New England Journal of Medicine最新文献

{"title":"Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity.","authors":"Sean Wharton,Ildiko Lingvay,Pawel Bogdanski,Ruben Duque do Vale,Stephan Jacob,Tobias Karlsson,Chaithra Shaji,Domenica Rubino,W Timothy Garvey, ","doi":"10.1056/nejmoa2500969","DOIUrl":"https://doi.org/10.1056/nejmoa2500969","url":null,"abstract":"BACKGROUNDOral semaglutide at a dose of 25 mg may provide an alternative treatment option to injectable semaglutide (2.4 mg) and higher-dose oral semaglutide (50 mg) for persons with overweight or obesity.METHODSIn a 71-week, double-blind, randomized, placebo-controlled trial conducted at 22 sites in four countries, we enrolled persons without diabetes who had a body-mass index (BMI; the weight in kilograms divided by the square of the height in meters) of 30 or higher or a BMI of 27 or higher with at least one obesity-related complication. The participants were randomly assigned in a 2:1 ratio to receive oral semaglutide (25 mg) or placebo once daily, plus lifestyle interventions. The coprimary end points at week 64 were the percent change in body weight and a reduction of 5% or more in body weight; confirmatory secondary end points included reductions in body weight of 10% or more, 15% or more, and 20% or more and the change in the Impact of Weight on Quality of Life-Lite Clinical Trials Version (IWQOL-Lite-CT) Physical Function score.RESULTSA total of 205 participants were randomly assigned to receive oral semaglutide, and 102 to receive placebo. The estimated mean change in body weight from baseline to week 64 was -13.6% in the oral semaglutide group and -2.2% in the placebo group (estimated difference, -11.4 percentage points; 95% confidence interval, -13.9 to -9.0; P<0.001). Participants in the oral semaglutide group were significantly more likely than those in the placebo group to have body-weight reductions of 5% or more, 10% or more, 15% or more, and 20% or more (P<0.001 for all comparisons) and to have an improved IWQOL-Lite-CT Physical Function score (P<0.001). Gastrointestinal adverse events were more common with oral semaglutide than with placebo (74.0% vs. 42.2%).CONCLUSIONSOral semaglutide at a dose of 25 mg once daily resulted in a greater mean reduction in body weight than placebo in participants with overweight or obesity. (Funded by Novo Nordisk; OASIS 4 ClinicalTrials.gov number, NCT05564117.).","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"72 1","pages":"1077-1087"},"PeriodicalIF":158.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Pharmacotherapy into Tobacco Control in Low- and Middle-Income Countries - A Critical Need.","authors":"Nancy A Rigotti,Natalie Walker,Amer Siddiq Amer Nordin","doi":"10.1056/nejmp2500685","DOIUrl":"https://doi.org/10.1056/nejmp2500685","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"472 1","pages":""},"PeriodicalIF":158.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing Tobacco Use Worldwide - A New Perspective Series.","authors":"Nancy A Rigotti,Kamran Siddiqi,Debra Malina,Genevra Pittman,Darren B Taichman,Kristine M Guinn,Stephen Morrissey","doi":"10.1056/nejme2510566","DOIUrl":"https://doi.org/10.1056/nejme2510566","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"36 1","pages":""},"PeriodicalIF":158.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protecting Medicaid Enrollees with Chronic Conditions amid Work Requirements.","authors":"John Z Ayanian","doi":"10.1056/nejmp2508966","DOIUrl":"https://doi.org/10.1056/nejmp2508966","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"164 1","pages":""},"PeriodicalIF":158.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mavacamten in Symptomatic Nonobstructive Hypertrophic Cardiomyopathy.","authors":"Milind Y Desai, Anjali T Owens, Theodore Abraham, Iacopo Olivotto, Pablo Garcia-Pavia, Renato D Lopes, Perry Elliott, Fabio Fernandes, Nicolas Verheyen, Lars Maier, Benjamin Meder, Olga Azevedo, Hiroaki Kitaoka, Kathy Wolski, Qiuqing Wang, Wael Jaber, Lisa Mitchell, Jonathan Myers, Thomas Rano, Zhiqun Gong, Yue Zhong, Suzanne Carter-Bonanza, Victoria Florea, Ron Aronson, Steven E Nissen","doi":"10.1056/NEJMoa2505927","DOIUrl":"10.1056/NEJMoa2505927","url":null,"abstract":"<p><strong>Background: </strong>Mavacamten is approved to treat adults with symptomatic obstructive hypertrophic cardiomyopathy (HCM). However, its effects in nonobstructive HCM remain uncertain.</p><p><strong>Methods: </strong>We conducted a phase 3, international, double-blind, placebo-controlled, clinical trial to determine whether mavacamten improves functional capacity and patient-reported health status among adults with symptomatic nonobstructive HCM. Patients were randomly assigned in a 1:1 ratio to receive mavacamten (starting at 5 mg per day and adjusted up to a maximum of 15 mg per day on the basis of left ventricular ejection fraction) or placebo (with sham dose adjustment) for 48 weeks. The two primary end points were the change from baseline to week 48 in peak oxygen uptake and in the 23-item Kansas City Cardiomyopathy Questionnaire clinical summary score (KCCQ-CSS; scores range from 0 to 100, with higher scores indicating better health status).</p><p><strong>Results: </strong>We randomly assigned 289 patients to receive mavacamten and 291 to receive placebo. The mean (±SD) age of the patients was 56±15 years, and 46% were women. From baseline to week 48, the least-squares mean change in peak oxygen uptake was 0.52 ml per kilogram of body weight per minute (95% confidence interval [CI], 0.09 to 0.95) in the mavacamten group and 0.05 ml per kilogram per minute (95% CI, -0.38 to 0.47) in the placebo group (between-group difference, 0.47 ml per kilogram per minute; 95% CI, -0.03 to 0.98; P = 0.07). The least-squares mean change in the KCCQ-CSS was 13.1 points (95% CI, 10.7 to 15.5) in the mavacamten group and 10.4 points (95% CI, 8.0 to 12.8) in the placebo group (between-group difference, 2.7 points; 95% CI, -0.1 to 5.6; P = 0.06). Reductions in ejection fraction and interruptions in the trial regimen were more common with mavacamten than with placebo.</p><p><strong>Conclusions: </strong>Among patients with nonobstructive HCM, mavacamten did not result in a significantly greater improvement in peak oxygen uptake or decrease in symptoms than placebo. (Funded by Bristol Myers Squibb; ODYSSEY-HCM ClinicalTrials.gov number, NCT05582395.).</p>","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":" ","pages":"961-972"},"PeriodicalIF":78.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ruptured Pulmonary Hydatid Cyst.","authors":"Yener Aydin, Hayri Ogul","doi":"10.1056/NEJMicm2502836","DOIUrl":"https://doi.org/10.1056/NEJMicm2502836","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"393 10","pages":"e15"},"PeriodicalIF":78.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pityriasis Rosea.","authors":"Efstathios Andreas Rallis, Constantinos Verros","doi":"10.1056/NEJMicm2503761","DOIUrl":"https://doi.org/10.1056/NEJMicm2503761","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"393 10","pages":"1016"},"PeriodicalIF":78.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Epididymo-orchitis in IgA Vasculitis.","authors":"Sheri Pariha, Christian Hanna","doi":"10.1056/NEJMicm2504368","DOIUrl":"10.1056/NEJMicm2504368","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":" ","pages":"e14"},"PeriodicalIF":78.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The End of Days.","authors":"Isaiah Thomas","doi":"10.1056/NEJMp2416519","DOIUrl":"10.1056/NEJMp2416519","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":" ","pages":"945-947"},"PeriodicalIF":78.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidomain Rehabilitation for Older Patients with Myocardial Infarction.","authors":"Elisabetta Tonet, Andrea Raisi, Silvia Zagnoni, Giorgio Chiaranda, Giovanni Pasanisi, Daniela Aschieri, Paola Emanuela D'Intino, Rita Pavasini, Paolo Cimaglia, Roberta Campana, Francesco Vitali, Tommaso Piva, Gianni Casella, Serena Caglioni, Valentina Zerbini, Giulia Bugani, Marta Cocco, Erica Menegatti, Martina De Raffele, Simona Mandini, Donato Martella, Nicola Pesenti, Gianni Mazzoni, Simone Biscaglia, Stefano Volpato, Giovanni Grazzi, Gianluca Campo","doi":"10.1056/NEJMoa2502799","DOIUrl":"10.1056/NEJMoa2502799","url":null,"abstract":"<p><strong>Background: </strong>The benefit of rehabilitation interventions in patients who are 65 years of age or older with myocardial infarction and impaired physical performance remains unclear.</p><p><strong>Methods: </strong>In this multicenter, randomized trial conducted in Italy, we assigned older patients with impaired physical performance 1 month after myocardial infarction in a 2:1 ratio to receive either an intervention consisting of control of cardiovascular risk factors, dietary counseling, and exercise training (intervention group) or usual care (control group). The primary outcome was a composite of cardiovascular death or unplanned hospitalization for cardiovascular causes within 1 year.</p><p><strong>Results: </strong>A total of 512 patients underwent randomization (342 to the intervention group and 170 to the control group). The median age of the patients was 80 years, and 36% were women. A primary-outcome event occurred in 43 patients (12.6%) in the intervention group and in 35 patients (20.6%) in the control group (hazard ratio, 0.57; 95% confidence interval [CI], 0.36 to 0.89; P = 0.01). Cardiovascular death occurred in 14 patients (4.1%) in the intervention group and in 10 patients (5.9%) in the control group (hazard ratio, 0.69; 95% CI, 0.31 to 1.55). Unplanned hospitalization for cardiovascular causes occurred in 31 patients (9.1%) in the intervention group and in 30 patients (17.6%) in the control group (hazard ratio, 0.48; 95% CI, 0.29 to 0.79). There were no serious adverse events associated with the intervention.</p><p><strong>Conclusions: </strong>Among older patients with impaired physical performance 1 month after myocardial infarction, a multidomain rehabilitation intervention resulted in a lower incidence of cardiovascular death or unplanned cardiovascular hospitalization within 1 year than usual care. (Funded by the Italian Health Ministry; PIpELINe ClinicalTrials.gov number, NCT04183465.).</p>","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":" ","pages":"973-982"},"PeriodicalIF":78.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}