telehealth

Nonprofit pivots to telemedical treatments and therapies amid pandemic

Planned Parenthood has made several of its services — including gender-affirming hormone therapy — available virtually. Getty Images

Naomi West has been homebound since COVID-19 became a threat in February. Sitting in front of her computer screen, much of her time is spent pursuing her graduate degree in physics from Rice University and teaching courses through Zoom. Most of her virtual meetings are the same except for one recurring appointment. Every 90 days, West logs on her computer to sit with a Planned Parenthood Gulf Coast (PPGC) nurse practitioner and check-in on her gender-affirming hormone therapy.

West, a Houston trans woman, made her first appointment to receive hormone therapy in October, prior to the pandemic. As she embarked on her transition, she saw an immediate change within herself.

"There was absolutely no going back...it was a night and day difference within 24 hours," she explains.

West has been receiving treatment for ten months at Planned Parenthood. After being hospitalized for depression and drowning in hundred-hour work weeks, West was feeling hopeless. Inspired by her best friend's journey with hormone therapy at Planned Parenthood, West felt motivated to change her life.

"The difference [trans care] makes is immeasurable to say the least," she says, "I couldn't imagine having it any other way. I couldn't imagine being without it."

Trans care is offered at two Houston-area Planned Parenthood locations—Prevention Park and Northville. Since the coronavirus, Planned Parenthood's services have gone virtual, allowing Texans outside of Houston to experience the service.

"COVID-19 has really changed the way we approach patient care," says Dr. Bhavik Kumar, medical director of Primary and Trans Care at PPGC.

The centers first rolled out virtual appointments on April 1, allowing them to safely serve 5,539 patients in four months.

"We've moved a lot of our care towards telehealth, which has allowed people to access care in a way that is safer for them and also protects our frontline workers," explains Dr. Kumar.

The healthcare provider has six centers in the Houston area, as well as two in Louisiana, that are providing virtual appointments with experts as well as access to curbside birth control. Trans care first became available at Planned Parenthood in 2019, and includes gender-affirming hormone therapy for patients over 18.

"We went into providing trans care knowing that a lot of folks have bad experiences accessing healthcare and perhaps bad experiences with providers," says Dr. Kumar. "There's a lot of fear and anxiety in accessing care for trans communities, whether it's being misgendered, having their dead name used, or having a number of different things that can lead to traumatic experiences," he explains.

To a transgender person, access to health isn't just a hot button political issue but a lifeline. Like West, many transgender Americans struggle with depression and feelings of hopelessness.

In a 2019 survey from The Trevor Project, 29 percent of trans and non-binary youth reported that they'd attempted suicide while 54 percent considered it. The striking statistics are a glimpse into the struggles trans and nonbinary people face daily as they experience discrimination, violence, and cohersion due to their gender identity.

West, like many in the trans community, shared the same fears prior to her first appointment.

"I've always come down with what I say is white coat syndrome, but within 10 minutes I realized it was all completely unfounded," she explains.

PPGC follows an informed consent treatment model, meaning patients are not required to receive an approval letter from a therapist to begin treatment. After speaking with a patient to explain the risks and benefits of hormone therapy, patients can make the decision to move forward.

"It was just a conversation," explained West, "I felt no judgement. It was just support for my decision to begin hormone therapy and suggestions for how to go about it, when to go about it—they were nothing if not accommodating.

Telehealth lends itself as a suitable substitution for in person care, according to West. Many of the appointments are spent discussing her psychological state and feelings regarding the treatment, and she goes for a blood test every 90 days. West, who has been very careful to prevent exposure to COVID-19, has felt at ease meeting virtually with her nurse practitioner.

Thanks to the ability telehealth has to connect us with people regardless of distance, transgender Texans have access to care at any distance. One of the core benefits of trans telehealth is that "folks who are further away from our health centers, perhaps in rural communities, don't have to make the several hour drive to the health center and then back," says Dr. Kumar.

The convenience has allowed PPGC to accommodate 240 gender-affirming hormone therapy appointments and serve 176 transgender patients.

More than cut travel time, the emergence of telemedicine also welcomes comfort. "They get to be in the safety and the comfort of their home or wherever they do feel safe," explains Dr. Kumar, "They can have other folks around them if they want, whether it's family or friends."

"We are constantly analyzing the way we provide care, but even more so in a different way during the pandemic," shares Dr. Kumar. Telehealth services include birth control consultation, emergency contraception, long-acting birth control implant consultations, PrEP follow-ups, primary care, STI treatment, and other healful visits to address problems like pelvic pain or bleeding.

Of the many services that are now remote, Depo birth control shots and oral contraceptives, are available curbside.

"Patients don't have to get out of the car; they don't have to worry about touching the door handle or anything else they have anxiety around," explains Dr. Kumar, "They're able to access the care they need without having to deal with potential exposure."

Will telehealth at PPGC become a permanent staple? Only time will tell, but Dr. Kumar has found that patients have found the service to be helpful during the COVID-19 pandemic.

"We always strive to provide as many options for our patients so that they can get the healthcare that's best for them," shares Dr. Kumar.

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Tvardi Therapeutics Inc. has fresh funds to support its drug's advancement in clinical trials. Photo via Getty Images

A Houston-based clinical-stage biopharmaceutical company has raised millions in its latest round.

Tvardi Therapeutics Inc. closed its $74 million series B funding round led by new investors New York-based Slate Path Capital, Florida-based Palkon Capital, Denver-based ArrowMark Partners, and New York-based 683 Capital, with continued support and participation by existing investors, including Houston-based Sporos Bioventures.

"We are thrilled to move out of stealth mode and partner with this lineup of long-term institutional investors," says Imran Alibhai, CEO at Tvardi. "With this financing we are positioned to advance the clinical development of our small molecule inhibitors of STAT3 into mid-stage trials as well as grow our team."

Through Slate Path Capital's investment, Jamie McNab, partner at the firm, will join Tvardi's board of directors.

"Tvardi is the leader in the field of STAT3 biology and has compelling proof of concept clinical data," McNab says in the release. "I look forward to partnering with the management team to advance Tvardi's mission to develop a new class of breakthrough medicines for cancer, chronic inflammation, and fibrosis."

Tvardi's latest fundraise will go toward supporting the company's products in their mid-stage trials for cancer and fibrosis. According to the release, Tvardi's lead product, TTI-101, is being studied in a Phase 1 trial of patients with advanced solid tumors who have failed all lines of therapy. So far, the drug has been well-received and shown multiple durable radiographic objective responses in the cancer patients treated.

Dr. Keith Flaherty, who is a member of Tvardi's scientific advisory board and professor of medicine at Harvard Medical School, offered his support of the company.

"STAT3 is a compelling and validated target. Beyond its clinical activity, Tvardi's lead molecule, TTI-101, has demonstrated direct downregulation of STAT3 in patients," he says in the release. "As a physician, I am eager to see the potential of Tvardi's molecules in diseases of high unmet medical need where STAT3 is a key driver."

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