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Another segment of her ACP 2024 interview featured a discussion on weight loss drugs, healthy living, and discussions with patients.

Anne Thorndike, MD, MPH: Discussing Obesity, Physical Activity, Weight Loss Drugs

American College of Physicians (ACP) Internal Medicine Meeting

 in Boston, Anne Thorndike, MD, MPH, discussed additional takeaways from she and her co-presenters’ talk titled ‘Annals Beyond the Guidelines: How Would You Treat this Patient with Obesity?’

Thorndike serves as an associate professor of medicine for the Division of General Internal Medicine of Massachusetts General Hospital as well as Harvard Medical School. In this talk, she described additional points on the subjects, beginning with a discussion of weight loss versus healthy living.

“I emphasize in my talk, and I will emphasize with my patients that it's not only about the weight loss,” Thorndike said. “Although we focus a lot on weight, the number of weight, how many pounds you lose, being regularly physically-active and eating a healthy diet, following your healthy dietary pattern, benefits your health even if you don't lose weight.”

Thorndike noted several statistics to support her points, highlighting the benefits of getting in more steps in a given day.

“There's a dose response with physical activity,” she explained. “So even going from 2000 steps to 5000 steps a day is going to be associated with improvements in health. One of the slides that I show shows that there's a decrease in mortality, as you gradually increase from 2000 steps up through 10,000 steps per day.”

Thorndike was also asked about the popular topic of weight loss drugs such as Ozempic.

“Clearly, the new medications have transformed what we can do to help our patients with obesity, so I don't in any way want to imply that I don't think these medications are going to benefit people,” Thorndike said. “Are they going to benefit everybody? No, not necessarily, but I do think that they are part of transforming what we can do. Now, as a person who has spent a large part of my career focused on prevention, I worry a little bit that we're going to take our eyes off of the prevention goals.”

Thorndike explained that treating individuals with obesity should, at least in part, be focused on the food environment and preventative care. Additionally, the cost of such medications, she noted, are highly expensive and inequitably available.

For further information on Thorndike’s presentation, view the full interview segment above.

The quotes used in this article were edited for clarity. Thorndike has no relationships with entities whose primary business is selling, producing, marketing, re-selling, or distributing healthcare products used by or on patients.

Videos

Another segment of her ACP 2024 interview featured a discussion on weight loss drugs, healthy living, and discussions with patients.


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Data from the phase 2 SAVITRI study suggest use of a novel agent could provide symptom relief in patients with 

 who are struggling to achieve results with their current antidepressant medications.

A potential first-in-class, investigational alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid positive allosteric modulator from Neurocrine Biosciences Inc, use of NBI-1065845 was associated with a statistically significant change from baseline in Montgomery Åsberg Depression Rating Scale (MADRS) total score at both day 28 and day 56.

"Many millions of people living with major depressive disorder do not benefit fully from currently available treatments and experience persistent debilitating symptoms," said Eiry W. Roberts, MD, chief medical officer at Neurocrine Biosciences. "NBI-1065845 has the potential to be a first-in-class treatment to alleviate many of these symptoms of MDD. The Phase 2 data from the SAVITRI study are very encouraging, and we look forward to meeting with the FDA to discuss a path into Phase 3 studies."

Of note, Neurocrine Biosciences and Takeda Pharmaceuticals entered a strategic collaboration in 2020 to develop and commercialize compounds in Takeda’s pipeline, including an exclusive license to NBI-1065845, formerly known as TAK-653. According to this agreement, Neurocrine Biosciences is responsible for developing and commercializing all compounds included in the collaboration and for compounds other than NBI-1065845 and NBI-1065846.

Launched in 2022, the SAVITRI trial was a phase 2 randomized, double-blind, placebo-controlled, dose-finding study aimed at assessing the efficacy and safety of NBI-1065845 in adult patients with major depressive disorder. Conducted at 41 sites in 6 countries, the trial enrolled 183 patients with a primary diagnosis of major depressive disorder who had inadequate response to current antidepressant treatment. These patients were randomized to low-dose NBI-1065845, high-dose NBI-1065845, or placebo therapy.

The primary outcome of interest for the trial was change in MADRS total score from baseline to day 28. The trial had multiple secondary outcomes of interest, including change from baseline in total MADRS score at day 7, 14, and 56.

Topline results announced by Neurocrine Biosciences on April 23, 2024 suggested one of the doses demonstrated an improvement over placebo of -4.3 (

= .0016) at day 28 and day 56, respectively. According to Neurocrine Biosciences, safety analysis indicated NBI-1065845 was generally well-tolerated, with headaches the most common adverse events associated with use. The release noted the adverse event profile for both doses examined was comparable to placebo, with no deaths or serious adverse events and low discontinuation rates observed throughout the trial.

In their release, Neurocrine Biosciences highlighted plans to present full data at an upcoming scientific congress.

Neurocrine Biosciences. Neurocrine Biosciences Reports positive phase 2 data for NBI-1065845 in adults with major depressive disorder. Neurocrine Biosciences. April 23, 2024. Accessed April 23, 2024. https://neurocrine.gcs-web.com/news-releases/news-release-details/neurocrine-biosciences-reports-positive-phase-2-data-nbi-1065845.

Study to Assess the Efficacy and Safety of NBI-1065845 in Adults With Major Depressive Disorder (MDD) (SAVITRI). Clinicaltrials.gov. Accessed April 23, 2024. https://clinicaltrials.gov/study/NCT05203341.

Articles

NBI-1065845 shows promise in alleviating symptoms of major depressive disorder in patients with inadequate response to current antidepressant treatments, according to phase 2 SAVITRI study data.

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Phase 2 SAVITRI Supports Use of NBI-1065845 in Major Depressive Disorder with Inadequate Response to Antidepressants

“At what age would you describe someone as old?”

Investigators of a new study, led by Markus Wettstein, PhD, from the department of psychology at Humboldt University of Berlin, posed this question to participants, hoping to gauge how the perception of “

” has changed over the years with the increase in life expectancy. A decade ago, middle-aged and older adults would have said 5 years younger than middle-aged and older adults do today, a new study found.

Empirical studies found older adults today perform better on cognitive tests, reported greater well-being, greater internal control beliefs, fewer perceived constraints, and are more socially embedded than older adults 20 years ago. Older adults nowadays tend to feel younger than older adults a decade before, and subjective age plays a factor in the perception of old age.

If a 60-year-old feels like a 40-year-old, they might perceive 60 years old as “not old,” but the same might not be the case if a 60-year-old feels 65 years old. Better self-rated health is linked to a later perceived onset of old age.

Wettstein and colleagues wanted to better understand how later-born cohorts perceive the onset of old age. Limited data existed on this topic. They also wanted to assess how specific factors impacted the perception of old age including chronological age, subjective age, gender, West vs East Germany, education, loneliness, number of chronic diseases, and self-related health.

“Life expectancy has increased, which might contribute to a later perceived onset of old age,” Wettstein said in a press release. “Also, some aspects of health have improved over time, so that people of a certain age who were regarded as old in the past may no longer be considered old nowadays.”

The team leveraged data from a German Ageing Survey, which had a comprehensive cohort-sequential, nationwide study sample of ≥ 14,000 individuals who were born from 1911 – 1974 (aged 40 – 85 years; mean age: 61.20 years) and who had 8 longitudinal observations throughout 25 years. Samples were from 1996, 2002, 2008, and 2014 and were assessed or reassessed in 1996, 2002, 2008, 2011, 2014, 2017, summer 2020, and winter 2020/21. Participants were community-dwelling and resided in Germany.

The final analysis included 34,490 observations of the perceived onset of old age among 14,056 individuals. Participants were broken into 3 historical times: 1911 – 1935 (n = 3600), 1936 – 1951 (n = 6256), and 1952 – 1974 (n = 4227). The mean chronological age at baseline was 58.1 years, an average of 13% younger than their chronological age.

Investigators found the mean perceived onset of old age was approximately 73 years. Older chronological age was linked to a later perceived onset of old age. People perceived the onset of old age to begin earlier if they were lonely, in worse health, or had an older subjective age.

The study showed participants born in 1911 who were 65 years old viewed old age as starting at 71 years, but participants born in 1956 who were 65 years old perceived old age to start at age 74.

The analysis demonstrated women had a subjective onset of old age that was, on average, 2.4 years later than men. Even when adjusted for gender, the team saw the perceived onset of old age was older for later-born cohorts (

Furthermore, individuals’ perceptions of old age-adjusted as they got older. A model found the individual’s perceived onset of old age at age 64 years increased by roughly 2 years over 10 years (

The model revealed for every 10-year difference in chronological age, the perceived onset of old age was about 2 years greater. For instance, the estimated perceived onset of old age for a 64-year-old was 74.7 years, compared to a perceived onset of old age at 76.8 years for a 74-year-old.

A limitation the team highlighted was how nursing home residents and very old adults were underrepresented despite the participants being as old as 85 years.

Despite the perceived onset of old age becoming later throughout the years, the research suggests the trend has been slowing in recent years.

“The trend toward postponing old age is not linear and might not necessarily continue in the future,” Wettstein said.

Wettstein M, Park R, Kornadt AE, Wurm S, Ram N, Gerstorf D. Postponing old age: Evidence for historical change toward a later perceived onset of old age. 

. Published online April 22, 2024. doi:10.1037/pag0000812

People think 'old age' starts later than it used to, study finds. EurekAlert! April 22, 2024. 

https://www.eurekalert.org/news-releases/1041660

A new study found the perceived onset of old age rose nearly 3 years from 1911 to 1953.

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Middle Age and Older Adults Perceive “Old Age” Begins Later Than a Decade Ago

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She joined MJH Life Sciences in August 2023 shortly after graduating from Monmouth University where she earned her BA in Communication with a concentration in Public Relations/Journalism and later an MA in Interactive Digital Media. She enjoys traveling, running, and reading books. She can be reached at abrooks@mjhlifesciences.com.

Shah discusses the prevalence of psychiatric illness among hospitalized patients and highlights key considerations for their management from her session at ACP.

Managing General Medical Inpatients with Psychiatric Illness, with Sejal Shah, MD

 is common among hospitalized patients, underscoring the importance of ensuring clinicians are equipped to both recognize and treat individuals with acute psychiatric diagnoses in the inpatient setting.

2024 American College of Physicians (ACP) Internal Medicine meeting

 in Boston, Sejal Shah, MD, chief of the division of medical psychiatry and associate vice chair of clinical consultation services at Brigham and Women’s Hospital, highlighted key considerations for managing general medical inpatients with psychiatric illness, emphasizing the importance of treating patients in a “nonjudgmental” manner.

“[These patients] often experience bias and judgment related to mental illness in the rest of their lives, so when they're admitted, being treated in a way that is equitable and in a nonjudgmental way is the number one principle to keep in mind, and then really just being able to recognize that they're experiencing not only medical illness, but also psychiatric illness,” Shah explained in an interview with 

Specifically, her session at ACP focused on depression, demoralization, anxiety, somatic symptom disorder, psychotic disorders, and substance use disorder. During her discussion of mood disorders and depression, Shah emphasized the importance of considering suicidality and identifying potential safety issues for patients experiencing psychiatric illness. Although she noted patients with psychiatric illness are more likely to be the victims of violence rather than perpetrating violence, she also mentioned the management of agitation in these patients given its prevalence in the general inpatient setting.

Looking ahead to ensuring safe transition and placement at discharge, Shah explained how this process varies based on location and the availability of mental health resources in the local community, saying “If a patient is experiencing mental illness, it is not unlikely that they will experience an exacerbation after an acute medical hospitalization… helping the patient help the clinician identify what resources would be helpful in the community to be able to continue caring for them more holistically and making sure that their mental illness is cared for is kind of the most important.”

Differentiating Medication Non-Adherence From Underlying Comorbidities 

The expert panel addresses the common assumption of medication non-adherence in patients with resistant diabetes, provides strategies to differentiate non-adherence from underlying comorbidities contributing to resistance, and discusses the challenges of patients who are post-metabolic surgery, yet experience weight gain and symptom recurrence. 

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Thorndike discussed highlights from her ACP 2024 talk titled ‘Annals Beyond the Guidelines: How Would You Treat this Patient with Obesity?’


Anne Thorndike, MD, MPH: Discussing Treatment Approaches for Patients with Obesity

An extension study showed upadacitinib 15 mg and 30 mg for rheumatoid arthritis continues to be favorable, with many patients achieving remission.

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More Than Half of RA Patients Achieve Remission After Upadacitinib 15 mg

Contrary to previous research, findings point to similar decreases in weight and improvements in glucose homeostasis between time-restricted eating and usual eating pattern groups.

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Isocaloric Time-Restricted Eating May Not Induce Weight Loss in Patients with Obesity

In this segment of his interview, Leff described what he hopes internal medicine physicians viewing his talk walk away realizing about Hospital at Home.

Bruce Leff, MD, MACP: Discussing ‘Hospital at Home’ Program, Important Takeaways

At the ACP Internal Medicine Meeting, Leff described the outcomes and implementation of the ‘Hospital at Home’ program for elderly adults.


Bruce Leff, MD, MACP: Discussing the ‘Hospital at Home’ Program for Older Adults

Data presented at ACP 2024 shows non-White patients may be particularly subjected to more risk of discrimination in their care when ED boarding extends past 24 hours.

Hospital Medicine

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Longer Emergency Department Boarding Increases Risk of Patient Discrimination, Dissatisfaction

This discussion with Hemming featured the biggest takeaways from his talk titled ‘Depression and Anxiety Treatment by the Internal Medicine Physician.’


Patrick Hemming, MD: Depression, Anxiety Treatment by the Internal Medicine Physician

Markland discusses the use of anticholinergics, beta 3-agonists, and nonpharmacologic treatments for urge urinary incontinence, based on her session at ACP.

Alayne Markland, DO: Considerations for Treating Urge Incontinence in Older Adults

Wilt discusses the different screening methods recommended by ACP and explains how he talks about screening with his patients. 

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Timothy Wilt, MD, MPH: Discussing Colorectal Cancer Screening Options Recommended by ACP

This interview at ACP 2024 featured a discussion with Hemming on the Mental Health Care Model (MHCM) and addressing depression in primary care settings.


Latest News

Anne Thorndike, MD, MPH: Discussing Obesity, Physical Activity, Weight Loss Drugs

Phase 2 SAVITRI Supports Use of NBI-1065845 in Major Depressive Disorder with Inadequate Response to Antidepressants

Middle Age and Older Adults Perceive “Old Age” Begins Later Than a Decade Ago

Managing General Medical Inpatients with Psychiatric Illness, with Sejal Shah, MD

Differentiating Medication Non-Adherence From Underlying Comorbidities