Talk:Steven Grinspoon

Edits for August 2024

I have a conflict of interest as a paid consultant for WhiteHatWiki.com, which was hired by the subject of this article. This page needs significant editing in order to address the issues raised in the warning flag. I plan to do so in more than one post so as not to overwhelm the editor reviewing this request. I will address the problems with the Research section in the next phase. Thank you for reviewing.

1. Please delete the fourth sentence through the tenth sentence in the Lead section. But please keep the eleventh sentence.

Delete:

He has investigated the effects of reduced growth hormone on metabolic dysregulation in obesity and was the first to propose the use of a Growth Hormone-releasing Hormone (GHRH) analogue to increase endogenous GH secretion on lipodystrophy and generalized obesity, which led to the FDA approval of Tesamorelin for excess visceral fat accumulation in HIV-infected patients. This work has now been extended to show effects on non-alcoholic fatty liver disease (NAFLD). More recently, his research focuses on the inflammatory mechanisms by which ectopic fat and other metabolic perturbations contribute to HIV-Cardiovascular disease (CVD), and in this regard, he led the AHA State of the Science Conference on CVD in HIV. Additionally, he is leading the multicenter REPRIEVE study, the first study of a primary prevention strategy for CVD in people living with HIV. He has also investigated increased Renin-Angiotensin-Aldosterone System (RAAS) activation and immune activation in relationship to visceral fat accumulation, and the mechanisms of subcutaneous adipose dysfunction involving DICER. Grinspoon has served on the Harvard faculty since 1995 and has been selected by the American Society for Clinical Investigation and the Association of American Physicians for his scientific contributions. He received the American Federation of Medical Research Investigator of the Year Award in 2005 and the Edward H. Ahrens Jr. Award for Patient Oriented Research in 2014 as well as the Endocrine Society Laureate Award for Translational Research in 2016. He has published over 330 articles and mentored over 40 trainees in his career. He was elected as a Member of the American Clinical and Climatological Association for his achievements in 2017. His work demonstrating the effects of Tesamorelin to reduce hepatic fat and fibrosis progression in NAFLD, published in Lancet HIV, was a finalist for the Clinical Research Forum’s top 10 Clinical Research Achievement Awards in 2020.

Why: As written, the Lead is excessively long and too highly detailed. The suggested replacement offers a concise overview of the topic and leaves the highly technical information fleshed out in the body of the article.

 Done 17:54, 27 August 2024 (UTC)

2. Please replace the “Publications” section and move beneath the “Research and awards” section, renamed as “Selected works”:

Grinspoon has published 309 original research articles, and over 50 review papers in his field. He has authored key Chapters in the Williams Textbook of Endocrinology and The Oxford textbook of Endocrinology on the endocrine manifestation of HIV/AIDS. He has served on the Weight Loss and Wasting Working Group Expert Panel on National HIV/AIDS to develop Nutrition Guidelines for the Department of Health and Human Services and developed guidelines for the Nutritional Assessment of HIV-infected Patients in work commissioned by the NIH and WHO. He has contributed to guidelines on the prevention and management of cardiovascular disease in HIV, Chairing the AHA State of the Science Conference on CVD Risk in HIV in 2008, published in Circulation and the NIH sponsored symposium on the Review and Recognition of Obesity in HIV in 2017, published in Clinical Infectious Diseases. He has also participated in the writing group of guidelines for the International AIDS Society-USA Management of Metabolic Complications Associated with Antiretroviral Therapy for HIV-1 infection. He has served on the Advisory Boards of JCEM, JAIDS AIDS, and Nature Reviews Endocrinology, and the Journal of Clinical Investigation.^{[citation needed]}

Replace with:

“Selected Works”

• Grinspoon, Steven K. (April 2003). "Weight loss and wasting in patients infected with human immunodeficiency virus.” Clinical Infectious Diseases 36 (69-78).
• Grinspoon, Steven K. (19 June 2008). “Initiative to Decrease Cardiovascular Risk and Increase Quality of Care for Patients Living With HIV/AIDS”.Circulation (journal) 18
• Grinspoon, Steven K. ;Lake, Jordan, Stanley, Takara; Apovian, Caroline; Brown, Todd. (15 May 2017). “Practical Review of Recognition and Management of Obesity and Lipohypertrophy in Human Immunodeficiency Virus Infection”. Clinical Infectious Diseases 64 (1422–1429).

• Grinspoon, Steven K; Brown, Todd T. (2020) Williams Textbook of Endocrinology:”Endocrinology of HIV/AIDS”. Elsevier.

• Grinspoon, Steven K; Stlanley, Takara L. (January 2022) Oxford Textbook of Endocrinology and Diabetes: “Abnormalities in HIV Infection”. Oxford University Press.

• Grinspoon, Steven K; Zanni, Markella V.; Fitchenbaum, Carl J. (July 23, 2023) New England Journal of Medicine: “Pitavastatin to Prevent Cardiovascular Disease in HIV Infection”. Massachusetts Medical Society.

Why: The existing section is missing citations and contains WP:OR (“Grinspoon has published 309 original research articles, and over 50 review papers in his field.”) The suggested replacement lists Grinspoon’s published works in publications that meet WP:MEDRS. I’ve suggested changing the section title and formatting to mirror the structure of similar pages.

 Done Mixed feelings here. I generally don't love when there's just a list of publications without any context whatsoever, and high-quality articles generally avoid this. However, the current content isn't great, and most of the important information here can be covered under research. 18:06, 27 August 2024 (UTC)

3. Please replace the first paragraph of the “Education” section:

Change from:

Grinspoon graduated from Cornell University in 1983, attended the University of Rochester School of Medicine, graduating in 1988, and was awarded AOA Alumni Award from the medical school in 2006. He did his medical residency and Chief Residency at Columbia Presbyterian from 1988 to 1992 and his Endocrinology Fellowship at Massachusetts General Hospital from 1992 to 1995.

Change to:

Grinspoon graduated from Cornell University in 1983. He attended the University of Rochester School of Medicine, graduating in 1988. He did his medical residency and Chief Residency at Columbia Presbyterian from 1988 to 1992 and his Endocrinology Fellowship at Massachusetts General Hospital from 1992 to 1995.

Why: The suggested revision includes citations for his degrees that are currently missing. I’ve also suggested removing the AOA Alumni Award because it’s unsourced and is probably promo.

 Done Rusalkii (talk) 18:06, 27 August 2024 (UTC)

4. Please replace the “Awards” subsection under the “Research and awards” section.

Change from:

Grinspoon was elected to the American Society of Clinical Investigation (ASCI) in 2003 and the Honor Society for Humanism in Medicine for the Arnold P. Gold Foundation in 2004. He received the Outstanding Investigator Award from the American Federation for Medical Research in 2005 and was honored with the Pfizer Visiting Professorship at UC Davis in 2004, the Frank H. Tyler Honorary Endowed Lectureship at the University of Utah in 2008, the Dorothy M. Kahkonen Lectureship at the Henry Ford Health System in 2009, the Johnson Maguire Visiting Professorship at the University of Cincinnati in 2015 and the Michael O. Thorner Distinguished Lectureship in Endocrinology from the University of Virginia in 2019. He was named the Alpha Omega Alpha Alumni of the year Awardee at the University of Rochester in 2006 and elected to the Association of American Physicians in 2011. In 2014, he received the Edward H. Ahrens Award for Patient Oriented Clinical Research from the Association of Clinical and Translational Science (ACTS) and the American Medical Federation for Medical Research (AMFAR). In 2016 He received the Gerald Aurbach Laureate Award for Outstanding Translational Research from the Endocrine Society. In 2017 he was elected to the American Clinical and Climatological Association. Grinspoon received an Albert Nelson Lifetime Achievement Award from Who’s Who in America in 2017 and his research on the use of Tesamorelin for fatty liver disease in the Lancet HIV was named as a finalist to the Top 10 Clinical Research Achievement Awards in 2020. In 2023, he was named the 2023 Berson-Yalow Lecturer for the Mt. Sinai Department of Medicine.

Change to:

Grinspoon was elected to the American Society for Clinical Investigation in 2003.

In 2016, he received the Gerald D. Aurbach Laureate Award for Outstanding Translational Research from the Endocrine Society.

Why: The current subsection is excessively long and detailed. As written, it reads more like a CV than an encyclopedic entry. The suggested replacement removes all unsourced awards as well as those that don’t have a Wikipedia page. I’ve suggested including the two awards that have Wikipedia pages and can be verified through reliable sources.

 Done Rusalkii (talk) 18:08, 27 August 2024 (UTC)

5. Please delete the “Key discoveries” subsection under the “Research and awards” section:

“Key discoveries”

• Efficacy of Tesamorelin to reduce visceral adiposity 2007 (NEJM)
• Efficacy of Tesamorelin to reduce liver fat 2014 (JAMA)
• Efficacy of Tesamorelin to prevent liver fibrosis progression in 2019 (Lancet HIV)
• Demonstration of Tesamorelin effects on key hepatic metabolic pathways in 2020 (JCI Insight)
• Demonstration of increased arterial inflammation in HIV in 2012 (JAMA)
• Identification of key genes and proteins leading to dysfunctional subcutaneous adipose tissue in HIV Lipodystrophy 2021 (JCI Insight)
• First use of macrophage specific imaging agent to identify plaque cardiovascular imaging (JID 2021)

Why: Key Discoveries is WP:OR as nothing in the sources supports the designation of “key discovery.” Furthermore, two of the items are unsourced. Those that are sourced already appear in the “Research” section so they’re inclusion here is redundant.

 Done Rusalkii (talk) 17:54, 27 August 2024 (UTC)

6. Please delete the “Selected talks” subsection under the “Research and awards” section.

Why: None of the information is supported by a source. And it’s all Promo.

 Done Rusalkii (talk) 17:54, 27 August 2024 (UTC)

Thank you for reviewing these proposals.

Brucemyboy1212 (talk) 18:38, 12 August 2024 (UTC)

Edits for November 2024

I have a conflict of interest as a paid consultant for WhiteHatWiki.com, which was hired by the subject of this article. This page needs significant editing in order to address the issues raised in the warning flag. In an effort not to burden the reviewer with too many requests, I’ve broken them into phases. The first has already been addressed here. Thank you.

@Rusalkii: Since you reviewed the first round of edits and are somewhat familiar with efforts to improve the page, I wanted to let you know the second round was here. Brucemyboy1212 (talk) 22:55, 27 November 2024 (UTC)

1. Please change the section “Education” to “Early life and education”: and add the following as the new first sentence of the renamed section:

Steven Grinspoon is the son of Eileen Grinspoon and real estate developer, Harold Grinspoon.

Why: This is the minimal information about early life that I was able to find from reliable sources. It also creates a mutual Wikilink between two pages. There had been an orphan issue with this page which is mentioned in the flag.

2. Please replace the first paragraph in the Research and awards section:

Change from:

Grinspoon’s primary research focus has been to investigate the effects of augmenting endogenous GH pulsatility on visceral fat in lipodystrophic patients with abdominal fat accumulation and nonalcoholic fatty liver disease. This work was initiated by an observation of reduced GH secretion in HIV patients with lipodystrophy. Subsequent studies examined the mechanisms and demonstrated reduced area under the curve per peak, but maintenance of the GH pulse generator in such patients. Reasoning that augmentation of GH pulsatility might reduce visceral fat, because of its potent effects to oxidize adipose tissue, Grinspoon led a series of studies culminating in a NEJM paper demonstrating that Tesamorelin, a GHRH1-44 secretagogue, reduced visceral fat by 20% and reduced triglyceride, while improving adiponectin. This work led to FDA approval of Tesamorelin as the only such approved drug for HIV lipodystrophy and first in class molecule. Subsequent studies, published in JAMA and Lancet HIV, demonstrated that Tesamorelin reduced hepatic steatosis as well, the first drug to demonstrate a significant effect among patients with HIV lipodystrophy. Subsequent work demonstrated significant effects to stimulate hepatic oxidative pathways and reduce inflammatory pathways in gene set enrichment studies. Grinspoon was granted a US Patent entitled “GHRH or Analogues thereof for the Use in Treatment of Hepatic Disease” for this work. Tesamorelin was also investigated in generalized obesity and showed significant effects to reduce cIMT, inflammatory markers, lipids and visceral adiposity.

Change to:

Grinspoon’s primary research has been centered on understanding the neuroendocrine regulation of body composition in HIV patients, and how it relates to the growth hormone (GH) axis. Hypothesizing that augmentation of GH pulsatility might reduce visceral fat, Grinspoon led a series of studies demonstrating that that growth-hormone-releasing drug Tesamorelin reduced visceral fat and triglycerides, while improving adiponectin in patients with HIV. Following the trials, the Federal Drug Administration approved Tesamorelin for HIV-associated lipodystrophy in 2010.

Why: As written, sentences in this paragraph are either uncited or dependent on primary sources, and written with excessive detail. The suggested replacement is more concise, and cites sources that are allowable under MEDRS. Under MEDRS, ‘Ideal sources for biomedical information include: review articles (especially systematic reviews) published in reputable medical journals, academic and professional books written by experts in the relevant fields and from respected publishers, and guidelines or position statements from national or international expert bodies.” Because the first sentence describes the focus of Grinspoon’s research without making any medical claims, I’ve used a reliable press source. For the second sentence UpToDate is considered a leading authority in peer-reviewed medical guidelines; I have added a second citation from a leading textbook in the field. The sources above include two of the major textbooks (professional books) in the field Endocrinology.

3. Please change the second paragraph in the Research and awards section:

Change from:

A second and related focus of Grinspoon’s work has been to investigate the mechanisms and strategies for CVD in HIV. In this regard, he led an AHA sponsored State of the Science Symposium on CVD in HIV. The conclusions from this conference called for a better understanding and treatment strategies of CVD in HIV. This work began with epidemiologic studies demonstrating increased myocardial infarction rates in HIV patients in the JCEM. This data was followed by a series of mechanistic studies demonstrating increased prevalence of plaque, particularly noncalcified, lipid rich, plaque. Grinspoon used FDG PET to demonstrate for the first time significant arterial inflammation in asymptomatic low traditional risk HIV patients, compared to Framingham risk matched control subjects, as well as non HIV patients with known CVD, published in JAMA. Of note, increased arterial inflammation was most significantly associated with increased markers of immune activation. He also recently proposed the first use of tilmanocept as a CD206 specific imaging agent for arterial inflammation, with success in HIV published in JID. This work was followed by studies in HIV patients in which he phenotyped the morphological characteristics of coronary plaque in HIV patients, demonstrating an increased prevalence of high risk plaque with low attenuation and positive remodeling, more vulnerable to rupture. His studies suggested that treatment with a statin might uniquely target both traditional risk factors including low-density lipoprotein (LDL) but also increased immune activation indices driving atypical noncalcified high risk plaque in this population. This work culminated in a recent paper in Lancet HIV, in which he showed for the first time that a statin can significantly reduce high risk plaque volume as well as improve the high-risk morphological features in coronary lesions in HIV. In recognition of this work, he has led the REPRIEVE trial, a global primary prevention study performed in 12 countries, since 2013 and gave the plenary lecture at CROI 2015 on this topic. The REPRIEVE trial was recently closed early by its Data Safety Monitoring Board for a robust efficacy signal, demonstrating that a statin strategy reduced major adverse cardiovascular event (primary heart attacks, strokes, and cardiovascular death) by 35% over 5 years, compared to placebo. This trial was recently published in the New England Journal of Medicine and the data presented by Grinspoon at the International AIDS Society 2023 meeting in Brisbane and featured in news articles and podcasts.

Change to:

Grinspoon also investigated strategies for managing cardiovascular disease in patients with HIV. He led the REPRIEVE trial, a study of more than 7,700 HIV patients worldwide between the ages 40 and 75, who were taking antiretroviral medication and had a low-to-moderate risk of developing heart disease. The trial found the cholesterol-lowering drug pitavastatin, a statin, decreased patients’ risk of heart attacks and strokes by one-third, lowered LDL levels, as well as immune activation and inflammation in HIV patients. The REPRIEVE trial was stopped early on the recommendation of an independent data safety and monitoring board that found sufficient evidence of efficacy.

Why: The current paragraphs about Grinspoon’s research are excessive in detail, and rely heavily on primary sources and press releases. The section was rewritten for concision and to include sources meeting the criteria for WP:MEDRS.

The first sentence cites a reliable news source to describe the focus of Grinspoon’s research. It makes no medical claims. The second sentence cites a reliable news source to describe the participants of a study, again, making no medical claims. The third sentence cites guidance from European AIDS Clinical Society, the leading expert body on HIV/AIDS in Europe, a MEDRS source. The fourth sentence cites a reliable news source to describe the length of the study, a non-medical claim.

4. Please remove the third paragraph in the Research and awards section:

Grinspoon has worked to understand the mechanism, and treatment strategies for metabolic dysregulation in HIV, and was among the first to assess metformin and rosiglitazone to reverse insulin resistance and increase adipogenesis in this population. He also recognized reduced DICER as a factor that may contribute to dysfunctional adipose tissue in HIV.

Why: The studies included in this paragraph are not aligned with WP:MEDRS.

5. Please divide the “Research and awards” section into two separate sections.

Why: Placing information about “career” and “awards and recognition” in separate sections is standard in BLP Good Articles: Chanda Prescod-Weinstein Adriana Ocampo and Alan Hale (astronomer)

6. Please remove the warning template from the top of the article.

Why: All issues raised in the template have now been addressed; undisclosed close connection, puffery and orphan. The article has been heavily revised to address WP:PUFFERY and WP:PROMO, which began with the first round of Request Edits Talk:Steven Grinspoon#Edits for August 2024, and the requests above would update the Research section to meet the high standards of WP:MEDRS. To rescue the orphan, I also made a request to update to Wikilink this page to a related article, Harold Grinspoon, which was approved by a neutral editor Talk:Harold Grinspoon#Add Wikilink. While I have no connection with any previous editors on this page, this and the previous proposal should address all issues on the page, so there should be nothing remaining on the page that the potential undisclosed COI editor may have done improperly.

Thank you for time reviewing these requests. Brucemyboy1212 (talk) 18:55, 13 November 2024 (UTC) Brucemyboy1212 (talk) 18:55, 13 November 2024 (UTC)

I agree that the material here is a significant improvement from various standpoints. However, before being implemented I believe it needs input from a volunteer better versed than myself on the operation of WP:MEDRS. Axad12 (talk) 23:18, 15 November 2024 (UTC)