Hello Health Rounds readers! Today we feature an exciting trio of reports on discoveries that could lead to important future treatments. One may help prevent or reduce severity of COVID-19 and even the common cold, another may allow for diagnosis of ALS long before symptom onset, while the third may tackle infections with mpox and related illnesses.

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An influential drug pricing watchdog said popular GLP-1 weight-loss injections have become more cost-effective as their prices have fallen and studies have documented their cardiovascular health benefits.

An over-the-counter nasal spray antihistamine reduced rates of COVID-19 infections and common colds in a midstage trial, German researchers reported in JAMA Internal Medicine.

The 450 study volunteers used either an azelastine nasal spray, typically used to ease allergy symptoms, or a placebo spray three times a day for 56 days.

During that time, COVID infections were confirmed in 2.2% of the participants in the azelastine group and 6.7% of those in the placebo group.

The azelastine group also had fewer symptomatic COVID-19 infections, fewer confirmed respiratory infections, and fewer infections with rhinoviruses, the most prevalent common cold-causing germs.

In the treatment group, 1.8% developed a rhinovirus infection, compared to 6.3% in the placebo group, the researchers found.

If further research confirms these findings, “azelastine nasal spray could provide an additional easily accessible prophylactic to complement existing protective measures, especially for vulnerable groups, during periods of high infection rates, or before traveling,” study leader Professor Robert Bals of Saarland University Medical Center said in a statement.

The presence of a distinct set of proteins in the blood can accurately identify patients who will develop the fatal nerve disease amyotrophic lateral sclerosis up to a decade before symptoms appear, researchers reported in Nature Medicine.

“We had always assumed that ALS was a rapid disease that starts 12 to 18 months before symptom onset,” study author Dr. Alexander Pantelyat from Johns Hopkins University School of Medicine said in a statement.

“But when we look at our findings, we see this has been a process that goes on for a decade or so before the patient ever steps into the doctor’s office or clinic.”

The researchers validated their test by analyzing blood samples obtained at the start of a long-term study from more than 23,000 volunteers, including 110 individuals who eventually developed ALS, also known as Lou Gehrig's disease.

Blood from those 110 had the predictive pattern of changes in 33 proteins 10 to 15 years before the disease was diagnosed, indicating early dysfunction of the muscles and nerves.

The test was 98% accurate in differentiating between blood samples taken from people with ALS, those without the disease, and those with other neurological disorders, the researchers said.

ALS causes muscle atrophy, respiratory failure and death, typically within two to four years. Patients often face a delay of 6 to 18 months before receiving a diagnosis.

“We see the light at the end of the tunnel here, and that target is an approved and available blood test for ALS,” Pantelyat said.

Treatments can slow the progression of the ALS and help manage symptoms, but there is presently no cure for the disease.

“With a test that allows for earlier detection of ALS, we have opportunities to enroll people in observational studies, and by extension, offer promising disease-modifying - and hopefully disease-stopping - medications, before ALS becomes debilitating.”

The discovery of three powerful antibodies in a person who recovered from an mpox infection might finally lead to a drug for treating the virus, researchers say.

The antibodies blocked the spread of the mpox virus in test tubes and protected mice against lethal doses of the virus, they reported in the journal Cell.

Mpox causes a painful rash, enlarged lymph nodes, fever, and scarring. The virus spreads mainly through close contact with an infected individual.

The newly discovered antibodies attack a surface protein called A35 that is found not only on orthopoxviruses, such as  mpox and smallpox, but also on the entire poxvirus family. That means the region is not prone to mutations, and so these antibodies will likely not lose their effectiveness, the researchers said.

They had previously observed high levels of antibodies against A35 in patients with mpox infection.

“Based on this earlier finding, we hypothesized that antibodies targeting A35 from mpox-infected individuals would be highly protective,” study leader Camila Coelh