Anish Koka, MD ✓

@anish_koka

Cardiologist

31 113Followers

640Following

56 450Posts total

102.6KViews on collected posts

Against accounts of the same size

21 posts from the last 90 days, next to the 10K–100K follower range. shown widely, but few of those viewers react.

Median views2 092this account964median for 10K–100K

Reach, %6.72%this account3.25%median for 10K–100K

Engagement, %1.36%this account2.01%median for 10K–100K

Metric	This account	Median for 10K–100K	Ratio
Median views per post	2 092	964	2.17×
Reach (views ÷ followers)	6.72%	3.25%	2.07×
Engagement rate	1.36%	2.01%	0.68×

Others in this range → Compare with another account → How these benchmarks are built →

Growth & engagement

How the posts we collected actually performed: views and reaction rate post by post, what the audience did with them, and where the follower count goes.

Views per post

2.1K21 Jun

1.9K

1.8K

3.7K

1.6K

1.7K

1.4K

1.3K

5.5K

2.2K

1.5K

862

Last 14 collected posts, oldest on the left. The scale is logarithmic: one post can outrun the rest a hundred times over.

Engagement rate per post

1.20%21 Jun

1.36%

1.56%

0.76%

1.35%

1.29%

2.34%

1.87%

1.91%

1.60%

0.92%

1.87%

1.99%

2.55%

Reactions — likes, reposts, replies and quotes — divided by views. Median for 10K–100K accounts is 2.01%.

What the audience does

Likes77.2%759 in total

Reposts9.1%89 in total

Replies3.6%35 in total

Quotes1.6%16 in total

Bookmarks8.5%84 in total

Share of every reaction we collected for this account. Replies mean argument, reposts mean endorsement, bookmarks mean the post was worth keeping.

The follower curve appears once this account has two daily snapshots — we take one a day, and this one is on its first.

Latest posts

@anish_koka Pharma’s preferred regulator is back in charge: https://t.co/yLv3wXFdTb 862 views · 17 likes · 2 reposts · 3 replies 21 Jun 2026 · Open on X →

https://t.co/NhEt3Jj7eH 1.5K views · 26 likes · 1 reposts · 2 replies 21 Jun 2026 · Open on X →

The FDA’s regulatory legitimacy rests entirely on the premise that its approval decisions are scientific rather than political. When the sequence of events is: official blocks drug, official is fired, drug is approved — the burden of proof shifts. The agency is no longer simply 2.2K views · 34 likes · 4 reposts · 2 replies 21 Jun 2026 · Open on X →

✓ The drug is given primarily to children ✓ It suppresses their immune systems ✓ At least 5 trial participants developed cancers consistent with immune suppression. The Oncology division’s assessment isn’t in the Davis memo, and isn’t public. ✓ EBV reactivation was seen in 5.5K views · 42 likes · 6 reposts · 1 replies 21 Jun 2026 · Open on X →

None of this proves wrongdoing. Teplizumab may eventually show clinical benefit. The BETA-PRESERVE confirmatory trial is ongoing. But here is what is not in dispute: 1.3K views · 20 likes · 0 reposts · 1 replies 21 Jun 2026 · Open on X →

Canal Row is populated almost entirely by former senior FDA officials, including the former FDA Associate Commissioner for Regulatory Affairs and the former FDA Chief Medical Officer. Its stated pitch: turning FDA institutional knowledge into “razor-sharp strategy” for drug 1.3K views · 23 likes · 1 reposts · 1 replies 21 Jun 2026 · Open on X →

Then there’s John Sharretts — Director of FDA’s Division of Diabetes, Lipid Disorders, and Obesity. The exact division that reviewed teplizumab and opposed Høeg’s position on the drug. He left the FDA during the tumult and is now Executive VP at Canal Row Advisors — a Bethesda 1.4K views · 23 likes · 1 reposts · 2 replies 21 Jun 2026 · Open on X →

The memo names Tracy Høeg more than 20 times. It is exhaustive in its documentation of her disagreement with approval of the drug. It does not say the Oncology division concurred with approval. It simply omits them. That omission is .. interesting. 1.4K views · 30 likes · 2 reposts · 1 replies 21 Jun 2026 · Open on X →

Immune suppression generally also increases the risk of cancer. Davis - the new CDER head - wrote a memo to address Hoeg’s concerns. In it he describes 5 cancer cases in trial participants. The memo addresses what the Office of Surveillance and Epidemiology concluded (no 1.7K views · 20 likes · 1 reposts · 1 replies 21 Jun 2026 · Open on X →

“EBV reactivation” does not appear as a coded reaction in the report. But the clinical syndrome — pharyngitis, lymphadenopathy, splenomegaly, cytopenias, hepatitis, multi-organ failure — is consistent with exactly that. Teplizumab was listed as the primary suspect drug by 1.6K views · 21 likes · 0 reposts · 1 replies 21 Jun 2026 · Open on X →

Clinical picture in the report: tonsillitis, pharyngeal swelling, tonsillar hypertrophy, lymphadenopathy, splenomegaly, thrombocytopenia, neutropenia, lymphopenia, elevated liver enzymes, elevated creatinine, elevated lactic acid. Terminal events: cardiorespiratory arrest. 3.7K views · 24 likes · 2 reposts · 1 replies 21 Jun 2026 · Open on X →

FAERS report 25854795. Filed by Sanofi. Received by FDA September 27, 2025 during the active review period. 30-year-old male. Started teplizumab September 3. Course ended September 16. Death reported 11 days later. 1.8K views · 25 likes · 1 reposts · 2 replies 21 Jun 2026 · Open on X →

Davis’s memo cites an FDA review of the FAERS adverse event database noting no deaths directly associated with teplizumab. That review was scoped to patients under 18. I checked the public FAERS database. There is one fatal case report. The patient was 30. 1.9K views · 25 likes · 0 reposts · 1 replies 21 Jun 2026 · Open on X →

In the Stage 2 trial: 8 of 30 EBV-seropositive patients had detectable EBV DNA in blood after treatment. All 8 were in the teplizumab group. Zero in placebo. In the PROTECT trial: 8 EBV reactivations in 217 treated patients — and this trial pre-screened out high-risk EBV 2.1K views · 24 likes · 0 reposts · 1 replies 21 Jun 2026 · Open on X →

Teplizumab causes lymphopenia in >70% of patients. That’s not rare. That’s the modal outcome of treatment. Immune suppression has consequences. One of them is EBV reactivation — a risk documented in both major teplizumab trials. 2.3K views · 41 likes · 3 reposts · 2 replies 21 Jun 2026 · Open on X →

So we have an immune-suppressing drug, given primarily to children, with unclear clinical benefit at this stage of disease — being approved based on a surrogate marker that doesn’t track with the clinical marker we should care about — HbA1c. Now let’s talk about the safety 2.5K views · 44 likes · 3 reposts · 1 replies 21 Jun 2026 · Open on X →

The new approval for Stage 3 is even shakier. The PROTECT trial used a surrogate endpoint: C-peptide levels. It showed no meaningful change in HbA1c — the actual measure of blood sugar control. No difference in insulin dose, time in glucose range, or hypoglycemic events. 2.7K views · 29 likes · 2 reposts · 1 replies 21 Jun 2026 · Open on X →

Year 1 of the trial: teplizumab patients had 87% lower risk of diagnosis. Dramatic. Year 2: teplizumab patients had nearly DOUBLE the risk compared to placebo. HR 1.8. The drug delayed disease onset. It did not prevent it. Those patients didn’t escape diabetes — it was just 3K views · 38 likes · 2 reposts · 1 replies 21 Jun 2026 · Open on X →

The drug’s actual track record: The pivotal trial showed a median delay to diabetes diagnosis of ~6 months — not the 24-month figure in the abstract. The abstract compares medians. The Kaplan-Meier curves and interval hazard ratios tell a different story. 3.5K views · 26 likes · 3 reposts · 1 replies 21 Jun 2026 · Open on X →

Tracy Høeg was acting director of FDA’s CDER division. She declined to approve Teplizumab (Tzield) for Stage 3 Type 1 Diabetes in children and ordered an advisory committee review. She was fired shortly after. No reason was given. 28 days later, her replacement, Mike Davis, 4.1K views · 37 likes · 5 reposts · 1 replies 21 Jun 2026 · Open on X →

The FDA fired its acting drug chief. 28 days later, her replacement approved a drug she had blocked — without the independent expert review she had ordered. The narrative: she was an out-of-control regulator. The record tells a different story. 🧵 56.2K views · 190 likes · 50 reposts · 8 replies 21 Jun 2026 · Open on X →