JAMA Editors' Summary Intratracheal Budesonide for BPD, Cell and Gene Therapy Access, Moderate Alcohol Consumption and Health, and more
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Oct 3, 2025 This week, discussions tackle the disappointing results of intratracheal budesonide in treating bronchopulmonary dysplasia. Barriers to accessing cell and gene therapies due to restrictive insurance policies are highlighted. Listeners learn about the risks of Medicaid disenrollment under new work requirements affecting vulnerable populations. The podcast also delves into the implications of moderate alcohol consumption on health and rising early-onset gastrointestinal cancers, underscoring the need for awareness and proactive health measures.
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Intratracheal Budesonide Didn't Improve Outcomes
- The B.I. trial randomized >600 infants <29 weeks to surfactant with or without intratracheal budesonide given early.
- The trial found no reduction in bronchopulmonary dysplasia or death at 36 weeks with budesonide added.
Two Definitive Trials Reached Same Conclusion
- The BIB trial ensured budesonide was administered with the first surfactant dose to mirror real-world use.
- PLUS and BIB both reached similar conclusions that the treatment failed to reduce BPD or death.
Payers Add Barriers Beyond FDA Labeling
- Commercial plans often add coverage requirements beyond FDA labeling for cell and gene therapies.
- These extra restrictions may limit patient access to FDA-approved treatments.