Chief Medical Officer at Northwestern Medicine Central DuPage Hospital Dr. Kevin Most joins the Steve Cochran Show to discuss a groundbreaking cancer treatment aimed at curbing peanut allergies, an innovative Alzheimer’s drug rolling out in July, and he debunks common misconceptions surrounding blood pressure. 

Dr. Kevin Most’s Steve Cochran Show Notes:

Cancer Drug that curbs peanut allergies?  More?

• A new drug to treat cancer may also block peanut allergy- Acalabrutinib- “A CAL A Brut In IB”
• Study published last month shows that a drug used to treat lymphoma, by inhibiting an enzyme in our body known as BKT, also reduced skin test responses to peanut allergies.
• BTK is an enzyme that is necessary for severe allergic reactions, and blocking it appears to stop on minimize the allergic reaction
• Baseline testing before the drug was given, showed a reaction to 29 milligrams of peanut protein ( a single peanut has 200 milligrams of peanut protein
• After being treated with this medication  for 2 days, some patients tolerated over 4,000 milligrams of peanut protein without having a reaction (highest dose for testing )
• Seven out of ten patients went thru a peanut ingestion test without any problems and the other 3 had a much higher threshold
• Larger trials need to be completed, and testing as to see if this drug will block other allergies is being reviewed
• This may lead to allowing a patient to take a drug they are allergic to, when no other alternative is available.
• The patient would be pre treated with this drug and then receive the treatment they need
• This is the first drug to prevent allergic reactions to foods in a rapid onset

Leqembi- Alzheimer’s Drug approved in July rolling out soon.

• Five major health systems are working on administration and payment for this drug and will be offering it soon, including Northwestern, here in Chicago
• CMS reported that Medicare will cover 80% of the cost of the drug, without having to be enrolled in a trial. Current cost is quoted at $26,500 per year
• This will change how Alzheimer’s is treated here in the US dramatically.
• 6.5 million individuals have been diagnosed with Alzheimer’s the vast majority of which are on Medicare.
• Doctors are now looking to see which patients in their practice qualify for the medication, as it is approved for individuals who are early in the illness
• In order to qualify, you must have cognitive testing, genetic testing to look for a specific genetic change that would disqualify some individuals and a spinal tape or imaging that shows amyloid
• Leqembi removes amyloid
• Health systems are now screening patients to see who qualifies and then presenting the risks to the patient and family and explaining the monitoring that will occur.

Blood Pressure Myths

• I can’t have High blood pressure, I feel fine and have no headaches- in US 75 million people have HTN of those 11 million do not know it.
• I take blood pressure pills so I am fine- It is estimated that 45% of those with HTN are poorly controlled mainly due to compliance and lifestyle changes
• HTN is only seen in old people- 7.5% of those between 18-39yo 33% of those between 40-59 and 63% of those over the age of 60 have Hypertension
• After taking BP meds for a while I can stop- individuals who take BP meds and do behavior modifications with diet and exercise may see the need for BP meds to drop, for most however it is a lifelong issue
• Only Men get HTN-  Men do have a higher risk of HTN until the age of 45 , between 45-64  the risk becomes equal for men and women and over 65 women have a higher risk of HTN
• Blood pressure is the pressure in the heart- No blood pressure taken in arm is actually the pressure measured as blood is pushing against the walls of the arteries.
• Doctors pump up the cuff until it hurts- No the cuff is pumped up to a pressure that stops blood flow thru the artery, the systolic number is the pressure noted when we hear movement as we decrease the pressure. The diastolic number is when we no longer hear any sounds.
• My family has High Blood Pressure so I will also end up with it- False- if an individual knows they have a family history of HTN, they should be following a healthy lifestyle – diet- exercise- weight control- low sodium intake- limited alcohol intake- may prevent HTN
• Apple Cider vinegar lowers blood pressure- There is no validated research that shows Apple Cider vinegar lowers Blood Pressure, you should see a doctor for treatment options
• Blood pressure machines for the home are not accurate – There are websites that verify the accuracy of machines as well as bringing the home machine with you to the doctor to compare results