Staying #Up2Date 🚨

1. Which triple therapy is best?

This cohort study of 40,776 COPD patients compared Breztri Aerosphere and Trelegy Ellipta for exacerbation prevention and safety. Breztri was associated with a 9% higher risk of moderate/severe COPD exacerbations (HR 1.09, 95% CI 1.04–1.14, NNH 38) and a 29% higher risk of severe exacerbations (HR 1.29, 95% CI 1.12–1.48, NNH 97) compared to Trelegy. Pneumonia-related hospitalizations were similar between groups (HR 1.00, 95% CI 0.91–1.10). With its better exacerbation prevention and lower environmental impact, Trelegy may be a preferred choice for COPD patients needing triple therapy.

2. Contraceptives & venous thromboembolism (VTE) 

This study analyzed (VTE) risk in over 1.3 million women in Denmark. Combined pills had the highest VTE rate ratios, with a 4.6-fold increase compared to nonuse, while third-generation progestin pills had the highest excess VTE rate of 14.2 per 10,000 person-years. Patches and implants showed moderate risks, with rate ratios of 5.0 and 2.4, respectively, and progestin-only pills had a lower VTE risk (rate ratio of 1.8). The study found that IUDs carried no increased VTE risk (rate ratio of 1.0), emphasizing the importance of personalized contraceptive counseling.

3. GLP1 RA in alcohol use disorder (AUD)

In this RCT, compared to placebo, semaglutide significantly reduced alcohol consumption in a laboratory self-administration test (β, -0.48; 95% CI, -0.85 to -0.11; P = .01) and decreased peak breath alcohol concentration (β, -0.46; 95% CI, -0.87 to -0.06; P = .03). While semaglutide did not affect total drinking days, it significantly reduced drinks per drinking day (β, -0.41; 95% CI, -0.73 to -0.09; P = .04) and weekly alcohol craving (β, -0.39; 95% CI, -0.73 to -0.06; P = .01). These findings support further clinical trials to assess GLP-1 receptor agonists as a potential treatment for AUD.

Healthcare On the Ballot 🗳️

What doctors should know.

What happened: As election day nears, candidates for Ontario’s next Premier unveil their heroic promises to fix the healthcare system. 

About 2.5 million Ontarians don’t have a family doctor or regular access to primary care. Many endure gruelling walk-in clinic lines or, in the worst cases, ER visits. What’s worse, it’s estimated that about 3 million Ontario residents will lose their family doctor to retirement in the next few years. 

So, what are the candidates proposing?

• Hiring family doctors

  • Liberals & Greens: Recruit over 3,000 family doctors in the next 4 years.

  • NDP: Invest $4.5 billion to ensure Ontarians have a doctor.

  • PC: Budget $1.6 billion to address the shortage. 

• Rural healthcare

  • All parties: Hire more doctors in northern communities.

  • NDP: Increase funding for educational and skills programs in rural areas. 

• Wait times

  • All parties: Create a centralized referral system for patients requiring specialists (to reduce backlog).

• Health human resources

  • PC: Launched the Practice Ready Ontario Program in 2023 to approve internationally trained physicians more quickly.

    • Only 50 spots are available each year, and it’s unclear if the PC party plans to expand this.

    • Liberals, Green Party, & NDP want to increase that number.

• Digital health

  • PC: Strengthen digital tools for medical bookings and referrals.

  • Liberals: Expand the use of AI in healthcare.

But what do other doctors have to say? Check out this video from a Canadian physician about the struggles of overcrowding, wait times, and a lack of doctors:

Bottom line: The candidates are battling hard to win the hearts and minds of Ontarians. Stay with us as we track their plans and what they mean for doctors.

Hot Off The Press

1: 🏥 Ousted Alberta Health Services CEO Athana Mentzelopoulos is suing for wrongful dismissal, claiming she was pushed out for raising red flags about inflated private healthcare contracts and political interference. Her lawsuit names high-ranking officials, hints at shady deals, and even claims she was warned to "be very careful." None of these claims have been tested in court, but if even some prove true, this could become one of Alberta’s biggest political scandals.

2: 🇺🇸 Protests are intensifying over Elon Musk’s influence in the Trump administration — specifically his push to cut federal health, education, and human services — with Congress on recess. Activists are targeting Tesla dealerships and congressional offices. They say these cuts threaten essential services like cancer research and veterans’ care.

3: 😷 A confirmed measles case in the Lower Mainland has public health officials on high alert. The individual, who recently travelled to Southeast Asia, was contagious while passing through Vancouver International Airport (YVR) on February 11. Fraser Health recommends a booster for those born in the 1970s who haven’t had two doses of the measles vaccine.

4: ⌚️ Apple continues to expand its push into healthcare, launching a new research study tapping into the health data of its 2.2 billion active devices. The study, which includes users of iPhones, Apple Watches, and AirPods, aims to explore both physical and mental health, and the potential to develop new health features. CEO Tim Cook believes Apple’s greatest legacy could be its contributions to healthcare.

Notable Numbers 🔢

8.7 million: how many new HIV infections could arise by 2029 due to the 90-day freeze on US foreign aid. UNAIDS warns this suspension could also result in 6.3 million AIDS-related deaths. 550 HIV workers have already been laid off, and the distribution of Lenacapavir (a promising twice-yearly shot) is in jeopardy. So far, no other countries have stepped in.

170 million: how many American users TikTok is back to serving, after nearly a month-long hiatus from the US app stores. The popular app, owned by Chinese firm ByteDance, was removed in January due to a law mandating its divestment or a ban. Thanks to Trump’s delay, TikTok avoided a mass migration to RedNote, where users dubbed themselves “TikTok refugees.”

5%: how much Canada's healthcare sector could contribute to the country's total emissions — and we’re among the highest per capita emitters globally. A proposed Healthcare Decarbonization Secretariat would coordinate efforts for tracking and reduction strategies, including switching anesthetic gases and using energy efficient practices, like turning off idle CT scanners.

$1.7 million: the amount Canada is investing to improve sexual and reproductive health access for underserved communities, as announced by Health Minister Mark Holland during Sexual Health Week. $1.2 million will go to the Society of Obstetricians and Gynecologists of Canada to develop resources for menopause and inclusive care for BIPOC and 2SLGBTQI+ populations. An additional $0.5 million will address educational misinformation about reproductive health.

Postcall Picks

📺 Watch: this highlight video for SNL’s 50th anniversary episode, including performances from Adam Sandler and skits from comedy legends.

😂Laugh: This seems about right?

🤑 Save: for the next 4 weeks, Costco is having a huge sale on electronics, including TVs, watches, and tablets! 

👂 Listen: to this episode of the White Coat Investor Podcast. The guest is an OBGYN who took 5 months off while still building wealth.

Relax

First Question: Third of your finger furthest from wrist, abbr.

If you enjoyed the puzzle, challenge your physician friends and see if they can beat your time.

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