Rob Weber

My daughter is on a real Daniel Tiger kick. PBS is definitely necessary in our house.

Ah that’s basically what you said, sorry I misread the first time.

@rnflex.bsky.social my hope is that with all the new ones in the pipeline, they all become cheaper (especially a single receptor target like semaglutide) and more accessible.

#Endo2025 #Endocrinology

Had a great time with my co-fellows at Endo. Learned a ton.

Primary Aldosteronism A new Endocrine Society guideline on Primary Aldosteronism updates a 2016 guideline, and suggests that everyone who is diagnosed with hypertension have their levels of aldosterone, renin, and potassiu...

New Hyperaldo Guidelines from the Endo society: www.endocrine.org/clinical-pra...

A figure showing the changes from baseline in systolic blood pressure (SBP), plasma aldosterone–renin ratio (ARR), and serum potassium level for each patient.

In 15 patients with primary aldosteronism, baxdrostat (a second-generation, nonimidazole aldosterone synthase inhibitor) resolved or reduced the severity of hypertension, excessive aldosterone production, and hypokalemia. Full SPARK study results: nej.md/40Js1kz

#ENDO2025

Uplifting to see the science presented by our UCSF early stage investigators in Endocrinology #ENDO2025. Congrats Drs. Karin Wu (bone metabolism) and Rob Weber (mineralocorticoid physiology)!
@endocrinesociety.bsky.social

From UCSF Endocrinology & Metabolism, welcome to our home #ENDO2025! Check out our 24 speakers & session chairs here: diabetes.ucsf.edu/Endo2025. We’re also presenting an amazing 33 posters! Find them here: eppro01.ativ.me/web/planner.ph…
Enjoy our City! @endocrinesociety.bsky.social

The Continuing Crisis, Part XVI: Get the Hell Out of Your Building

Just horrible stuff, brought to you by horrible human beings:

Does he have two Adam’s apples?

This is a great slide, thank you for this. Do you know the status of dexfadro? Is it going to get a phase 3 or has it been abandoned? I searched around and couldn’t find any indication either way.
#NephJC

Theoretically:
- it targets the primary issue in many patients- unregulated aldosterone production.
-avoid effect of further elevated Aldo during MRA treatment

Obvs -avoid gynecomastia and off-target effects of Spiro.
For other MRAs it has always been difficult to push dose high enough.
#NephJC

For a single patient

Why not just use spironolactone?

#NephJC

Totally. Someone should do the economic analysis. Spiro is dirt cheap, I’m sure these new ones will be out of control. Osilidrostat is not even selective (blocks both aldo and cortisol) and it costs our hospital something like $100,000 a year.

Low-dose spironolactone and cardiovascular outcomes in moderate stage chronic kidney disease: a randomized controlled trial - Nature Medicine A randomized controlled trial involving patients with stage 3b chronic kidney disease from primary care reported that in contrast to reported cardiorenal protective effects of nonsteroidal mineralocor...

There was this spiro study where only CKD 3B was enrolled. Based on intention to treat analysis, no difference between placebo and spiro 25 because many could not tolerate the spiro. In my mind this and worse GFR is where ASIs could be helpful.

www.nature.com/articles/s41...

In RALES (spiro trial for HF, only 25 mg) 10% gynecomastia, in EPHESUS (eplerenone) 0.5%.

I’m not sure….as far as I know, the blood vessel and cytokine effect is still mediated by MR in mice and in cells. Theoretically spiro should block it. I’m can’t tell you I know the clinical data on this though.

Are they still toxic if you block their receptor?

He let snakes bite him some 200 times to create a better snakebite antivenom Scientists have created a broadly effective antivenom using the blood of a Wisconsin man who has spent years exposing himself to deadly snakebites from black mambas, taipans, cobras and many others.

Scientists have created a broadly effective antivenom using the blood of a Wisconsin man who has spent years exposing himself to deadly snakebites from black mambas, taipans, cobras and many others.

Just finished “The Pitt”. Wow, incredible.

Whenever I’ve interacted with Dr. Coleman (usually in a rapid or code situation) she is invariably a force of measured calm and moving things in the right direction. She’s a gem in our hospital.

Diagnosis and treatment of primary aldosteronism: practical clinical perspectives - PubMed Primary aldosteronism (PA), the most common form of secondary hypertension, can be either surgically cured or treated with targeted pharmacotherapy. PA is frequently undiagnosed and untreated, leading...

The remaining 10% being genetic/familial causes (which would also be bilateral….)

pubmed.ncbi.nlm.nih.gov/30255616/

According to Bill Young at Mayo (in various recent reviews) he says it’s the opposite: 60% bilateral, 30% unilateral. I’ve scoured his references though and I’m unsure from what data he is pulling that from.

Anecdotally, that matches with what I’ve seen in clinic.

Pretty sure mRNA could show up in grants for non-therapeutic reasons……

What a Wrongful Death Lawsuit Reveals About America’s Largest Oxygen Provider When an at-risk sleep apnea patient needed his breathing machine replaced, Lincare, a $2.4 billion behemoth with a decadeslong history of regulatory and legal problems, acted slowly. The result was disastrous.

NEW: After Vernor’s breathing machine stopped working, a Lincare representative promised his mother a company respiratory therapist would be in contact “until we get him a new machine.”

But she didn’t hear from Lincare until 7 days later, the same day Vernor died.

Fascinating read

JUST IN: The head of the US African Development Foundation is suing Peter Marocco and DOGE — and he is describing in detail the standoff in which he blocked DOGE from entering the agency's offices.

storage.courtlistener.com/recap/gov.us...