What the papers say – weekly digest (10/05/24)

Your weekly digest of the top healthcare stories, covering news published from 06/05/2024 – 10/05/2024.

Daily Telegraph

One in 50 people is 95% likely to develop Alzheimer’s, a study has found. Researchers have discovered that almost all of those with two copies of a gene called APOE4 develop signs of the condition. A team from the Sant Pau Research Institute in Barcelona analysed data from more than 10,000 people and more than 3,000 brain donors. They discovered that more than 95% of people aged 65 and above with two copies of the APOE4 gene went on to show early signs of the disease. Those with two copies of APOE4 also tended to develop the condition earlier than those with other variants of the gene, they found. Researchers said the study showed that having two copies of APOE4 can be described as a distinct genetic form of Alzheimer’s. The team said their discovery is especially important as around 2% of the population – equivalent to one in 50 – carries two copies of this gene. It could also help identify the best people to include in clinical trials for treatment. Doctor Juan Fortea, director of the research area on neurological diseases, neuroscience and mental health at the institute, said: ‘’These data represent a re-conceptualisation of the disease or what it means to be homozygous for the APOE4 gene. This gene has been known for over 30 years and it was known to be associated with a higher risk of developing Alzheimer’s disease. But now we know that virtually all individuals with this duplicated gene develop Alzheimer’s biology.’’ The APOE gene comes in three different variations – APOE2, APOE3 and APOE4. Everyone carries two copies of APOE, one inherited from each parent. Past studies have shown that having at least one APOE4 gene variant almost triples the risk of getting the disease. The research showed that by the age of 65, almost all people who had two copies of APOE4 had abnormal levels of a protein known as amyloid in the fluid around the brain and spinal cord which is a sign of Alzheimer’s. Dr Reisa Sperling is a professor in neurology at Harvard Medical School, and director of the Centre for Alzheimer Research and Treatment at Brigham and Women’s Hospital in Boston, Massachusetts. She said: ‘’We have to think about how we can treat APOE4 carriers. These individuals are desperate – they have seen (the disease) in both of their parents. This research really suggests that we should be treating them quite early, at a younger age and at an early stage of pathology, because we know they are very likely to progress to impairment quickly.’’ Prof Tara-Spires-Jones, president of the British Neuroscience Association, said: ‘’This study adds compelling data to suggest that people with two copies of this gene are almost guaranteed to develop Alzheimer’s if they live long enough, and that they will develop Alzheimer’s earlier than people without this gene.’’ More than 900,000 in the UK are believed to be living with dementia, while the figure is believed to be around 7 million in the US.

Marriage fees should be reduced by the Government to combat an epidemic of post-Covid loneliness, a think has said. Research by the Centre for Social Justice (CSJ), founded by Sir Iain Duncan Smith, found that 60% of people felt lonely most, often or some of the time, with its prevalence increasing by 5% since the pandemic. Loneliness was highest among adults aged 18 to 24, where seven in 10 said they had experienced the condition at least some of the time. This compared with under half of those aged over 65. People cohabiting were about half as likely to be lonely as their single peers and marriage people were even less likely than cohabitees to be lonely. In its Lonely Nation report published today (Tuesday), the CSJ recommends that the Government encourages people to form relationships and marry by discounting the administrative, legal and booking fees for weddings for couples in relative or absolute low income up to £550 per wedding. Receiving the discount would help people to form stable and secure long-term couple relationships which are predictive of low levels of loneliness, the CSJ said. Taken together, the annual cost would be about £35 million, a fraction of the estimated £2.5 billion price of loneliness to employees alone through time taken off for illness, poor mental health and lower productivity. Half of adults agreed that marriage had become less important, leading to more loneliness, with only 28% disagreeing. In 2023 fewer adults were married and not for the first time. In the poll of 2,000 adults, half said that marriage was important and that the Government should offer more financial support to couples. Only 32% disagreed. The CSJ also proposed a government family office with a dedicated minister for family and a review of the tax system. Josh Nicholson, a CSJ senior researcher, said: ‘’Helping more people to get married by subsidising the bill for those on the lowest incomes offers significant health, social and economic benefits for them and the taxpayer. Our research confirms that family relationships, and particularly marriage, are the best defence (to loneliness) as well as providing many more benefits over the long term.’’

Britain is refusing to sign the World Health Organisation’s pandemic treaty while it insists the UK would have to give away a fifth of the jabs it produces, The Telegraph understands. The Government is believed to be firmly against such vaccine-related commitments and will not sign any form of the pandemic agreement that undermines Britain’s sovereignty. At the peak of the Covid emergency, nations planned to sign a legally binding document, informally known as the pandemic treaty, or pandemic accord, that would force countries to tackle the next global health emergency in a united way. Now representatives of the WHO’s 194 member states are halfway through talks to form a WHO Pandemic Agreement, an initiative first announced in May 2021. Under the latest draft of the treaty, now in its ninth and final iteration, all WHO members, including the UK, would be obliged to give up 20% of ‘’pandemic-related health products’’ to other states and would be prevented from stockpiling supplies. This would include therapeutics, personal protective equipment (PPE) and vaccines. The Who document states the United Nations-run agency would get ‘’real-time access’’ to 10% of these products free of charge and 10% ‘’at affordable prices’’. The divisive document says countries should ‘’set aside a portion of total procurement of relevant diagnostics, therapeutics or vaccines in a timely manner for use in countries facing challenges…. and avoid having national stockpiles. A source familiar with the negotiations said: ‘’The UK could not accept these proposals in their current form and they have not been agreed.’’ It is understood the UK will only agree to a legally binding global accord if there was a commitment that British-made jabs are used for what the UK deems to be its own national interest. Officials are understood to want to keep control by being able to choose when it is best for the UK to distribute products globally and when resources will be best deployed domestically. It is understood that while the UK is keen to work towards a united approach, it is not prepared to give up autonomy on its own assets. The sharing of healthcare items is seen as a red line for many of the other countries locked in discussions. Poorer nations see it as essential in ensuring equitable treatment for all but richer countries are concerned about relinquishing autonomy. Experts warn it is likely the two-weeks of talks will fail to resolve fundamental disagreements by tomorrow’s (Friday) deadline, which means only a ‘’vanilla treaty’’ will go before the World Health Assembly at the end of May. Dr Clare Wenham, associate professor of global health policy at the LSE, told The Telegraph:  ‘’I wouldn’t be surprised if deals were being done behind the scenes for low and middle income countries to acquiesce.’’

Couch potato children are more likely to suffer premature heart damage, a new study warns. An increase in time from childhood spent sitting down caused progressing heart enlargement, according to the findings. However, light physical activity, such as walking a dog or cycling to the shops, can reverse the risk, scientists say. Scientists from the Universities of Bristol and Exeter teamed up with the University of Eastern Finland for the study, published in the European Journal of Preventive Cardiology. Left ventricular hypertrophy refers to an excessive risk in heart mass and size. In adults, it is known to increase the risk of heart attack, stroke and premature death. The study involved 1,682 children from the University of Bristol’s Children of the 90s group, who were followed from the ages of 11 to 24. The participants spent an average of 6 hours per day in sedentary activities at the start of the study, increasing to 9 hours per day by young adulthood. The Increase in time spent seated was associated with progressing heart enlargement, contributing 40% to the total increase in heart mass within a seven-year growth period from adolescence to young adulthood. The more time spent sitting down increased heart mass, regardless of obesity or higher blood pressure, according to the findings. But an average of three to four hours per day of light physical activity (LPA) reduced the increase in heart mass by 49%, scientists say. In addition, higher LPA was also associated with better cardiac function. Prof Andrew Agbaje, of the University of Eastern Finland, said: ‘’There is growing evidence that childhood sedentariness is a health threat that needs to be taken seriously. There must be a paradigm shift in how we view childhood sedentariness, as the mounting evidence is pointing at a ticking time bomb.’’ He said that examples of LPA are taking part in indoor and outdoor games, playing in the playground, walking a dog, running errands for parents, walking and biking to the shopping centre or to school, or playing sports such as football or frisbee.

Ministers are facing calls to crackdown on local takeaways amid concerns that large salty portions are fuelling Britain’s obesity crisis. High street leaders are calling for the Government to step up work on curbing obesity, including targeting more fast-food outlets.The British Retail Consortium (BRC) is urging policymakers to shift their attention away from supermarkets, which have so far borne the brunt of regulation relating to obesity. Most notably, grocers have been banned from putting foods high in fat, salt and sugar in prominent places in store, while most pre-packed foods must also contain nutrition information labels. But the industry lobby group, which represents the country’s largest stores, said swathes of businesses were flying under the radar when it comes to improving the nation’s health. This includes takeaways which can have dishes containing more than double a person’s maximum daily salt intake, but are not required to provide calorie information. Andrew Opie, the BBC’s director of food and sustainability, said: ‘’Many takeaway establishments are actually not part of a bigger chain. At least larger food takeaways now have to display calories. But your local chicken shop, they are not engaging in these areas.’’ He said providing calorie information ‘’surely needs to be taken as seriously a public health issue as allergen Information is and required for all businesses.’’ Mr Opie said current legislation on tackling obesity was limited to a ‘’narrow part of the food industry’’, which allowed for smaller cafes, smaller restaurants and cinemas to avoid scrutiny. The BRC director said: ‘’We understand there will be more challenges for some smaller food businesses, but that in itself shouldn’t be an excuse not to be included.’’ He said this could mean that the Government ‘’needs to give support to small and medium businesses to help them in their choices, so around how much oils or salt are in something or the size of portions’’.

The Times

AstraZeneca is withdrawing its Covid-19 vaccine worldwide, citing a ‘’surplus of available updated vaccines’’ since the pandemic that target newer variants of the virus. The European Commission withdrew marketing authorisation for Vaxzevria, the vaccine, in March in the European Union at the request of AstraZeneca, which decided to ‘’permanently discontinue the marketing of the product for commercial reasons’’. The withdrawal became effective on Tuesday. Applications elsewhere, including the UK, are being made. In a statement released yesterday (Wednesday), AstraZeneca said: ‘’We’re incredibly proud of the role Vaxzevria played in ending the global pandemic. According to independent estimates, over 6.5 million lives were saved in the first year of use alone and over 3 billion doses were supplied globally. Our efforts have been recognised by governments around the world and are widely regarded as being a critical component of ending the global pandemic. As multiple, variant Covid-19 vaccines have since been developed, there is a surplus of available updated vaccines. This has led to a decline in demand for Vaxzevria, which is no longer being manufactured or supplied.’’ AstraZeneca, which was not among the pharmaceutical industry’s vaccine specialists before the Covid crisis, produced the vaccine on a non-profit basis as part of a partnership with the University of Oxford. The vaccine’s widespread use in the UK made it a household name. Despite its widespread use, the company also became embroiled in an extraordinary legal battle with the European Commission over supply delays, faced unprecedented criticism over the presentation of clinical data from regulators in America, where it was ultimately never sold, and continues to defend lawsuits in the UK over the safety of the vaccine. AstraZeneca stated in a High Court document filed in February that it ‘’can, in very rare cases, cause TTS. The causal mechanism is not known. Further, TTS can also occur in the absence of the AZ vaccine (or any vaccine). Thrombosis with thrombocytopenia syndrome is a very rare syndrome that occurs when a person has blood clots together with a low platelet count. A spokesman for AstraZeneca said today (Thursday) that the withdrawal was unrelated to the vaccine’s safety profile. Globally it made the decision to withdraw licences in all markets and began that activity some months ago, meaning few active licences remain. In addition to Vaxzevria, AstraZeneca also sold Evusheld, its Covid-19 antibody drug. The FTSE 100 multinational has become one of the world’s biggest drugs companies through the launch of a series of new blockbuster medicines over the past decade, particularly cancer treatments, under Sir Pascal Soriot, its chief executive since 2012. Shares in the company closed up 146p or 1.2% at £122.64, valuing it at more than £190 billion. The rally comes ahead of an important investor event this month at its new research headquarters in Cambridge where executives will outline growth plans. Daniel Chancellor, healthcare analyst at the global pharmaceutical intelligence company Citeline, said: “AstraZeneca formally withdrawing its Covid-19 vaccine is symbolic more than anything. Demand for Covid-19 boosters in major markets is being met entirely by other companies that are selling at for-profit prices, and future development will involve co-formulation with flu and RSV vaccines. Nevertheless, AstraZeneca’s venture into infectious diseases is leaving a legacy with its newly created vaccines and immune therapies business unit.’’

Researchers have developed a vaccine technology shown to protect against a range of coronaviruses, even some we may not have discovered yet. The scientists, from the universities of Oxford, Cambridge and Caltech in California, used a new approach called ‘’proactive vaccinology’’ to build a vaccine before a disease-causing pathogen becomes a threat. Tested on mice, it works by training the immune system to recognise parts of eight coronaviruses, including several that are circulating in bats, and could one day infect humans. ‘’Our focus is to create a vaccine that will protect us against the next coronavirus pandemic and have it ready before the pandemic has even started,’’ said Rory Hills, a graduate researcher at Cambridge and the first author of the report. ‘’We’ve created a vaccine that provides protection against a broad range of different coronaviruses, including ones we don’t even know about yet.’’ Conventional vaccines include a single antigen, the marker on the outside of a given virus that causes an immune response. In this vaccine, researchers used new ‘’quartet nanocage’’ technology. It includes different viral antigens held together by a ‘’protein superglue’’. This trains the immune system to recognise a broad range of coronaviruses. By including multiple antigens in the vaccine, the immune system can target specific areas of these antigens that many coronaviruses share. The vaccine does not, for example, include the coronavirus responsible for the 2003 Sars outbreak, but the mice in the trials still produced an immune response to it. The results, published yesterday (Monday) in Nature Nanotechnology, found that the new vaccine gave a broad immune response, even in mice vaccinated against the strain responsible for Covid-19. ‘’We don’t have to wait for new coronaviruses to emerge. We know enough about coronaviruses and different immune responses to them, that we can get going with building protective vaccines against unknown coronaviruses now’’, said Professor Mark Howarth, the senior author of the research, of the department of pharmacology at Cambridge. ‘’Scientists did a great job in quickly producing an extremely effective Covid vaccine during the last pandemic, but the world still had a massive crisis with a huge number of deaths. We need to work out how we can do even better than that in the future, and a powerful component of that is starting to build the vaccines in advance.’’ The research improves on work by Oxford and Caltech to develop a novel all-in-one vaccine against coronaviruses. It is far simpler in design than other broadly protective vaccines in development, which researchers say should accelerate its route to clinical trials.

Eating ultra-processed meat is linked to an increased risk of early death, a Harvard study over 30 years has found. Scientists tracked more than 114,000 adults in one of the most extensive studies into the long-term consequences of modern diets. The highest risks were associated with the most processed meats such as sausages and ham. Regular consumers of such products had a 13% higher chance of dying over the 34 years that were tracked. Diets high in sugary and artificially sweetened drinks had a nine percent increased risk, the study found. Overall, those eating diets with a high proportion of packaged goods and snacks were found to have a 4% higher risk of death over the period. Such foods have already been linked with obesity, heart disease, diabetes and bowel cancer. However, few studies have tracked participants for such a long time, or examined overall deaths. Dairy desserts – such as cheesecake and fromage frais – were linked to a 6% increase risk, while breads and breakfast cereals were linked to a 4% increase. Researchers tracked the long term health of 74,563 female nurses and 39,501 male health professionals between 1984 and 2018. Female participants were aged between 30 and 55 at the start of the research, while men were between 40 and 75. Their diets were analysed and split into four groups. Overall, those with the highest intake of ultra-processed foods – an average of seven servings daily – had a 4% higher risk than those in the lowest group, which consumed an average of three daily servings. The strongest links were found between meat, poultry and seafood ready-to-eat products, such as sausages, ham, ready meals and processed snacks. Wholegrain foods were not counted as ultra-processed, with researchers saying they were excluded because of their established benefits in lowering mortality. The study, published in the BMJ, was observational, meaning no firm conclusions could be drawn about cause and effect. Dr Duane Mellor, a spokesman for the British Dietetic Association, said: ‘’It is noticeable that those who consumed most ultra-processed foods tended to eat few vegetables, fruit, legumes and wholegrain. This appeared to suggest that it might not be as simple as that those who ate more ultra-processed foods were more likely to die earlier.’’

The Guardian

The Work and Pensions Secretary has said too many Britons are falling into a ‘’spiral of sickness’’ as a new pilot scheme aimed at tackling ‘’sick note culture’’ is expanded. Mel Stride made the remark as it was announced WorkWell, a program which connects people with work support when they seek to be signed off sick, is to be launched in 15 areas. Greater Manchester, where last year 3/4 of a million fit notes were issued, is one target area. Lancashire and South Cumbria, which saw almost half a million, is another. The scheme is part of Mr Sunak’s wider drive to tackle worklessness. Some 2.8 million people are currently economically inactive due to long-term illness, up from 2.1 million before the Covid pandemic.The Prime Minister discussed his welfare reform in a speech last month, with a number of different focal points emerging as he attempts to avoid more people dropping out of work. He said he wanted to end the country’s ‘’sick note culture’’. One idea is to end GPs being the sole decision-makers for sick notes, with health and work specialists making the calls instead.The idea is that GPs, who are already under strain with record NHS waiting lists, may have little incentive not to sign someone off sick and that the benefits of work are being undervalued. WorkWell is a pilot programme that sees someone referred to a work and health coach for an assessment if they think they are too ill for employment. GPs, employers and local services can make the referrals. The individual is then offered sessions with a physiotherapist, a counsellor and a human resource expert for employment advice to discuss their circumstances. Sometimes putting in place a plan to overcome barriers to work or being given extra training can follow. Government insiders argue that people too often are being disregarded as too ill to work by the welfare system and that a more tailored approach could help people retain their jobs. Mr Stride said: ‘’Too many today are falling out of work in a spiral of sickness that harms their finances, their  prospects and ultimately their health, where with the right workplace adjustments and help, this needn’t be the case. And so we have designed WorkWell that will integrate health and work advice at the local level, as part of our plan to stem the flow into economic inactivity, grow the economy, and change lives for the better.’’ Some mental health charities have sounded the alarm on the Government’s sick note rhetoric, which are now called fit notes, questioning whether ministers are treating reports of increasing mental health issues with enough seriousness. A press release on the announcement said 59,000 people will use the service from October. Participants do not have to be receiving benefits to use the scheme. The drive is backed up with £64 million of public money.

Record shortages of drugs in the UK are now at such critical levels that patients are at risk of immediate harm and even death, pharmacists warn today (Thursday). The situation is so serious that pharmacists increasingly have to issue ‘’owings’’ to patients – to tell someone only part of their prescription can be dispensed and ask them to come back for the rest of it later, once the remainder has been sourced. Hundreds of drugs have become hard or impossible to obtain, according to Community Pharmacy England (CPE), which published the report. Widespread and often long-lasting shortages were posing ‘’immediate risks to patient health and wellbeing’’ and caused distress, it said. Janet Morrison, CPE’s chief executive, said: ‘’The medicine supply challenges being faced by community pharmacies and their patients are beyond critical. Patients with a wide range of clinical and therapeutic needs are being affected on a daily basis and this is going far beyond inconvenience, leading to frustration, anxiety and affecting health. For some patients, not having access to the medicines they need could lead to very serious consequences, even leaving them needing to visit A&E. Medicine shortages are leading to delays in patients being able to access certain critical or potentially life-saving medicines in a timely manner.’’ In recent months, the UK has been hit by key medicines for treating type 2 diabetes, ADHD and epilepsy becoming unavailable. Last year there were shortages of HRT, adrenalines and antibiotics. CPE, which represents England’s 10,500 community pharmacies, based its findings on a survey of the views of owners of 6,100 pharmacy premises and 2,000 of their staff. It found that 79% of pharmacy staff were saying medicine shortages were putting patient health at risk; 91% of pharmacy owners had seen a ‘’significant increase’’ in the problem since last year; and 99% of pharmacy workers were finding a drug unavailable at least weekly with 72% encountering that situation several times a day. Pharmacists are finding themselves on the receiving end of abuse and hostility from patients who are frustrated and angered by not being able to get the drugs they have been prescribed. ‘’Most people are very understanding, but they are worried and frightened, and inevitably sometimes that boils over and we have people taking it out on us,’’ said Fin McCaul, the owner of an independent community pharmacy in Greater Manchester. Overall 84% of pharmacy staff had experienced aggression from patients, CPE said. Experts say that global supply and manufacturing problems are contributing to drugs being unavailable. But Morrison said: ‘’Low prices of medicines have made the UK a less attractive market for manufacturers and this is contributing to the reduction in supply chain resilience.’’ In a report last month, the Nuffield health thinktank warned that drug shortages had become a ‘’new normal’’, worsened by Brexit. Mark Dayan, Brexit programme lead at the Nuffield Trust, said: ‘’Nearly every available indicator shows that since 2021 we have experienced a once unthinkable level of medicines shortages again and again.’’ While other western countries such as Italy and Germany were also being hit by disruptions to supply, ‘’Brexit created some extra obstacles for the UK because our market is now partly separated from the wider European pool of supplies’’, added Dayan. The Department of Health was contacted for a response.

The Metropolitan Police has said its refusal to routinely send officers to mental health calls means that they can spend more time at crime scenes – but Charities said the policy could endanger lives. Six months ago the Met introduced a scheme called Right Care, Right Person, aiming to cut the time officers spent dealing with mental health calls, which it said was diverting the force from fighting crime. The Met, Britain’s largest police force, said six months in it has seen the benefits, with officers getting to robberies 6% quicker and for all crime types, being able to spend 21% more time at the scene. A total of 34,000 officer hours a month had been saved from 6,000 fewer deployments to health calls. Detective Superintendent Alistair Vanner, the mental health lead for the Met, said the type of calls officers were not attending included concerns for someone’s welfare because a neighbour had not seen them for some time, or because they had missed an appointment. He said officers would still attend if there was a concern about a potential crime. The Met commissioner, Mark Rowley, had wanted to introduce the scheme in September 2023, triggering ‘’fear and animosity’’ among health organisations, Vanner said. Tense talks lead to the deadline being pushed back by two months and the scheme introduced in phases. In return, the health and social care sector agreed to pick up the extra work. Other forces have adopted the scheme, which was pioneered by Humberside Police. But two leading mental health charities said they had serious concerns, while supporting the principle that health professionals, not police officers, were best placed to help those with a medical need. Mark Winstanley, the chief executive of Rethink Mental Illness, said: ‘’We’ve become increasingly concerned that the decision by the Metropolitan police and other forces across the country to step back from responding to most mental health calls has put lives at risk, which is why we are calling for a pause to the Right Care, Right Person scheme. Health and social care services simply do not have the resources to plug the gap.’’ Gemma Byrne, the policy and campaigns manager at Mind, said: ‘’We have grave concerns about how it is being rolled out nationally. It is a patchy picture across the country, with some areas delivering well integrated support while other areas are struggling. Failing to properly fund NHS mental health crisis services while instructing police forces to step back from mental health calls is an unsafe and frankly irresponsible decision.’’ Vanner said he disagreed with claims that patients had been placed in danger. Emergency call handlers have been trained in assessing whether the mental health calls the force receives need a police response. Vanner said the London ambulance service was usually going where once police would have gone, and that only a handful of calls may have been incorrectly assessed. He said to send a police officer to deal with a mental health patient could worsen their condition. ‘’What does someone in mental health crisis want?’’ he asked. ‘’Do they want to be dealt with by someone in a stab-proof vest, handcuffs and possibly (with) a Taser, or do they want a healthcare professional in front of them? When police turn up they (a person’s neighbours) don’t think that person is in a health crisis, they think they are a criminal and being arrested and taken away for a criminal offence. That’s criminalisation of people in mental health crisis.’’

Chemicals used to produce vapes could be acutely toxic when heated and inhaled, according to research. Vaping devices heat the liquid flavouring to high temperatures to form an aerosol that is inhaled. And the devices contain chemicals including vegetable glycerin, propylene glycol, and nicotine. Previous experiments showed that some fruit-flavoured vapes – such as strawberry, melon and blueberry – created dangerous compounds (volatile carbonyls) due to this heating. The compounds are known to have health implications for chronic obstructive pulmonary disease, cardiovascular disease and cancers. The study used AI to analyse the chemical composition of 180 vape flavours and simulate how they decomposed when heated. The research, published in Scientific Reports, predicted that vapes produce 127 ‘’acutely toxic’’ chemicals. 153 ‘’health hazards’’ and 225 ‘’irritants’’. Nearly every flavour put through the AI predictor showed at least one product that was classified as a health hazard; many predicted several. The toxins were associated with vapes with and without nicotine. The research team, at RCSI University of Medicine and Health Sciences, Dublin, concluded there was a ‘’potential public health threat facing the 4.5 million vapers in the UK’’ and an urgent need for ‘’enhanced restrictions’’ on flavours. The Department of Health and Social Care said disposable vapes would be banned alongside limits on ‘’flavours, packaging and displays… to reduce the appeal to children’’.

A drugs company developing cannabis-based medicines backed by the tobacco group Imperial Brands is to delist from the London stock market, blaming turbulent UK markets for exerting ‘’continuous, irrational and regressive pressure’’ on its share price. Oxford Cannabinoid Technologies (OCT), a clinical stage biopharma company developing prescription medicines for the pain market, said the ‘’turbulence’’ in the UK public markets has had a ‘’punitive effect on sentiment in biopharma as a sector, and on quoted biopharma businesses in particular’’. It said this had constrained it from sustaining a ‘’sensible’’ valuation that reflected its ‘’record of scientific and clinical achievements’’ and, in turn, had impeded it from raising money to develop its pipeline. OCT is the latest small-cap company to delist from the London Stock Exchange, following the recent exits of C4X Discovery and Redx Pharma from the junior Alternative Investment Market (Aim). The departures have raised concerns about structural weaknesses in the smaller-cap market and a broader de-equitisation of the London market. OCT, which was founded in 2017, floated three years ago, when it raised £16.5 million and was valued at £48 million. Its largest shareholders include Imperial Brands Ventures, a subsidiary of the FTSE 100 tobacco company, which retains a stake of 9.6% and until March had a representative on the board. Casa Verde, the cannabis-focused venture capital firm, is also a shareholder. OCT’s shares have slumped since its float and dropped another 55% yesterday (Wednesday). The company said it plans to delist on June 6.