Allegheny County Medical Society
BULLETIN
BULLETIN
Opinion
Editorial
• Summer Nourishment
Deval (Reshma) Paranjpe, MD, MBA, FACS
Society News
ACMS News
• 2025 Candidate Slate for ACMS Board of Directors and Delegates
Sara Hussey
ACMS News
• Preview of 2024 House of Delegates Resolutions
Richard Hoffmaster, MD and Michael M. Aziz, MD
ACMS News
• ACMS Leadership Social August 2024
ACMS News
• Women in Healthcare Committee Announces 20242025 Co-Chairs
ACMS News
• Specialty Group Updates
ACMS Staff: Nadine Popovich, Eileen Taylor, and Melanie Mayer
Articles
Article
• Duquesne University College of Osteopathic Medicine Welcomes Inaugural Class
Holly McCalmon & Ken Walters
Medical News
• Reportable Diseases 2024: Q1-Q2 Allegheny County Health Department Selected Reportable Diseases/Conditions
Kristen Mertz, MD Allegheny County Health Department
Materia Medica
• Lecanemab-irmb (Leqembi™) Eva Stachler, PharmD; Elisabeth Marker, PharmD, BCPS
Cover Photo by Robert Cicco, MD
Robert Cicco, MD specializes in Neonatal-Perinatal Medicine Bubbles on the Beach
2024
Executive Committee and Board of Directors
President
Raymond E. Pontzer, MD
President-elect
Keith T. Kanel, MD
Secretary
Kirsten D. Lin, MD
Treasurer
William F. Coppula, MD
Board Chair
Matthew B. Straka, MD
Directors
Term Expires 2024
Douglas F. Clough, MD
David J. Deitrick, DO
Jan B. Madison, MD
Raymond J. Pan, MD
G. Alan Yeasted, MD, FACP
Term Expires 2025
Anuradha Anand, MD
Amber Elway, DO
Mark A. Goodman, MD
Elizabeth Ungerman, MD, MS
Alexander Yu, MD
Term Expires 2026
Michael M. Aziz, MD, MPH, FACOG
Michael W. Best, MD
Richard B. Hoffmaster, MD
Micah A. Jacobs, MD, FIDSA
Jody Leonardo, MD
PAMED District Trustee
G. Alan Yeasted, MD, FACP
2024 Board Committees
Bylaws
Kirsten D. Lin, MD
Finance
William Coppula, MD
Nominating
Keith T. Kanel, MD
Women’s Committee
Anu Anand, MD & Tiffany DuMont, DO
Bulletin
Managing Editor
Sara C. Hussey, MBA, CAE ACMS Executive Director shussey@acms.org
Medical Editor
Deval (Reshma) Paranjpe, MD reshma_paranjpe@hotmail.com
Bulletin Designer Victoria Gricks victoria@thecorcorancollective.com
Term Ending 2024
Richard Daffner, MD; Anthony Kovatch, MD; Andrea Witlin, DO, PhD
Term Ending 2025
Robert Howland, MD; John Williams, MD; Alexandra Johnston, DO; Charles Mount, MD
Administrative Staff
Executive Director
Sara Hussey shussey@acms.org
Vice President - Member and Association Services
Nadine M. Popovich npopovich@acms.org
Manager - Member and Association Services
Eileen Taylor etaylor@acms.org
Operations CoordinatorACMS & ACMS Foundation Melanie Mayer mmayer@acms.org
Part-Time Controller Elizabeth Yurkovich eyurkovich@acms.org
Bulletin Designer Victoria Gricks victoria@thecorcorancollective.com
EDITORIAL/ADVERTISING
OFFICES: Bulletin of the Allegheny County Medical Society, 850 Ridge Avenue, Pittsburgh, PA 15212; (412) 321-5030; fax (412) 321-5323.
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Summer Nourishment
By: Deval (Reshma) Paranjpe, MD, MBA, FACS
As summer slowly ambles to an end and memories of vacations start to fade, it’s time to explore the food scene in Pittsburgh once again. Here are some exciting new openings which are worth checking out as the heat and humidity start to ease.
Amboy
400 E. Ohio Street (North Side)under construction
Currently operating out of Soju (4923 Penn Avenue, Garfield 15224) Sunday Brunch and Dinner
Amboy will be a new fixture close to Allegheny General serving classic and modern Filipino Cuisine and is the creation of Chef Rafael Vencio. While construction finishes on the North Side location, Amboy is currently operating as a pop-up at Soju in Garfield. Look for a pricy but comprehensive prix-fixe Sunday Brunch and Dinner featuring both classic and modern Filipino cuisine with a different theme at each pop-up meal (beef, chicken, fish, vegetarian) and includes drink and dessert. No substitutions, so choose your protein wisely. Visit the Amboy website for tickets at www.amboypittsburgh.com
Soju
4923 Penn Avenue, Garfield Dine-In and Takeout Tues-Thurs 5-9pm; Fri-Sat 5-10pm
Soju serves Korean food of various styles ranging from bibimbap and classic beef bulgogi with banchan to modern fusion dishes like Nori French fries and Kimchi-chi Nachos and street food dishes. You’ll also find a Hawaiian
Poke bowl and Chicken Katsu on the menu, as well as the Soju take on the spicy chicken sandwich served with Nori fries. The drinks menu features the eponymous Soju, a Korean liquor distilled from rice with a similar taste to vodka. Soju is available in a wide variety of flavors and is featured in much of the cocktail list. Happy hour is 5-6pm with half off draft pints and select soju bottles for $10.
Mango Mango Desserts
5845 Forbes Avenue, Squirrel Hill Sun-Thu 12pm-10pm; Fri-Sat Noon11pm
If you’re in the mood for exquisite treats, venture out to our local outpost of this well-known Asian dessert spot in NYC. In addition to boba tea, juices and smoothies, look for a wide array of cakes, crepes, ice-cream stuffed waffles, and the famous green tea mille crepe cake.
Poetry Lounge
313 North Avenue, Millvale Daily, 3pm-2am
At first glance, it’s a dive bar in Millvale. But dig deeper, and it’s anything but that. Sean Enright, poet and most recently former manager of Spork, is being supported by Andy Tepper (also of Spork) in this eclectic venture. Enright brings a serious resume to the venture: he has worked at Spoon, Andora, Bar Marco, and Big Burrito Group to name a few places. Walk in and choose from the large selection of vinyl records to play, or listen to live music acts, or step up and read your own poetry at
an open mic poetry night, as one of my friends bravely did for the first time last week. Geochemist by day and open-mic poet by night, she finds exercising her creative side liberating and a way to make new friends—maybe some of us might too. Both cocktails and mocktails are excellent here; try the Mai Tai, no doubt a favorite of general manager James Morrow who oversaw the Tiki Bar and now features tropical Sundays at Poetry Lounge. This is one place in Pittsburgh where you can get an authentic Ramos Gin Fizz.
Grapow
411 South Craig St, Oakland Daily, 11:30am-9pm
If you’re in the mood for a wide variety of casual Pan-Asian street food, head to Grapow. The name derives from the Thai basil stir-fry dish Pad Kra Pow, but the restaurant serves street food dishes from nearly every East Asian country plus Gazar (Carrot) Halwa from India. Small bites include chicken satay and enoke tempura; try the Korean chicken bites. Grapow bowls include stir fries with choice of protein, rice and an egg on top; try the Grapow burger for a Wagyu beef burger with special sauce and fries.
Boca Loca
451 Melwood Avenue, Oakland Tues-Sat 11am-9:30pm
Southern Mexican cuisine reigns supreme at Boca Loca. Made to order guacamole, yes, but so much more. Birria tacos and other delights! Smoked carnitas (pork) nachos and bowls!
Home-made fresh guajillo salsa! Try the choriqueso nachos and dip for a taste of smoky chorizo. Tortas and bowls with smoked brisket, BBQ pulled pork sandwiches, Mexican street corn, fried chicken tacos, and a Colorado smoked brisked bowl with chile de arbol and guajillo sauce are just some of the excellent dishes on offer. Finish your meal with a smooth and simple flan. And yes, they cater.
Reva Modern Indian Cuisine 220 North Highland Avenue, East Liberty Daily 10am-11pm
While I haven’t tried this place yet, I do have it on good authority that the owners of Sankalp (excellent Indian restaurant in Cranberry) are behind this new venture in upscale Indian cuisine in East Liberty, and therefore the food should be equally incredible. Featuring primarily Northern Indian and IndoChinese dishes, Reva offers a range of tandoor grilled meats, biryanis and both nonvegetarian and vegetarian curries. Look for an effort towards fusion or modern dishes (think Indian preparations using nontraditional ingredients, viz: asparagus kofta, sweet potato chaat, and rosemary, goat
cheese and mint truffle varieties of naan.) However, any Indian restaurant that actually offers Reshmi Kabab, Goat Curry and Goan Fish Curry on the menu looks to be solid on the classics as well. While the old comfort standby chicken tikka masala is certainly available, I would recommend also trying my namesake dish, Reshmi Kabab (thus named because the grilled meat is tender and silky—resham means silk). Catering, private dining, special event venue, delivery and takeout available.
Enjoy!
Duquesne University College of Osteopathic Medicine Welcomes Inaugural Class
By: Holly McCalmon
– Marketing Communications Manager at Duquesne University & Ken Walters - Media Relations Manager at Duquesne University
Duquesne University was abuzz with excitement on reaching another historic milestone as the College of Osteopathic Medicine (COM) welcomed its first class of medical students in early July.
Duquesne President Ken Gormley delivered the opening remarks, setting the stage for the momentous occasion.
“This is a day that really means so much to not just us here at Duquesne, but the whole Pittsburgh region. Knowing that we are going to focus on creating a new generation of primary care doctors that includes physicians for underserved urban and rural communities is exciting,” said Gormley.
Dr. John Kauffman, founding dean of the new medical school, was also full of excitement as he welcomed the students, “There's nothing like the energy of a new medical school and the inaugural class is always special.”
More than 90 students participated in a comprehensive two-day orientation program, which featured a detailed review of the curriculum, introductions to faculty and staff, and a tour of the college’s state-of-the-art education and
training simulation facilities.
Approximately two-thirds of the COM class hails from Pennsylvania, with 43 percent having earned their degree from a Pennsylvania institution, including Duquesne University.
Selected from over 4,300 applicants, the incoming class reflects Duquesne’s commitment to diversity and inclusion with more than 50 percent who are minorities or from underrepresented populations.
“These demographics show how we are striving to live that mission of being an inclusive osteopathic medical school,” emphasized Tyrone Carr, COM director of student affairs and diversity, equity and inclusion.
To kick off their medical school journey with a touch of fun, the students also enjoyed a unique trip aboard the Gateway Clipper. This excursion offered them a chance to bond with each other and their faculty while cruising along Pittsburgh’s three rivers. As the students took in the scenic views, they also got a preview of the institutions they will partner
with for clinical experiences and the communities they will serve throughout their four years at the medical school.
"Our students will be heavily involved with community service projects, both locally in our region and then internationally. And that really is the fiber of what we do here, to grow physicians who have a heart for community service," said associate dean for academic affairs, Dr. Renee Prater emphasizing Duquesne’s dedication to service and engagement.
Duquesne’s College of Osteopathic Medicine is poised to make a lasting impact on its students and the community. The inaugural class began their journey with excitement and anticipation, marking the start of a new era for medical education at Duquesne.
“Duquesne has a long history of preparing excellent pre-med students and placing them in top medical schools,” states Kauffman. “Now, our bigger goal is to be the number one producer of physicians in the region by selecting students who really have a heart for people and a heart for service.”
"WE ARE SURROUNDED BY STUDENTS WHO COME WITH VERY HIGH ASPIRATIONS AND TREMENDOUS DRIVE, AND FACULTY WHO ARE VERY EXCITED TO BE HERE TO PROVIDE THEM WITH THE SUPPORT THEY NEED TO SUCCEED."
-- DR. JOHN KAUFFMAN, FOUNDING DEAN
Founded in 1878, Duquesne is consistently ranked among the nation's top Catholic universities for its award-winning faculty and horizon-expanding education. A campus of nearly 8,000 graduate and undergraduate students, Duquesne prepares students by having them work alongside faculty to discover and reach their goals. The University's academic programs, community service and commitment to equity and opportunity in the Pittsburgh region have earned national acclaim.
Follow Duquesne University on Facebook, X, Instagram & LinkedIn. www.duq.edu/com
Reportable Diseases 2024: Q1-Q2
Allegheny County Health Department Selected Reportable Diseases/Conditions
* Case classifications reflect definitions utilized by CDC’s Morbidity and Mortality Weekly Report. ** These counts do not reflect official case counts, as current year numbers are not yet finalized. Inaccuracies in working case counts may be due to reporting/investigation lag.
NOTE: Disease reports may be filed electronically via PA-NEDSS. To register for PA-NEDSS, go to https://www.nedss. state.pa.us/NEDSS. To report outbreaks or diseases reportable within 24 hours, please call the Health Department’s 24-hour telephone line at 412-687-2243. For more complete surveillance information, see ACHD’s Disease Surveillance page Disease Surveillance - Allegheny County, PA or the Infectious Disease Dashboard.
2025 Candidate Slate
ACMS Board of Directors and Delegates
As of August 1, 2024, the ACMS Bylaws were changed to move the election period to the first week in September annually. Members will receive a virtual ballot in their inboxes on September 2, 2024, and voting will conclude at 11:59 P.M. on September 9, 2024. The election results will be presented at the Board of Directors meeting on September 10, 2024, and will be certified by the Board of Directors. Here is the slate of candidates for the 2025 election:
Board Chair (Not Elected):
President (Not Elected):
President-Elect:
Secretary:
Treasurer:
BOLD = Elected Positions
Nominees to the ACMS Board of Directors
There are six open spots on the ACMS Board of Directors. There are five available full-term spots (3-year terms) and one two-year term that will be left vacant if Richard Hoffmaster, MD, is elected to the Secretary position. Members will vote for 6 of the 10 candidates below.
Three-Year Term (EXPIRES 2027) (5 OPEN)
Two-Year Term (EXPIRES 2026) (1 OPEN)
Francis R. Colangelo, MD
Douglas F. Clough, MD
Patricia L. Dalby, MD
David J. Deitrick, DO
Sharon L. Goldstein, MD
Farhad Hasan, MD
Kevin G. Kotar, DO
Prerna Mewawalla, MD
Raymond J. Pan, MD
Nicole F. Velez, MD
BOLD = Currently Serving, Running for Re-election
Raymond E. Pontzer, MD (Immediate Past President)
Keith T. Kanel, MD
Kirstin D. Lin, MD
Richard B. Hoffmaster, MD
William F. Coppula, MD* (Final Term)
Nominees to the ACMS Delegation
Our delegation is based on membership numbers, and for the current term, we require at least 12 delegates. We have 6 delegates who are not up for re-election this year. With the current nominees and those already serving, we are confident that we will have a strong delegation pool for 2025. Our Alternate Delegate pool will only strengthen our Delegation. Although all candidates will appear on the ballot, to fully fill our delegation, all eligible delegate and alternate delegate candidates on the ballot will be elected without contest.
Two-Year Term 2025-2026
Michael M. Aziz, MD
Vint Blackburn, MD
Douglas Clough, MD
Molly Fisher, MD
Geoffrey Lim, MD
Michael McDowell, MD
Charles Mount, MD
Alexander Yu, MD
BOLD = Currently Serving, Running for Re-election
The 2025 Candidate Slate has been submitted by the 2024 Nominating Committee:
Keith T. Kanel, MD - Chair, Nominating Committee
Amber L. Elway, DO
Jody Leonardo, MD
Jan Madison, MD
Raymond Pan, MD
G. Alan Yeasted, MD
Alternate Delegates (ONE YEAR TERM ENDING DEC. 31, 2025)
Rasha Abdulmassih, MD
William Coppula, MD
Amber Elway, DO
Richard B. Hoffmaster, MD
Anthony Kovatch, MD
Self-Care in Healthcare 2024
The Next Step Forward
By: Sara C. Hussey, MBA, CAE -- ACMS Executive Director
The Allegheny County Medical Society's "Self-Care in Healthcare" campaign focuses on promoting wellness and self-care practices among healthcare professionals, particularly the physicians within our ACMS membership. Recognizing the high levels of stress and burnout in the medical field, this campaign emphasizes the importance of mental, emotional, and physical well-being for those who care for others. Through educational resources, community initiatives, advocacy, and some fun giveaways, the campaign aims to encourage healthcare workers to prioritize their health, adopt healthy habits, and seek support when needed. By fostering a culture of self-care, the Allegheny County Medical Society strives to enhance the overall wellbeing and resilience of the healthcare community, ultimately improving patient care.
As we enter the third year of the Self-Care in Healthcare campaign, I’m inspired by its evolution. What began as a feel-good initiative to help reduce the stigma around mental health by providing resources and tools for physicians to disconnect from their busy workloads has transformed into a deeper conversation about physician suicide and a public awareness campaign highlighting the struggles physicians face. Last year, ACMS Board Member, Dr. Anu Anand and I were able to take this conversation to Talk Pittsburgh, where we shared our message with the public ahead of Physician Suicide Awareness Day.
This year, we are taking everything we've learned over the past two years
and turning it into actionable tools for our members and all physicians in our region.
Hopefully, you’ve heard that the ACMS Foundation launched the ACMS Physician Wellness Program earlier this year. This program symbolizes our dedication to supporting medical professionals. It is both a resource and a testament to our commitment to prioritizing physicians’ well-being. The ACMS Physician Wellness Program offers confidential counseling services to address the challenges medical professionals face today. This initiative underscores our commitment to supporting our dedicated physicians’ emotional and mental health. Visit www.acms.org/physicianwellness to learn more or to take advantage of a few free counseling sessions. Why not make prioritizing your mental health a part of your self-care goals this September?
Additionally, the ACMS is working with key stakeholders to address the removal of intrusive language in licensure and credentialing applications within hospital systems. ACMS member Dr. Vint Blackburn, Medical Director of the Physician Wellness Program, authored a resolution for the 2024 House of Delegates. Resolution 24-209 proposes that the Pennsylvania Medical Society (PAMED) conduct a comprehensive review of the state's medical licensure application to identify and address intrusive language related to mental health disclosures. The resolution recommends establishing a task force, including legal experts, mental health professionals, and medical community representatives, to recommend best practices aligned with the Dr. Lorna
Breen Heroes’ Foundation. The hope is that this task force will work with state regulatory bodies to implement these changes, aiming to support the mental health of medical professionals while maintaining patient safety. Additionally, this resolution recommends that PAMED create educational resources to inform members of the changes and promote a supportive culture and create an annual report that will track the progress and impact of these initiatives.
As in previous years, we will continue our social media campaign throughout September as we approach Physician Suicide Awareness Day on September 17. This year, you’ll hear from key stakeholders who will share guidance on self-care in healthcare, learn about statistics that affect you as physicians, and discover how you can win our most exciting self-care prize yet! If you’re not already following us on social media, now’s the time to do so—you won’t want to miss all the great things we have in store.
Finally, I want to take a moment to express my gratitude to all the physicians, residents, students, and healthcare workers reading this article. Your work is tireless, sometimes thankless, and often exhausting. But being a physician is one of the most important jobs in the world, and you are both appreciated and necessary. We thank you for all that you do, and we look forward to helping you find ways to practice self-care this September.
Society News
As we approach the 2024 House of Delegates (HOD) meeting, several significant resolutions are set to shape the future of medical practice and policy in Pennsylvania. Here is a preview of the key resolutions to be discussed, reflecting a broad spectrum of issues from bylaws amendments to public health initiatives.
BYLAWS AMENDMENTS
1. Independent Practice Physicians Section Provisions:
• Establishes a special section for physicians in independent practices, promoting their involvement and addressing delegate allocations and Board representation.
2. Executive Committee Provisions:
• Expands the Executive Committee to include the Vice Speaker and Secretary, enhancing consistency in committee operations.
3. District Alignment Provisions:
• Realigns districts to reflect the merger of the Lackawanna and Luzerne County Medical Societies, forming the Northeast Counties Medical Society.
KEY RESOLUTIONS
1. Equitable Apportionment of Delegates:
• Focuses on ensuring fair representation of student, resident, and fellow delegates in the HOD, addressing current urban-rural disparities.
2. Medical Society Consortium on Climate and Health:
• Proposes establishment of a consortium to address impacts of climate change on health.
Preview of '24 House of Delegates Resolutions
By: Richard Hoffmaster, MD – ACMS Delegation Chair & Michael M. Aziz, MD – ACMS Delegation Vice-Chair
4. Gender Identification on Vital Statistics Forms:
• Seeks to broaden gender identification options on Pennsylvania's vital statistics forms to be more inclusive.
5. Streamlining Medical Licensing for International Graduates:
• Aims to simplify the licensing process for international medical graduates to address workforce shortages.
6. Medical Spanish Education:
• Advocates for incorporating medical Spanish education and foreign language certification in medical school curricula.
7. Harm Reduction Programs in Medical Education:
• Proposes integrating harm reduction programs into medical school curricula to better prepare future physicians.
8. Interdisciplinary Learning:
• Promotes interdisciplinary learning to enhance collaborative practices among healthcare professionals.
9. Review of Mental Health Disclosures in Licensure Applications:
• Calls for a comprehensive review of the Pennsylvania medical licensure application to identify and assess potentially intrusive language regarding mental health disclosures.
10. Reducing Admissions Costs for In-State Applicants:
• Seeks to reduce the financial burden of medical school admissions for Pennsylvania residents.
11. Protecting Cultural Competency and DEI Training:
• Emphasizes the importance of cultural competency, diversity, equity, and inclusion (DEI) training in medical institutions.
12. Support for Caregiver and Elder Abuse Prevention:
• Supports efforts to increase caregiver support and address elder abuse.
PUBLIC HEALTH INITIATIVES
1. Universal Free School Meals:
• Advocates for providing universally free school meals to ensure no child goes hungry.
2. Single-Payer Health Insurance:
• Proposes support for a singlepayer health insurance system to simplify and improve healthcare access.
3. Fertility Treatment Coverage:
• Seeks to provide comprehensive fertility treatment coverage for Pennsylvania residents.
4. Access to Emergency Contraception:
• Advocates for full coverage of accessible, over-the-counter emergency contraception for individuals with Pennsylvaniaprovided health insurance.
5. Adult Use of Cannabis:
• Suggests a neutral stance on the adult use of cannabis, reflecting evolving public opinion and legal landscapes.
This year's resolutions reflect a commitment to advancing equitable healthcare policies, supporting public health initiatives, and addressing the needs of a diverse medical community. The discussions and decisions made at
Society News
the 2024 HOD meeting will undoubtedly have a lasting impact on the medical profession in Pennsylvania.
The Written Reference Committee Testimony is now officially open online on the PAMED website. All ACMS members are encouraged to review resolutions and report and share their expertise. All PAMED members (not just HOD members) are invited to participate in written and oral testimony.
Saturday, September 21 is the Virtual Opening Session of the House of Delegates. The business session will include an opportunity for candidate nominations to “run from the floor”. Reference Committee Oral Testimony will follow. Again, all PAMED members are invited to participate in the Reference Committee testimony
process.
October 25-27 is the Hybrid Hershey Annual Meeting and Business Session. It is not too early to begin making plans for this weekend. The HOD Speakers have arranged a Saturday Night of Surprises to celebrate our HOD and enjoy time with one another. The ACMS sponsors the participation of elected Delegates and Alternates at the HOD but any ACMS member interested in attending HOD should reach out to Sara Hussey, ACMS Executive Director, to discuss opportunities for participation. As a reminder, this is YOUR organization, and your input is crucial. The ACMS has a large and impactful delegation. The ACMS Delegation is well respected, and we have a lot of sway at the House of Delegates. Your written or virtual testimony is vital. If
you aren’t comfortable sharing your testimony directly, please feel free to contact ACMS Delegation Chair Richard Hoffmaster, MD and/or ViceChair Michael M. Aziz, MD so they can provide testimony on your behalf. Stay tuned for further updates and outcomes from this pivotal event or visit www.pamedsoc.org/HOD for more information.
Leadership Social
August 2024
On Tuesday, August 6, the ACMS hosted its annual Leadership Social and Legislative Networking Event at the Kimpton Hotel Monaco. This event provides ACMS leaders, including Board Members, Delegates, Alternate Delegates, PAMED representatives, and other members of the ACMS leadership, the opportunity to hear from key stakeholders about current advocacy efforts. Attendees heard from Dave Thompson from the PAMED Advocacy team and Representative Arvind Venkat, MD. A special thank you to Tucker Arensberg who sponsored the event.
1. Richard Hoffmaster, MD (Delegation Chair/ Board Member), Micah Jacobs, MD (Board Member), Holly Appleberry, MD (Delegate)
2. Vivian Wang (Med Student), Cynthia McMahon (Med Student), Raymond Pan, MD (Board Member)
3. Prerna Mewawalla, MD (Women in Healthcare Committee Chair), Meilin Young, MD (Women in Healthcare Committee Chair), Alexandra Johnston, DO (Delegate/Bulletin Editorial Board)
4. Attendees hear from Representative Arvind Venkat, MD
5. Dave Thompson (PAMED), Rep. Arvind Venkat, MD
6. Michael Aziz, MD (Board Member, Delegation Vice-Chair, PAMED PAC Board), Todd Hertzberg, MD (PAMED Speaker of the House), Nadine Popovich (ACMS Vice President Membership), Dave Thompson (PAMED)
7. Micah Jacobs, MD (Board), Adam Appleberry, Esq. (Tucker Arensberg), Raymond Pontzer, MD (ACMS President), Kevin Kotar, DO (Delegate)
Women in Healthcare Committee Announces 2024-2025 Co-Chairs
The Allegheny County Medical Society (ACMS), under the leadership of President Raymond Pontzer, MD is pleased to announce that Prerna Mewawalla, MD and Meilin Young, MD, FCCP will assume the roles of Co-Chairs for the ACMS Women in Healthcare Committee. They succeed Tiffany Dumont, DO and Anuradha Anand, MD in these positions. The Society extends gratitude and appreciation to Dr. Dumont and Dr. Anand for volunteering to serve in the inaugural role and to their utmost dedication to the committee. They leave a solid foundation of programming to continue to nurture talent and foster professional growth among women physicians.
Dr. Mewawalla serves as the Medical Director of Apheresis, Chair of the Women Physician’s ERG, Diversity Officer at the Cancer Institute, Division of Hematology and Bone Marrow Transplant at Allegheny Health Network - West Penn Hospital and is Associate Professor at Drexel University.
Dr. Young is a specialist in Pulmonary and Critical Care medicine, Neurocritical Care Medicine at Allegheny Health Network. She currently serves as core faculty for the PCCM fellowship and subspecialty education coordinator for the Internal Medicine Residency program. She will soon be transitioning to a full-time role as co-medical director of the Neuro-ICU at Allegheny General Hospital.
The ACMS Women in Healthcare Committee, established in May 2023, aims to empower women in healthcare. It has become a beacon of inspiration and progress by fostering a supportive environment for women physicians,
advancing their leadership roles, and promoting their active participation in medicine. Several programs, attracting
Dr. Mewawalla and Dr. Young are committed to continuing the committee's existing initiatives while identifying and creating new programs that align with its core mission. They will work alongside 15 dedicated female physicians who opted into this committee to create a meaningful impact for this cohort of members.
The Women in Healthcare Committee not only empowers women physicians but also enriches the fabric
of ACMS and its broader community. The committee's efforts have increased engagement and value for women physicians within the organization. Furthermore, partnerships with external organizations have led to sponsorship opportunities, amplifying the impact of the committee's initiatives.
We are always looking to grow the committee! If you are interested in getting involved with the Women in Healthcare Committee, please reach out to Nadine Popovich at npopovich@ acms.org.
Prerna Mewawalla, MD Meilin Young, MD
Lecanemab-irmb (Leqembi™)
By: Eva Stachler, PharmD & Elisabeth Marker, PharmD, BCPS
Background
Lecanemab-irmb (Leqembi) is an amyloid beta(Aβ)-directed antibody approved by the FDA for treatment of Alzheimer’s Disease (AD) in the mild cognitive impairment (MCI) or mild dementia stage.1 Amyloid beta forms oligomers and protofibrils which combine to produce Aβ plaques, a hallmark finding in AD.2 As a humanized immunoglobulin gamma (IgG) monoclonal antibody, lecanemab binds to Aβ aggregates to reduce amyloid plaque formation.3
Safety
Lecanemab-irmb (Leqembi) has no contraindications to its use, however serious adverse effects can occur such as infusion-related reactions and Amyloid Related Imaging Abnormalities (ARIA).1 ARIA is differentiated into ARIA-E, MRI brain abnormalities showing vasogenic edema, and ARIA-H, showing hemorrhage.1,4,5 Anticoagulation increases the risk of hemorrhage, therefore concomitant use of anticoagulants is not recommended until further data is obtained regarding its interaction with lecanemab.6 There are several other criterion that limit the use of lecanemab including, but not limited to, a transient ischemic attach (TIA) or stroke within past year, untreated bleeding disorders, low platelet count less than 50,000 x109/L, international normalized ratio (INR) greater than 1.5, and a thyroid stimulating hormone (TSH) above normal range.7 This extensive list of exclusion criteria is utilized by local sites as requirements for prescribing.7
A 2023 phase 3 randomized controlled trial found that the incidence
of ARIA-H was 17.3 percent and the incidence of ARIA-E was 12.6 percent.8 However, 78 percent of participants who experienced either ARIA-E or ARIA-H were asymptomatic and the majority had an occurrence within the first 3 months of treatment.8 Higher risk is associated with apolipoprotein E homozygotes compared to heterozygotes and non-carriers.4,8
Of note, ARIA is a common adverse event for other monoclonal antibodies targeting Aβ plaques.4,5,9 In a phase 3 clinical trial of aducanumab, patients had an increased risk of ARIA-E and ARIA-H compared to placebo and nearly 25 percent experienced symptoms.5 The Alzheimer's Association has released recommendation for ARIA in amyloid modifying therapeutic agents, suggesting positron emission tomography (PET) imaging with frequent magnetic resonance imaging (MRI) monitoring.4 If symptoms associated with ARIA occur, therapy should be held and continued monitoring with MRI should continue until symptoms resolve.1,3
Current prescribing information suggest obtaining a brain MRI prior to initiation of treatment and with the 5th, 7th, and 14th infusions of lecanemab.1 If symptoms of ARIA occur, patients should receive additional MRI imaging to assess the type, severity, and presence.1
Tolerability
In the phase 3 clinical trial, the most reported adverse events included infusion-related reactions (26.4 percent), ARIA (12.6 percent), headache (11.1 percent), and fall (10.4 percent).8 Infusion-related reactions
were described as mild to moderate in 96 percent of participants and occurred with the first dose in three-quarters of patients.8 Of note, 56 percent of participants did not take preventative medications such as non-steroidal anti-inflammatory drugs (NSAIDs), antihistamines, or glucocorticoids.8 The most common symptoms associated with ARIA include headache, confusion, dizziness, vision changes, nausea, difficulty walking, and seizures.3,8
Efficacy
The primary endpoint in the phase 3 clinical trial was change from baseline at 18 months in the clinical dementia rating – sum of boxes (CDR-SB) score in patients 50-90 years old with diagnosis of MCI due to AD or mild AD-related dementia.8 This is a validated scoring system used in Alzheimer’s Disease clinical trials that assesses cognition and function through interviews with patients and their care partners.10 Scores range from 0 to 18, with higher scores indicating greater impairment and scores of 0.5 to 6 indicating early Alzheimer’s disease.10 The adjusted mean change from baseline in CDRSB score at 18 months was 1.21 for lecanaemab vs. 1.66 in the placebo group, for a mean difference of -0.45, which met statistical significance (95 percent CI:-0.67 to -0.23).8
Secondary endpoints measured a change in baseline at 18 months in amyloid burden on PET, 14-item cognitive subscale of the Alzheimer’s Disease Assessment Scale (ADAScog14), Alzheimer’s Disease Composite Score (ADCOMS), and Alzheimer’s Disease Cooperative Study-Activities of Daily Living Scale for Mild Cognitive
Impairment (ADCS-MCI-ADL).8
Lecanemab showed statistically significant change in all secondary endpoints compared to placebo.8 Centiloids, a unit of measure for Aβ on imaging, changed by -55.48 in the lecanemab group vs. 3.64 in placebo (95 percent CI:-62.64 to -55.6).8 Increasing scores on ADAS-cog14 and ADCOMS indicate greater cognitive impairment, and although lecanemab had an increase in score on both assessments, change in score was to a statistically significant lesser extent than placebo.8 For ADAS-cog14 lecanemab scores increased by 4.14 vs. placebo increasing by 5.58 for a between-group difference of -1.44 (95 percent CI:-2.27 to -0.61).8 Using ADCOMS, change from baseline for lecanemab was 0.164 vs. 0.214 for placebo, a difference of -0.05 (95 percent CI: -0.074 to -0.027).7 ADCSMCI-ADL indicates greater cognitive impairment with reduced scores. Lecanemab scores decreased -3.5 on average vs. -5.5 in placebo (95 percent CI: 1.2-2.8).8
Inclusion criteria for the randomized control trial was age 50-90 years, mild cognitive impairment due to Alzheimer’s Disease or mild Alzheimer’s Disease-related dementia, and amyloid positivity.8 Amyloid positivity was determined by PET imaging or cerebrospinal fluid (CSF) measurement via lumbar puncture (LP).8 Patients on anticoagulation were excluded, however use of antiplatelet agents, including aspirin or clopidogrel, was permitted.6 The majority of patients included in efficacy studies were white (77%) with lack of diversity of other races, creating a health disparity in the populations selected for treatment.8
Price
Currently there are no generic equivalents for Leqembi available in the United States.11 Per the manufacturer Eisai, the estimated launching price is $26,500 per year based on the dose of 10mg/kg for a patient that weighs 75kg.12 Wholesale acquisition cost (WAC) for the 200mg vial is $254.81 and the WAC for the 500mg vial is $637.02.12
Financial assistance is available via the Leqembi copay assistance program by Eisai, but the benefit varies by insurance plan.12 It is available for Medicare and Medicaid beneficiaries, which can have out of pocket cost as low as $0.12 Under Medicare Part B, patients will be responsible for 20% of cost, with estimated out-of-pocket yearly cost $5,292.50 based on a weight of 75kg patient.12
Simplicity
Leqembi is available as an intravenous solution 100mg/1mL via 200mg or 500mg vials.1,11,12 It is dosed 10mg/kg using actual body weight.1,11 At this time, prescribing and administration of lecanemab requires access to specialized centers for cognitive health as well as one hour of dedicated infusion chair time every two weeks. Patients must qualify for first-time dose through verification of amyloid plaques via Magentic Resonance Imaging (MRI) or lumbar puncture(LP).1 Patients should receive MRI prior to initiation and before the 5th, 7th, and 14th infusions or if any symptoms of ARIA arise.1
Bottom Line
Lecanemab may be effective for slowing the progression of mild AD in patients with MCI. 1,13 Current guidelines suggest a primary management of mild cognitive impairment through mitigating risk factors, such as deprescribing medications known to contribute to cognitive impairment, due to lack of efficacious pharmacologic treatment options.14 Lecanemab fills this gap in treatment in the early stages of Alzheimer’s Dementia, but has not been studied in patients with moderate to severe neurocognitive disorder. The prevalence of serious adverse events such as ARIA, frequent imaging requirements, high cost, and restricted access to treatment may outweigh the benefits for its use. Patient’s goals of care should be considered in light of significant treatment and financial burden.
References
1. Lecanemab. Package Insert. Eisai Inc; 2023.
2. Hampel H, Hardy J, Blennow K, et al. The amyloid-β pathway in Alzheimer’s disease. Mol Psychiatry. 2021;26(10):5481-5503.
3. About Leqembi. Leqembi. Accessed November 1, 2023. https://www.leqembi.com/ about-leqembi#diagnosing
4. Sperling RA, et al. Amyloid related imaging abnormalities (ARIA) in amyloid modifying therapeutic trials: Recommendations from the Alzheimer’s Association research roundtable workgroup. Alzheimers Dement. 2011;7(4):367-385. doi:10.1016/j.jalz.2011.05.2351
5. Salloway S, et al. Amyloid-related imaging abnormalities in 2 phase 3 studies evaluating aducanumab in patients with early Alzheimer disease. JAMA Neurol. 2022;79(1):13-21. doi:10.1001/jamaneurol.2021.4161
6. Cummings J, et al. Lecanemab: Appropriate use recommendations. J Prev Alzheimers Dis. 2023;10(3):362-377. doi:10.14283/jpad.2023.30
7. Fuller MA. Lecanemab-irmb (LEQEMBI) criteria for use August 2023. VA Pharmacy Benefits Management Services, Medical Advisory Panel, and VISN Pharmacist Executives. February, 2023. Updated August 2023. www.va.gov/ formularyadvisor/DOC_PDF/CFU_Lecanemabirmb_LEQEMBI_CFU_rev2_Aug_2023.pdf
8. Van Dyck CH, et al. Lecanemab in early alzheimer’s disease. N Engl J Med. 2023;388:9-21. doi:10.1056/NEJMoa2212948
9. Mintun MA, et al. Donanemab in early alzheimer’s disease. N Engl J Med. 2021;384:16911704. doi:10.1056/NEJMoa2100708
10. O’Bryant SE, et al. Staging dementia using clinical dementia rating scale sum of boxes score. Arch Neurol. 2008;65(5):1091-1095. doi:10.1001/ archneur.65.8.1091
11. Leqembi. IBM Micromedex Solutions. Truven Health Analytics, Inc. Ann Arbor, MI. Accessed November 1, 2023. http://www. micromedexsolutions.com
12. Eisai’s approach to U.S. pricing for leqembi (lecanemab), a treatment for early alzheimer’s disease, sets forth our concept of “societal value of medicine” in relation to “price of medicine”. Eisai Global. Accessed November 1, 2023. https://www. eisai.com/news/2023/news202302.html
13. Lacorte E, et al. Safety and efficacy of monoclonal antibodies for alzheimer’s disease: A systematic review and meta-analysis of published and unpublished clinical trials. J Alzheimers Dis. 2022;87(1):101-129. doi:10.3233/JAD-220046
14. Peterson RC, et al. Practice guideline update: Mild cognitive impairment. Neurology. 2018;90(3). doi:10.1212/WNL.0000000000004826
Dr. Eva Stachler is a PGY1 Pharmacy resident at UPMC St. Margaret and can be reached at stachlere@upmc.edu.
Dr. Elisabeth Marker is a PGY2 Geriatric Pharmacy resident at UPMC St. Margaret and can be reached at Markerer@upmc.edu.
Dr. Heather Sakely, PharmD, BCPS, BCGP, the Director of Clinical Pharmacy Services and Director of the PGY2 Geriatric Pharmacy Residency served as editor and mentor for this work and can be reached at sakelyh@upmc.edu.
Society News
Specialty Group Updates
August 2024
By: Nadine Popovich, Eileen Taylor and Melanie Mayer
Allegheny County Immunization Coalition (ACIC) — 2024 Chair - Patrick Hussey, PharmD, MBA: The Allegheny County Immunization Coalition (ACIC) is pleased to announce that Pat Hussey, MBA, PharmD, will serve as the Chair for the 2024-2025 term. The coalition also welcomes all new board members and extends a big thank you to those rolling off. The coalition recently hosted its June general membership meeting, which saw record attendance both in person and virtually. Highlights included a compelling presentation by Samantha Faulds and Dr. Diego Chaves-Gnecco on "Increasing HPV Vaccination Rates in Pediatric Primary Care," leaving attendees motivated and well-informed about current public health challenges and solutions.
Mark your calendars for the next General Membership Meeting, scheduled for September 19, 2024. Additionally, ACIC is gearing up for its 19th Annual Conference, "Guardians of Public Health: Strengthening Vaccine Confidence," slated for November 6, 2024, at the Regional Learning Alliance in Cranberry, PA. This event promises valuable insights and networking opportunities for healthcare professionals committed to enhancing vaccine confidence and public health outcomes.
For more details on ACIC activities, membership benefits, and upcoming events, visit www.ImmunizeAllegheny. org. Whether attending meetings in person or via Zoom, or volunteering at local events, ACIC encourages all interested individuals to join its mission of promoting immunization and public health in Allegheny County and beyond.
American College of Surgeons
Southwestern Pennsylvania Chapter (ACS-SWPA) — 2024 President –Richard Fortunato, DO, FACS: Get ready for an engaging and educational evening! Our annual Resident Surgical Jeopardy competition and dinner is scheduled for Wednesday, October 2nd at Eddie Merlot's. This event offers a fantastic opportunity to challenge your surgical knowledge and network with fellow surgeons in a fun, competitive atmosphere. More details will be coming soon. The society will also have a new website in early fall as well as a new membership protocol for joining. Stay updated by visiting our website (www.acs-swpa.org) for the latest news and events. For any questions or membership inquiries, please contact Eileen Taylor, Chapter Administrator, at 412-321-5030 x105 or etaylor@acms.org.
Pennsylvania Geriatric Society Western Division (PAGS-WD) — 2024 President - Heather Sakely, PharmD, BCPS, BCGP: We are delighted to share the latest news from the Pennsylvania Geriatrics Society Western Division. Our commitment to providing exceptional educational and networking opportunities for geriatric healthcare professionals continues to flourish.
We are thrilled to announce our Fall Program, set for Wednesday, November 6th. This event is a prime opportunity to explore the latest advancements in geriatric care and connect with colleagues dedicated to enhancing the health and well-being of older adults. We will also recognize the 2024 Teacher of the Year Awardees and David. C Martin Award Recipients at our Fall Program. More details will be available
soon. Be sure to visit our PAGS-WD website (www.pagswd.org) regularly for the latest news and updates on upcoming events. For any questions or to join the society, please contact Eileen Taylor, Chapter Administrator, at 412-321-5030 x105 or etaylor@acms.org.
The Pittsburgh Ophthalmology Society (POS) — 2024 PresidentPamela P. Rath, MD: Pamela P. Rath, MD, along with the POS Board of Directors, is pleased to announce the schedule for the 2024-2025 Monthly Meeting Series and Annual Meeting dates. A total of six meetings are scheduled, starting in September and concluding with the Annual Meeting on March 21, 2025. Last year’s monthly meetings averaged 62 registrants, and similar attendance is anticipated this year.
The Society will host monthly meetings as in-person events at the PNC Champions Club at Acrisure Stadium (100 Art Rooney Ave, Pittsburgh, PA 15212), centrally located on the North Side with nearby parking options. Additional details can be found on the POS website.
Each meeting will commence with registration at 4:00 pm, followed by the first lecture at 4:30 pm. The agenda includes a Resident Case Presentation featuring second-year residents from the University of Pittsburgh Department of Ophthalmology: Oliver Beale, MD; Amani Davis, MD; Aidan Dmitriev, MD; Crystal Lee, MD; and Sami Melachuri, MD.
Members will receive registration information, including the registration link, one month prior to each meeting. Registration, managed exclusively online, is required (no walk-ins, please).
Society News
Please note our Cancellation and NoShow Policy. For more information, visit our website or contact Nadine Popovich if you are unable to attend a meeting.
The 2024-2025 monthly meetings are scheduled as follows: September 12, 2024; November 7, 2024; December 12, 2024; January 9, 2025; and February 13, 2025. Please note that there will be no meeting in October due to the American Academy of Ophthalmology Meeting scheduled for October 18-21, 2024, in Chicago, IL.
The Society is honored to host distinguished guest faculty:
• September 12: Lisa Feulner, MD, PhD, Chief Medical Officer and founder of Advanced Eye Care & Aesthetics, Hartford, CT.
• November 7: Christopher C. Glisson, DO, MS, FAAN, Medical Director, Warren Clinic Neurology | St. Francis Health System | Tulsa, OK.
• December 12: Lauren S. Blieden, MD, Associate Professor, Ophthalmology-Departmental Glaucoma | Assistant Clinical Professor, Alkek Eye Center | Cullen Eye Institute Baylor College of Medicine | Houston, TX.
• January 9: Courtney L. Kraus, MD, Assistant Professor of Ophthalmology, Wilmer Eye Institute, Wilmer Eye Institute, Baltimore, MD.
• February 13: Tarek Hassan, MD, Professor of Ophthalmology at Oakland University William Beaumont School of Medicine | Senior Partner and previous Director, Vitreoretinal Fellows Training Program at Associated Retinal Consultants; President, Foundation of the American Society of Retina Specialists; Immediate Past President, American Society of Retina Specialists (ASRS) Royal Oak, MI.
Contact Nadine Popovich to confirm your membership status or to inquire about an upcoming program.
The Pittsburgh Ophthalmology Society (POS) September 12 Meeting: 2024-2025 Monthly Meeting Series
Begins September 12.
The Pittsburgh Ophthalmology Society (POS), led by President Pamela Rath, MD, is set to open its 2024-2025 meeting season on September 12. The society is pleased to welcome Lisa Feulner, MD, PhD, Chief Medical Officer and Founder of Advanced Eye Care & Aesthetics in Hartford, CT, as the guest speaker.
Special thanks to Pamela Rath, MD for inviting Dr. Feulner, and to our sponsors BioTissue, Dompé, and Sight Sciences for their support.
Dr. Feulner is a board-certified comprehensive ophthalmologist specializing in cataracts, glaucoma, and ocular surface disease. She was recognized in 2016 as a Premier Surgeon 300 by Ocular Surgery News, highlighting her as a leading innovator in refractive cataract surgery.
All meetings, including this one, will be held at the PNC Champions Club at Acrisure Stadium (100 Art Rooney Ave, Pittsburgh, PA 15212). The venue is centrally located on the North Side with several parking lots within walking distance.
Registration begins at 4:00 pm, with the first lecture starting at 4:30 pm. Members will receive registration information, including the registration link, via email. Please note that registration is required (no walk-ins) and will be managed online only.
For more details, please visit the POS website.
University of Pittsburgh Department of Ophthalmology Alumni Reunion including Wet Lab Training Session — September 26 through 28
The University of Pittsburgh Department of Ophthalmology Alumni Reunion Planning Committee invites POS members to attend the 2024 Pitt Ophthalmology Alumni Reunion. The event will take place from September 26 to September 28, 2024, at the UPMC Vision Institute at the Mercy Pavilion.
This event is open to both alumni and non-alumni, and attendance is complimentary. CME credits will be available throughout the weekend.
On Saturday, September 28th, there will be a Wet Lab Training Session. Limited hands-on slots are available, and interested individuals are encouraged to register today.
Those not participating in the hands-on session can join via a live broadcast from the conference room in the facility. All participants will receive CME credit for the Wet Lab session. Questions regarding the event may be directed to: Craig Smith | Director of Development and Community Initiatives craig@eyeandear.org.
