignancies—and, of course, in heart disease.

Now, add one more cancer to the list—at least tentatively. Also today (and in the same journal, as I mentioned), Dr. Andrew Chan and colleagues have published a study demonstrating that “long-term aspirin use appears to be associated with a reduced risk” of hepatocellular carcinoma, or liver cancer. Unlike the findings in Tworoger’s study, though, the measured risk reduction here seems to increase along with the dose consumed and the duration of use.

Importantly, any potential benefit for taking aspirin has to be weighed carefully against the potential for increased bleeding, which can be particularly risky in some people. So talk to your physician before taking this (or any) drug on your own.

“But to me,” says Tworoger, “one of the most exciting things about this finding, is that some women are already being recommended to take low-dose aspirin on a regular basis for the prevention of cardiovascular disease. Now there’s evidence that this could help prevent ovarian cancer.”

And there’s more evidence, too, that the world’s first wonder drug might be its all-time best.

Clifton Leaf, Editor in Chief, FORTUNE
@CliftonLeaf
clifton.leaf@fortune.com

DIGITAL HEALTH

Nobel Prize winning chemists honored for evolution in a lab that created medicines. The 2018 Nobel Prize in Chemistry was awarded to two Americans and a U.K. citizen (Frances Arnold, George Smith, and Sir Gregory Winter, respectively) for what is, frankly, just an awesome set of work. (Of note: Arnold won one-half ot he prize, while the other half was awarded to Smith and Winter; she is just the fifth woman to win the Chemistry prize in its entire history). The trio were able to harness the power of evolution and recreate it in test tubes, speeding up the development of new enzymes in order to fuel multiple scientific breakthroughs, including the creation of medicines. Pretty, pretty cool. (NPR)

INDICATIONS

Lilly spikes, Novo sinks on former’s diabetes drug data. Shares of U.S. drug maker Eli Lilly rose 4% in Thursday trading after the company reported that its dual-combo diabetes drug was able to lower blood sugar and cut weight in a clinical trial. The treatment, a two-pronged therapy in the so-called GLP-1 drug class, was able to reduce blood sugar levels by nearly 2.5% and was associated with nearly 13% weight reductions among type 2 diabetes patients in a mid-stage study. The impressive results also sent Danish rival and diabetes giant Novo Nordisk’s shares sinking nearly 7.5% in Thursday trading. (Reuters)

Roche’s Hemlibra racks up another FDA nod. The Food and Drug Administration (FDA) has given Roche unit Genentech’s Hemlibra another green light, clearing the way for the company to sell its medicine to the bulk of hemophilia patients. Hemlibra is meant to treat the bleeding disorder by mimicking the clotting factor that such patients are missing.

THE BIG PICTURE

Workers keep shouldering more of the health care cost burden. A new Kaiser Family Foundation survey confirms that employers’ long-standing trend of pushing more and more health care costs onto their workers is going strong. While premiums in employer-sponsored health plans continued to increase modestly (a 5% spike in 2018 over the previous year, according to KFF), average deductibles continue to rise. In fact, the average worker’s deductible in 2018 spiked to $1,573, or a 4.5% year-over-year raise, and a record 85% of workers now have a deductible. While some health economists tout high-deductible plans as a market-based approach to containing health costs, critics point out that it may lead people to intentionally avoid necessary care or forgo prescriptions. (Modern Healthcare)

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Produced by Sy Mukherjee
@the_sy_guy
sayak.mukherjee@fortune.com

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