‘‘The drug works. It gives you your life back,” says Austin Jacobson. Watch the video
The U.S. Food and Drug Administration has approved a new biologic drug that is based on seminal research by Emma Guttman-Yassky, MD, Professor of Dermatology, and Medicine (Clinical Immunology), at the Icahn School of Medicine at Mount Sinai. The drug, dupilumab, was approved in March—fast-tracked because it is a “breakthrough therapy” for adult patients with uncontrolled eczema. “It brings hope to patients who have tried everything.” Dr. Guttman-Yassky says.
One of them is her patient Austin Jacobson, a personal injury defense lawyer in Manhattan. “Living with eczema is like having poison ivy from head to toe,” he says. “You can’t sleep because you’re itching so badly. It affects every single aspect of your life.” Mr. Jacobson took part in clinical trials of the drug, which is injected every two weeks, and still uses it now. He says he felt relief from itching “two hours after taking the first injection.”
Emma Guttman-Yassky, MD, Professor of Dermatology, and Medicine (Clinical Immunology), at the Icahn School of Medicine at Mount Sinai
At least 31 million Americans are affected by some form of eczema. The most common type is atopic dermatitis, caused by a combination of genetic, immune and environmental factors. Dupilumab, sold by Regeneron Pharmaceuticals as Dupixent, is an antibody that binds to a protein, IL-4 receptor alfa, inhibiting the inflammatory response that leads to eczema’s rashes and itching. Dr. Guttman-Yassky’s laboratory was the first to map immune pathways underlying eczema, including those now targeted by dupilumab and other drugs in clinical trials.
Her team is among those testing more new therapies, including a drug made by Pfizer Inc. that targets a different immune molecule, interleukin 22 or IL-22. Dr. Guttman’s research was the first to identify the lymphocytes that produce IL-22, and show their link to eczema. With funding from the National Institutes of Health, she designed a study that tested IL-22 antibody targeting in the clinic and in the lab—a treatment that is showing promising preliminary results.
“These are exciting times for patients with eczema, and for me specifically, as I am able to contribute to the scientific development for this disease and help millions of patients worldwide,” Dr. Guttman-Yassky says. “This is a dream come through for a physician-scientist.”
As for Mr. Jacobson, he says that his skin, which had been “100 percent” covered with a scaly, flaking rash, is now largely clear. “The drug works,” he says of dupilumab. “It gives you your life back.”
Dr. Guttman-Yassky has received research funding from Regeneron, and drug and research support from Pfizer, and is working with most companies developing treatments for atopic dermatitis/eczema.
When 32-year-old Julissa Marquez sustained 27 stab wounds to the head, face, and eyes in December 2013, she was told by the trauma specialist who saw her that she would never see again. But thanks to doctors at the New York Eye and Ear Infirmary of Mount Sinai, including Ronald Gentile, MD, FACS, FASRS, Professor of Ophthalmology at the Icahn School of Medicine at Mount Sinai and Chief of Ocular Trauma Service, she was able to see her son graduate from high school.
Kenneth Teasley, HIV-positive with end-stage renal disease, had been on a waiting list for a kidney transplant for five years. He learned from The Mount Sinai Hospital in the spring of 2016 about his eligibility for an organ from another HIV-positive patient. Mount Sinai was the first hospital in New York State and only the second in the country approved to perform kidney and liver transplants from a deceased HIV-positive donor to an HIV-positive recipient.
Here is his story:
“I was originally diagnosed with HIV in 1993. Then a couple months later, I was diagnosed with CKD at 23 percent,” Kenneth says. “I basically thought I had two years to live.”
CKD or Chronic Kidney Disease is a condition characterized by gradual loss of kidney function over time. Kenneth’s kidneys were functioning at only 23 percent of capacity. After years of suffering, Kenneth began three times a week dialysis treatment sessions.
“It was very hard for me at the beginning. And all you want to do is go to sleep. I was also having issues with my blood pressure,” he says. “I actually fell once, really bad, and that’s actually how they found the stroke that I had earlier that year.”
Kenneth remained on dialysis for five years.
Sander S. Florman, MD: “He’s going to have a much better quality of life, and he’s going to live longer thanks to the gift of organ transplantation.”
“When you’re on dialysis your chances of having a heart attack or a stroke go up dramatically. In fact, most of the people who are on dialysis will die of a heart attack or a stroke,” says Sander S. Florman, MD, Director of The Recanati/Miller Transplantation Institute at Mount Sinai and Charles Miller, MD Professor of Surgery at the Icahn School of Medicine at Mount Sinai. “If you’re lucky enough to get a transplant that risk goes way down.”
Kenneth was placed on the transplant waiting list. But for HIV patients the wait was typically much longer than for those without disease.
“Mount Sinai was a big enroller in an NIH-sponsored trial offering transplants to very carefully selected people with HIV,” says Dr. Florman. “And it turns out, very counter-intuitively, that the medicines that we use for transplant to prevent rejection work synergistically, work right alongside with the medicines that are used to treat HIV. They did well, and this opened the door.”
Kenneth Teasley: “I think I can do anything now. I guess I could be Superman.”
After the surgery, “his kidney function was normal right away and he didn’t have any complications,” says Antonios Arvelakis, MD, MPH, Transplant Surgeon at the Recanati/Miller Transplantation Institute and Assistant Professor of Surgery at the School of Medicine. “Being able to offer an HIV patient the organ of an HIV donor, I’m pretty sure it’s going to help move forward the approach of the treatment for HIV patients.”
Adds Dr. Florman: “He’s going to have a much better quality of life, and he’s going to live longer thanks to the gift of organ transplantation. I couldn’t be more proud of Mount Sinai and of my team’s efforts to offer transplant to HIV because when it comes to transplanting people with HIV there’s a lot of stigma still and a lot of places talk ‘yes’ but very few places do ‘yes.’”
After a week in the hospital, Kenneth returned home.
“I finally realized that I actually can do anything, and it’s not what’s put on you, it’s what you do with it,” he says. “I think I can do anything now. I guess I could be Superman.”
Patient Louis Burns told Douglas T. Dieterich, MD: “You are always full of joy and compassion.”
The Institute for Liver Medicine held a special party on Tuesday, March 7, on The Mount Sinai Hospital campus, for an extraordinary group of patients: men and women who have been cured of Hepatitis C.
“It’s rare in medicine that we get to bring people back to celebrate a cure,” Barbara Murphy, MD, Murray M. Rosenberg Professor of Medicine and Chair of the Department of Medicine for the Mount Sinai Health System, told the 85 jubilant patients, who clapped and cheered.
Hepatitis C is a liver disease caused by a virus, but most individuals do not have any symptoms until 10 years or more after infection. Without medical treatment, chronic Hepatitis C can eventually cause liver cancer or liver failure. Frequently, patients need liver transplants to survive.
The patients who came together were celebrating their health—and the nine new direct-acting antiviral medications that have transformed treatment and significantly increased cure rates in the last three years. A patient is considered cured if a blood test reveals no presence of virus in the blood 12 weeks after treatment is completed.
“The advances in Hepatitis C treatment have been revolutionary—it is now possible to cure up to 99 percent of patients with virtually no side effects,” says Douglas T. Dieterich, MD, Director, Institute for Liver Medicine, and Professor of Medicine (Liver Diseases), who hosted the celebration. The new medications, given in daily pill form for 8 to 24 weeks, replaced former treatments that had severe side effects, little tolerability, and cure rates of only 20 percent to 30 percent.
“This is astounding scientific progress,” says Dr. Dieterich, who notes that Mount Sinai clinical researchers helped develop the new medications. “Through medication and liver transplants, we have now cured more than 2,000 patients at The Mount Sinai Hospital and a total of 5,000 in the Health System since the beginning of 2014. Still, there remain huge numbers of people who have Hepatitis C who do not even know they have it. Our task now is to identify, test, and treat them.”
Dr. Dieterich, other physicians, and staff, including Alyson Harty, RN, and Maria Rivera, Medical Assistant, were among those singled out by a dozen patients who gave spontaneous testimonials. “I want to give kudos to you, Dr. Dieterich. You are always full of joy and compassion,” said patient Louis Burns. “I am just so grateful for the treatments. You have definitely transformed my life. You have helped us.” Patient Harry Bangel sought Ritu Agarwal, MD, Assistant Professor of Medicine (Liver Diseases) in the crowd, posed for a photograph, and said, “This is the woman who cured me.” Patient Arlene Gray recalled a long-ago memory of being “so afraid” when she was diagnosed. At the party, she spoke of the compassion she felt from the staff. “This is a family of love,” she said. Patient David Jordon smiled and posed with Danielle Carter, MD, fellow, Liver Diseases, and said: “I’m cured. I can’t think of anything better.”
From left: Robert Friedman; Aaron E. Miller, MD, Professor of Neurology, and Medical Director, Corinne Goldsmith Dickinson Center for Multiple Sclerosis at Mount Sinai; Blair Underwood; and Fred D. Lublin, MD.
More than 225 donors, patients, faculty, and friends attended the 15th Annual Gala for the Corinne Goldsmith Dickinson (CGD) Center for Multiple Sclerosis at Mount Sinai, which was held Thursday, March 2, at The Plaza. The event was chaired by Meruka Hazari, MD, a patient at the Center; her sister, Kernika Gupta, MPH; and their mother, Renu Gupta, MD.
A highlight of the evening was the presentation of a special award to Blair Underwood, actor, director, and philanthropist, by Robert Friedman, Mount Sinai Health System Trustee and a member of the CGD Center Advisory Board. The award recognized Mr. Underwood’s exemplary contribution to the advocacy community. He shared with the audience that his television show, GIVE, which profiles philanthropic efforts, was created to honor his philosophy that “to whom much is given, much is required.” He went on to say, “I’ve been given a great deal in my 50-something years on this planet. Though I believe ‘giving back’ and ‘being of service’ is a requirement, it also feels good, and it is a joy.”
The evening also featured a panel presentation moderated by Kate Milliken, founder of the website mycounterpane.com. Ms. Milliken interviewed CGD Center patients and caregivers, each with an inspirational personal journey that exemplified the program’s theme, “The Power Within.”
The Clifford H. Goldsmith Award for Outstanding Service was presented to Joan Noto, President of the Corinne Goldsmith Dickinson Center Advisory Board. “Through the efforts of generous, committed individuals, such as Joan, we have been able to provide comprehensive, compassionate care and become a worldwide leader in clinical research aimed at ending this disease,” said Fred D. Lublin, MD, Saunders Family Professor of Neurology at the Icahn School of Medicine at Mount Sinai and the Center’s Director.
Michael Greene went through more in his first 28 years than most of us will face in our entire lifetimes combined: Two new hearts. An extra set of kidneys.
At 8, it was determined he needed his first heart transplant, which was performed at The Mount Sinai Hospital. Last year, it was clear Michael needed another heart. He was transferred to Mount Sinai, where doctors told him his valves were not opening as much as they should, leading half the blood that’s supposed to circulate throughout his body straight into his heart.
When 32-year-old Julissa Marquez sustained 27 stab wounds to the head, face, and eyes in December 2013, she was told by the trauma specialist who saw her that she would never see again. But thanks to doctors at the New York Eye and Ear Infirmary of Mount Sinai, including Ronald Gentile, MD, FACS, FASRS, Professor of Ophthalmology at the Icahn School of Medicine at Mount Sinai and Chief of Ocular Trauma Service, she was able to see her son graduate from high school.
