LW - Medical Roundup #3 by Zvi

The Nonlinear Library: LessWrong

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Welcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Medical Roundup #3, published by Zvi on July 9, 2024 on LessWrong.
This time around, we cover the Hanson/Alexander debates on the value of medicine, and otherwise we mostly have good news.
Technology Advances
Regeneron administers a single shot in a genetically deaf child's ear, and they can hear after a few months, n=2 so far.
Great news: An mRNA vaccine in early human clinical trials reprograms the immune system to attack glioblastoma, the most aggressive and lethal brain tumor. It will now proceed to Phase I. In a saner world, people would be able to try this now.
More great news, we have a cancer vaccine trial in the UK.
And we're testing personalized mRNA BioNTech canner vaccines too.
US paying Moderna $176 million to develop a pandemic vaccine against bird flu.
We also have this claim that Lorlatinib jumps cancer PFS rates from 8% to 60%.
The GLP-1 Revolution
Early results from a study show the GLP-1 drug liraglutide could reduce cravings in people with opioid use disorder by 40% compared with a placebo. This seems like a clear case where no reasonable person would wait for more than we already have? If there was someone I cared about who had an opioid problem I would do what it took to get them on a GLP-1 drug.
Rumblings that GLP-1 drugs might improve fertility?
Rumblings that GLP-1 drugs could reduce heart attack, stroke and death even if you don't lose weight, according to a new analysis? Survey says 6% of Americans might already be on them. Weight loss in studies continues for more than a year in a majority of patients, sustained up to four years, which is what they studied so far.
The case that GLP-1s can be sued against all addictions at scale. It gives users a sense of control which reduces addictive behaviors across the board, including acting as a 'vaccine' against developing new addictions. It can be additive to existing treatments. More alcoholics (as an example) already take GLP-1s than existing indicated anti-addiction medications, and a study showed 50%-56% reduction in risk of new or recurring alcohol addictions, another showed 30%-50% reduction for cannabis.
How to cover this? Sigh. I do appreciate the especially clean example below.
Matthew Yglesias: Conservatives more than liberals will see the systematic negativity bias at work in coverage of GLP-agonists.
Less likely to admit that this same dynamic colors everything including coverage of crime and the economy.
The situation is that there is a new drug that is helping people without hurting anyone, so they write an article about how it is increasing 'health disparities.'
The point is that they are writing similar things for everything else, too.
The Free Press's Bari Weiss and Johann Hari do a second round of 'Ozempic good or bad.' It takes a while for Hari to get to actual potential downsides.
The first is a claimed (but highly disputed) 50%-75% increased risk of thyroid cancer. That's not great, but clearly overwhelmed by reduced risks elsewhere.
The second is the worry of what else it is doing to your brain. Others have noticed it might be actively great here, giving people more impulse control, helping with things like smoking or gambling. Hari worries it might hurt his motivation for writing or sex. That seems like the kind of thing one can measure, both in general and in yourself. If people were losing motivation to do work, and this hurt productivity, we would know.
The main objection seems to be that obesity is a moral failure of our civilization and ourselves, so it would be wrong to fix it with a pill rather than correct the underlying issues like processed foods and lack of exercise. Why not be like Japan?
To which the most obvious response is that it is way too late for America to take that path. That does not mean that people should suffer. And if we find a way to fix the issues ...