Data Stream
Teaching an Old BTK Inhibitor New Tricks
Researchers may have found a new use for ibrutinib, the Bruton tyrosine kinase
inhibitor approved for the treatment of various lymphoproliferative disorders:
stopping reactions to common airborne allergens.
In a small study of 35 patients with cancer who had
allergic reactions to airborne irritants such as ragweed
and pet dander and were being treated with ibrutinib,
authors observed an 80% to 90% drop in reactivity in
one week.
“It almost completely knocked out the patients’ skin test and blood cell allergic reactivity,” the
authors added, and the study is being expanded to include adults with severe food allergies.
Sources: Regan JA, Cao Y, Dispenza MC, et al. Ibrutinib, a Bruton tyrosine kinase inhibitor used for treatment of lymphoprolif-
erative disorders, eliminates both aeroallergen skin test and basophil activation test reactivity. J All Clin Immunol. 2017 April 4.
[Epub ahead of print]; Northwestern University press release, May 22, 2017.
A Clear Bill of Health
Researchers who questioned whether displaying Medicare allowable fees in
patients’ electronic health records at the time of order entry would potentially
stem overuse of inpatient laboratory tests found that price transparency alone
was not enough to change clinicians’ ordering behavior.
In the study, 30 clinicians saw the Medicare allowable fees and 30 did not. Over
one year and more than 100,000 patients, there were only small differences:
0.05 more tests ordered per
patient-day (p=0.06)
$0.24 increase in fees per
patient-day (p=0.47)
“Future price transparency interventions may need to be better targeted,
framed, or combined with other approaches,” the authors concluded.
Source: Sedrak MS, Myers JS, Small DS, et al. Effect of a price transparency intervention in the electronic
health record on clinician ordering of inpatient laboratory tests: the PRICE randomized clinical trial.
JAMA Intern Med. 2017;177:939-45.
16
ASH Clinical News
Much Ado About Nothing?
The promises of genomics and a new era
of personalized medicine may not live
up to the hype, according to a study that
found that most people who had their
genome sequenced and were told they
had a disease-causing DNA variant did
not actually have that disease.
Of 50 healthy volunteers
who visited a primary-
care physician and
received a whole-genome
sequencing report:
11 (22%) had DNA
variants associated with
a particular disease, but
only 2 of these patients
(4%) developed the
disease.
These new molecular findings were “of
uncertain clinical utility,” the authors
noted, adding that the study results
“show how much further we need to go to
make our databases reliable.”
Source: Vassy JL, Christensen KD, Schonman EF, et
al. The impact of whole-genome sequencing on the
primary care and outcomes of healthy adult patients:
a pilot randomized trial. Ann Intern Med. 2017 June 27.
[Epub ahead of print]
August 2017