One Day in January: A News Quiz

January 12, 2018, was a big day for health care headlines. From Medicaid work requirements and a virulent flu season to recall of a popular drug and a label expansion for another -- find out what you recall about the details with our One Day In January News Quiz. (Caveat: we cheated a bit - one news story appeared on January 10!)

1. Which state became the first under the Trump administration to institute Medicaid work requirements?A. Arizona

B. Indiana

C. Maine

D. Kentucky

Please click below for answer, discussion, next question.

Answer: D. Kentucky

On January 12 2018, Kentucky became the first state under the Trump administration to institute Medicaid work requirements. The new Medicaid rules will require able-bodied Medicaid recipients aged 19-64 to take part in at least 80 hours of “employment activities” each month, which includes job training, education and community service. Exempt groups include former foster-care youth, pregnant women, primary caregivers of a dependent, full-time students, the disabled and the medically frail. These changes will take effect in Kentucky in July 2018.¹

The move came one day after the Trump administration announced for the first time that states could begin imposing work or job training requirements for recipients to obtain Medicaid, with the proviso that states would have to make “reasonable modifications” for people with opioid addiction and other substance use disorders. States that have proposed similar changes to Medicaid but have yet to do so (as of January 17, 2018) include Arizona, Arkansas, Indiana, Kansas, Maine, New Hampshire, North Carolina, Utah and Wisconsin.

2.  Approximately how effective is the flu vaccine for 2017-2018 flu season?A. 20%

B. 30%

C. 40%

D. 50%

Please click below for answer, discussion, next question.

Answer: B. 30%

On January 12 2018, representatives of the CDC announced that so far H3N2 is the predominant circulating form of influenza for the 2017-2018 flu season. H3N2 causes more severe illness, as well as increased hospitalizations and deaths, especially in children, people age 65 and over, and those with underlying conditions. The flu vaccine is generally less effective against H3N2 than other strains of influenza. While preliminary effectiveness data from surveillance studies will not be available until mid-February 2018, information so far suggests that the flu vaccine will have an effectiveness of around 30% for the 2017-2018 season.²

3. In January 2018, which of the following was recalled due to a labeling error:A. Simvastatin

B. Warfarin

C. Clopidogrel

D. Atorvastatin

Please click below for answer, discussion, next question.

Answer: C. Clopidogrel

On January 10, 2018, International Laboratories voluntarily recalled one lot (lot number 117099A) of clopidogrel USP 75 mg tablets due to a labeling error. The company said that this lot may contain clopidogrel 75mg or simvastatin USP 10-mg tablets. The recall happened one day after the US FDA issued a safety alert about the mislabeling.³ In August 2017, International Laboratories issued a nationwide recall of a single lot of pravastatin sodium USP 40-mg tablets, which was mislabeled and contained the antidepressant bupropion.

4. Which of the following is the first drug indicated specifically for BRCA-mutated breast cancer?

A. Olaparib

B. Rucaparib

C. Niraparib

D. None of the above

Please click below for answer and discussion.

Answer: A. Olaparib

On January 12, 2018 the US Food and Drug Administration (FDA) extended the approval for olaparib (Lynparza, AstraZeneca/Merck & Co) to include the treatment of metastatic BRCA-positive, HER2-negative breast cancer,⁵ making it the first FDA-approved drug indicated specifically for BRCA-mutated breast cancer.

Approximately 10-15% of patients with any type of breast cancer carry the BRCA mutation. Olaparib inhibits poly-(ADP-ribose) polymerase (PARP), which is involved in DNA repair. The drug is already approved for treating BRCA-mutated ovarian cancer.  Other PARP inhibitors include rucaparib (Rubraca, Clovis Oncology), approved for treating BRCA-positive ovarian cancer, and niraparib (Zejula, Tesaro), approved for treating ovarian cancer regardless of BRCA mutation status. 
 

References

1. Abutaleb Y. Kentucky becomes first U.S. state to impose Medicaid work provisions. Reuters  January 12, 2018. Accessed January 17, 2018.

2. Abutaleb Y. Trump administration to let states adopt Medicaid work requirements. Reuters January 11, 018. Accessed January 17, 2018.

3. Centers for Disease Control. Transcript for CDC update on widespread flu activity. January 12, 2018. Accessed January 17 2018.

4. US Food and Drug Administration (US FDA). Clopidogrel Tablets USP, 75 mg by International Laboratories: Recall - Product Mislabeling. January 10, 2018. Accessed January 18 2018.

5. US Food and Drug Administration (US FDA). FDA approves first treatment for breast cancer with a certain inherited genetic mutation. January 12, 2018. Accessed January 18, 2018.