Home Care In Baldwin, MD

August 9, 2023

Redwood City – In her first interview as San Mateo County’s Health Officer, Dr. Kismet Baldwin-Santana said her vision includes addressing the opioid epidemic, improving disaster preparedness and expanding health equity.

Baldwin-Santana this week began her tenure as health officer, a role that gained widespread public attention during the COVID-19 pandemic. She succeeds Dr. Scott Morrow, who retired after 31 years of service, and is the first woman to hold the post in the County’s history.

“The role of health officer is uniquely challenging,” said Dave Pine, president of the Board of Supervisors. “While the pandemic thrust health officers into the spotlight, the day-to-day work involves improving the overall health of our entire community.”

“Dr. Baldwin-Santana is uniquely positioned to guide us as we continue to shape a public health system that will help San Mateo County residents live longer and better lives,” Pine said.

Appointed by the Board of Supervisors, the pick vaults Baldwin-Santana into a role with broad authority under California law to prevent disease and the authority to issue health orders. The health officer serves as a principal spokesperson and a trusted voice during outbreaks or emergencies.

Yet the majority of the day-to-day work entails developing public health policy, working with community-based organizations and advising elected officials on public health strategies.

Most recently the interim health officer in Sonoma County, Dr. Baldwin-Santana has been a deputy health officer in Sonoma County, a health officer in San Joaquin County, and a quarantine medical officer for the Centers for Disease Control and Prevention.

Baldwin-Santana has been deeply involved in public health work since earning her bachelor’s degree in microbiology and a Doctor of Medicine degree at Ohio State University. She did post-doctoral work at UCLA where she studied ways to reduce the incidence of sickle cell disease.

Early in her career as a neonatologist in New Hampshire, Baldwin-Santana developed treatment plans and managed care for newborns experiencing neonatal abstinence syndrome due to exposure to opioids in the womb.

Babies often suffered from tremors, poor feeding reflexes, and irritability. In some cases, she found that mothers who had developed an addiction to painkillers often escalated to heroin and other street drugs during their pregnancies.

She teamed up with obstetricians and gynecologists working in methadone clinics to help get mothers into treatment programs. Such first-hand experiences helped to shape her career.

“I really enjoyed that work,” she said. “It allowed me to see the upstream aspect of medicine, addressing the causes of the problems facing my patients.”

Such work led her to the broader field of public health. She has worked with coalitions involving law enforcement, schools, substance use disorder treatment providers, general health care providers, emergency medical services and other key players to tackle opioid overdoses and deaths.

Her interest in community health led her to San Joaquin County, where she served as health officer from 2018-19. She focused on programs for communicable disease, sexually transmitted infection and tuberculosis. This included a mobile team of community health workers, disease investigators and nurses to perform rapid testing and vaccine administration.

As COVID-19 pandemic began, she served as a quarantine medical officer for the Centers for Disease Control and Prevention at San Francisco International Airport. She supervised entry-screening procedures and assessed travelers’ disease exposure, working with local health care providers and agencies, including San Mateo County Health, to prevent further spread.

As Sonoma County’s deputy health officer, she oversaw COVID-19 testing, vaccine administration, case investigation and contact tracing and participated in the region’s coordination and response through the Association of Bay Area Health Officials.

During the pandemic, she also made time to complete a master’s degree in public health at the University of California, Berkeley.

“I really liked the ethics class and the course on implementation science,” she said. “How do you get people to take a vaccine? The COVID-19 vaccines were well tested and very effective, but they were a tough sell for many communities.”

As she steps into the role as the County’s top public health official, Baldwin-Santana praises Morrow’s decades of service and the support for public health from elected leaders and the community. “There’s a really strong foundation here,” she said. “I’m excited to take a broad look. What are the best initiatives and policies and how can we all collaborate to move things forward?”

Louise Rogers, chief of San Mateo County Health, said, “I’m excited to welcome Dr. Baldwin-Santana to our county, where we share her passion for working to address the underlying causes of poor health in the community. She brings a wealth of experience that we can all learn from.”

In her spare time, Baldwin-Santana enjoys salsa dancing, hiking and cycling with her husband. Together, they have a cat named Diego.

0:06 Introduction0:37 Background of Dr. Baldwin9:56 Promising data on OPT-302/sozinibercept16:39 Making decisions as a clinician, industry leader22:11 Future of the treatment landscape28:24 What’s next for Opthea?32:39 Conclusion

The latest episode of New Insight with Veeral Sheth, MD, features a conversation with Megan Baldwin, PhD, the CEO and managing director of Opthea Limited, on OPT-302 (sozinibercept), a treatment for wet age-related macular degeneration (AMD) and other retinal diseases.

Sozinibercept, is a novel “trap” fusion protein that inhibits vascular endothelial growth factors C and D (VEGF-C, VEGF-D), ligand mediators of angiogenesis and vascular leakage involved in retinal vascular diseases.

The molecule is being evaluated in two phase 3 clinical trials for wet AMD and is administered via intravitreal injection in combination with standard-of-care anti-VEGF-A therapy. These trials include the ShORe trial of 2 mg sozinibercept + 0.5 mg ranibizumab, and the COAST trial of 2 mg sozinibercept + 2 mg aflibercept.

It has received fast-track designation from the US Food and Drug Administration. At the American Society for Retina Specialists 41st Annual Meeting, new data suggested sozinibercept combination therapy had a favorable safety and tolerability profile, compared to standard-of-care anti-VEGF-A monotherapy.

In this episode of New Insight with Veeral Sheth, MD, experts discuss the exciting promise of sozinibercept, how it may fit into the ophthalmologist’s armamentarium, and the behind-the-scenes work that goes into creating a new molecule.

Dr. Baldwin shares insight into her background, her PhD research work on VEGF-D, and her movement toward the drug development space. She described joining Opthea, her growth at the company, and ultimately, her move to CEO as the company made a pivotal move from oncology to ophthalmology.

Baldwin described the opportunity the novel pathway presented, the effort to raise capital and gain support from shareholders and the larger market and working to improve the standard of care to maximize patient outcomes with this new mechanism.

The experts touched on the data from the clinical trial program, the importance of not only durability in treatment, but improved visual acuity, and working to shut down the disease progression as early as possible. They discussed the difference in decision-making between being a clinician and an industry executive, as challenges may arise between these two viewpoints.

Baldwin described the shift into the ophthalmology market as requiring highly strategic focus and proper assessment, ultimately deeming it completely the right decision for the company. She noted that positive data helps justify these decisions, but day-to-day challenges still arise and require making compromises and defending those decisions to stay on that critical path.

Experts discussed the future of the field, as treatment options continue to be added, and how sozinibercept may slot into that armamentarium. They discussed the potential for individualizing treatment, as more therapies become available, and how this might change the approach to patient management in ophthalmology. To conclude, the expert touched on the future of sozinibercept and where the company may be headed in the near future.

Every episode of New Insight is available on HCPLive.com and be sure to subscribe to our channel on Spotify, Apple Podcasts, and YouTube. Please direct any podcast-related inquiries to show producer Connor Iapoce at [email protected].

Keep an eye out for more from New Insight!

Coming to terms with the irreversible blindness and visual impairment often associated with wet age-related macular degeneration (AMD) has been a difficult journey for millions of people living with the condition. But a new therapy from Australian biotechnology firm Opthea could drastically improve the outlook for those affected.

Wet AMD develops when abnormal blood vessels grow at the back of the eye, leaking blood and fluid that causes the retina to swell. The past 15 years have seen little additional progress in the treatment of this disease, according to Opthea CEO and Managing Director Dr Megan Baldwin.

“Right now, there are only limited treatments available for patients. The majority of patients actually do not achieve sufficient vision gains or restoration to allow them to resume their routine daily activities,” she explains.

“There’s a need to develop better treatments so that physicians can offer their patients something better, giving them the ability to go above and beyond what the current treatments can offer them.”

Treatment breakthrough

Such a therapy is in the making, with Opthea working clinically on a molecule for the eye disease since 2015 when it initiated its phase one clinical trials with 51 patients. A phase two study of 366 patients followed.

“We reported those outcomes in 2019, and we were the first – the only company, actually – that’s demonstrated a better outcome for patients when you add our drug on top of the current treatment,” Baldwin says.

“There have been a lot of other pharmaceutical companies that have tried to do what we are doing, have tried to target other pathways, and haven’t actually achieved the improved results that we have.”

Opthea’s approach is to block, at a molecular level, the signals that cause blood vessels at the back of the eye to grow.

“If you can block that, you can actually normalize the vessel growth and you can reduce the swelling at the back of the eye. And that helps to restore vision,” she explains.

What we are looking for is global approval of this drug to actually tap into the worldwide market.

Baldwin is confident that Opthea’s product goes “above and beyond” any previous therapy in the treatment of wet AMD with the potential to revolutionize the outcomes for patients.

The molecule is now in phase three clinical development – the final phase. It represents a major breakthrough, both in the field and also for Australian biotechnology as a whole. As Baldwin points out, not many Australian companies make it to the phase three approval stage.

“What we are looking for is global approval of this drug to actually tap into the worldwide market,” she says. “There are very few Australian companies that take on such a large task as that.”

A vision for the future

Currently ongoing are two clinical trials of 990 patients each, both across more than 25 countries, taking in a variety of populations. Opthea expects patient recruitment to be complete as early as the end of 2023, with top-line results expected to be released at the end of 2024.

“For our treatment regimen, each patient receives treatment for 12 months to the top-line data, and then they stay on treatment for a further 12 months beyond that in order to further understand the efficacy of how well and how safe the drug is,” Baldwin says.

If the trials “read out” positively, the idea is to then seek approval first in the United States, then the European Union followed by all the other regions of the world.

“We need to be ready to submit our application to the regulators and to actually be ready with a plan to launch the drug so it can be available for physicians to prescribe it to patients,” she adds.

It’s important to plan for success, because we have a lot of conviction with this product.

This involves the creation of a sales force, working out how best to transport the drug, negotiating with players in the healthcare industry and other commercial aspects – all necessary to successfully launch a product. According to Baldwin, the key is to make these preparations during the final stages of phase three.

“That’s why we are building out our team. That’s why we’ve now got people located around the world working with us. It’s important to plan for success, because we have a lot of conviction with this product,” she stresses.

It’s a big task that lies ahead of Opthea, but Baldwin and her team are more than prepared to put in the hard work.

“When you’re looking at a drug that’s shown very promising results and has the potential to really change people’s lives by improving how well they can see, their quality of life, their independence and their ability to stay in the workforce, then it’s absolutely worth it.”

Proudly supported by:

“Almac is proud to have partnered with Opthea since 2017 to provide clinical supply solutions, ensuring that vital medicine reaches patients suffering from retinal eye diseases. As an organization with a mission to advance human health, Almac is honored to support Opthea’s vital work.” – Helen Leiton, Business Development Manager, Almac Clinical Services

The field of acne treatment is anticipated a major breakthrough in the next year—one that which may change the hierarchy of prescribing strategies from the top down.

In the second segment of an interview with HCPLive during the Maui Derm 2023 NP + PA Summer Conference in Colorado Springs this week, Hilary Baldwin, MD, medical director of the Acne Treatment & Research Center in New York, discussed lindamycin phosphate / benzoyl peroxide / adapalene gel (IDP-126), an investigative tripe-combination topical therapy from Ortho Dermatologics that has fared significantly well in the treatment of moderate to severe acne in phase 2 and 3 trials.

The US Food and Drug Administration (FDA) accepted Ortho’s New Drug Application (NDA) for IDP-126last month, and will decide on its application by late October. If approved, it would be the first triple-combination therapy indicated to treat acne—a breakthrough that Baldwin said she and colleagues have waited years to accomplish.

“It takes care of the inflammation, the bacteria, and the follicular hyperkeratinization that’s part in parcel of acne,” she said. “The phase 2 and 3 trials showed excellent efficacy—not only compared to vehicle, but also compared to the (double-combination therapies), the one’s we’ve been relying on all these years. I think it’s going to blow me away.”

Her anticipation is that IDP-126 will move immediately to the top of her treatment strategies.

“I think a better question is, ‘Where does it not fit?’” Baldwin said. “I don’t see a scenario, except for maybe pregnancy, where I wouldn’t reach for this first.”

Baldwin additionally discussed her involvement with the Personalizing Acne: Consensus of Experts (PACE) panel, an 18-member consortium of acne experts re-establishing best practices for patient-centered acne management. The general sentiment of the panel was that the acne care journey must become more personalized with the individual patient.

“We talk in means when we go over data: we talk about the mean patient type, the mean patient efficacy and tolerability,” Baldwin said. “And the point is you need to focus on that person in front of you and forget about the rest of the world. We need to take into consideration all their habits and lifestyle…personalizing it to the individual.”

Among the ways dermatologists can better do this is to take into better consideration treatment after-effects including post-inflammatory erythema, post-inflammatory hyperpigmentation, and acne scarring, Baldwin said. Another critical facet of acne care is keeping consideration for the psychological effects of the disease.

That’s a crucial part of the whole acne process and the life of an acne patient,” Baldwin said.

South Baldwin Regional Medical Center celebrates its first class of graduates from the Family Medicine Residency Program, which launched in July 2018. Eight residents were honored at the graduation ceremony for their achievements and dedication to developing their medical skills and knowledge to treat patients.

Approved by the Accreditation Council for Graduate Medical Education (ACGME), the three-year family medicine program offers admission to eight residents in each class. The goal is to provide a well-rounded experience for physician residents who want to pursue a career as a community-based family medicine provider. Each year includes 13 four-week rotations in which residents provide hands-on patient care for the specified topic focus, including but not limited to general surgery, obstetrics, ER and pediatrics.

“We celebrate the graduating resident class of 2021 as they enter their chosen field of practice at South Baldwin, in our region and across the nation,” said Eric Roach, CEO at South Baldwin Regional Medical Center. “The excellence of each graduate is exemplified by their many hours and achievements, and most certainly by their commitment and leadership during the past three years. We wish them the best, and greatly anticipate the energy of the next rising classes of residents as they progress in our program.”

Family medicine physicians specialize in caring for children, teens and adults, offering well checks, immunizations, sick visits, men and women’s health screenings and office-based procedures such as skin biopsies, orthopedic injections and contraception.

Specialists in family medicine also support the prevention and management of chronic diseases, such as diabetes, asthma and heart disease.

Timothy Mott, M.D., Michael Linder, M.D. and Cary Ostergaard, M.D. designed the Family Medicine Residency Program, and Carol Motley, M.D. and Chris Bogar, Ph.D. were part of the initial core faculty.

“I am both proud and honored to have watched these eight graduating residents succeed through the Family Medicine Residency Program. They have persevered and grown tremendously over the last three years,” said Timothy Mott, M.D., Family Medicine Residency Program Director. “Each resident has had to learn in challenging, uncharted territory and has excelled. I wish each of them the best and feel grateful they chose South Baldwin’s Family Medicine Residency Program to complete their medical training.”

Graduating physicians from South Baldwin Regional Medical Center’s Family Medicine Residency Program this year include Liza Hamrick, D.O.; David Echeverri, M.D.; Luke Fondren, D.O.; Adam Hamrick, D.O.; Brian Hopkins, D.O.; Ashley Hunter, M.D.; Ethan Sellers, D.O.; and Autumn Walker, M.D. Each of the graduates passed their board certification exams on the first attempt and the program’s average score was significantly above the national average. This is the first graduating class from South Baldwin Regional Medical Center’s residency program.

For more information on South Baldwin Regional Medical Center’s Family Medicine Residency Program or to apply, visit www.southbaldwinrmc.com/hospital-residency-program.