Annals of Internal Medicine最新文献

{"title":"The Cost-Effectiveness of Semaglutide and Tirzepatide for Patients With Knee Osteoarthritis and Obesity.","authors":"Michael R Bubb","doi":"10.7326/ANNALS-26-02923","DOIUrl":"https://doi.org/10.7326/ANNALS-26-02923","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":"179 10","pages":"1522"},"PeriodicalIF":17.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223131","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":"Q&A: The costs of a measles outbreak.","authors":"Jennifer Kearney-Strouse","doi":"10.7326/ANNALS-26-03275-IM","DOIUrl":"10.7326/ANNALS-26-03275-IM","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"IMN101-IMN103"},"PeriodicalIF":17.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668057","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":"Economic Impact of the 2025 New Mexico Measles Outbreak: Highlighting the Cost of Efforts to Prevent Future Outbreaks.","authors":"Jamison Pike, Nora Holzinger, Han Tiffany Xiao, Emma Stanislawski, Jessica Leung, Andrea Romero, Chad Smelser","doi":"10.7326/ANNALS-26-00718","DOIUrl":"10.7326/ANNALS-26-00718","url":null,"abstract":"<p><strong>Background: </strong>In 2025, the United States experienced its highest measles case count since 1992. In New Mexico, 100 confirmed measles cases (99 outbreak-related cases), including 1 death, occurred across 9 counties from February through September 2025.</p><p><strong>Objective: </strong>To estimate the societal economic burden of this outbreak while highlighting public health expenditures for vaccination-related activities that supported outbreak control and prevention of future outbreaks.</p><p><strong>Design: </strong>Cost analysis from a societal perspective to estimate 3 types of costs: public health response costs, direct medical costs, and productivity losses.</p><p><strong>Setting: </strong>Nine counties in New Mexico during February to September 2025.</p><p><strong>Participants: </strong>133 public health responders, 100 patients with confirmed measles, and 205 exposed contacts.</p><p><strong>Intervention: </strong>Public health response activities, including vaccination campaigns, case management, and contact tracing.</p><p><strong>Measurements: </strong>Costs were categorized as response costs (labor, materials, travel), direct medical costs (third-party), or productivity losses (illness, isolation, quarantine, caregiving).</p><p><strong>Results: </strong>The overall societal cost was estimated at $5.4 million ($53 522 per case, or $1817 per contact). The largest component of the public health response to the outbreak (about $3.2 million) was costs from vaccination-related activities (about $2.1 million).</p><p><strong>Limitations: </strong>Costs may be overestimated or underestimated due to incomplete reporting; insurance data were used rather than actual medical costs; certain direct medical costs were excluded; and assumptions were made for productivity losses.</p><p><strong>Conclusion: </strong>These estimates offer important insights for decision making by policymakers and public health stakeholders regarding budgets for and expansion of vaccination coverage during an outbreak and strengthening outbreak preparedness. This study also highlights the societal value of protecting communities from vaccine-preventable diseases like measles, which can be effectively prevented through high vaccination coverage.</p><p><strong>Primary funding source: </strong>None.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"1369-1374"},"PeriodicalIF":17.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148667939","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":"A Synopsis of the 2025 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline for Lipid Management for Cardiovascular Disease Risk Reduction.","authors":"Michael J Arnold, Lance Spacek, Kelvin N V Bush, Ashley Arana Waring, Jennifer Ballard-Hernandez, Darrick Beckman, Catherine Kelley, Sundar Natarajan, Brian E Neubauer, Edward M Phillips, Sophie Roberts, James Sall, Colleen Walsh-Irwin, Paul Heidenreich","doi":"10.7326/ANNALS-26-01374","DOIUrl":"10.7326/ANNALS-26-01374","url":null,"abstract":"<p><strong>Description: </strong>In December 2025, the U.S. Department of Veterans Affairs (VA) and the U.S. Department of Defense (DoD) released a clinical practice guideline (CPG) update on lipid management for cardiovascular disease risk reduction in adults. This synopsis reviews the 2025 updates and describes the major recommendations.</p><p><strong>Methods: </strong>The VA/DoD guideline development team updated the 2020 VA/DoD lipid management CPG with clinical stakeholders. The guideline panel developed 12 key questions, systematically evaluated the literature (English-language publications from 16 May 2019 to 15 January 2025), and developed 24 evidence-based recommendations. The recommendations were graded using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system.</p><p><strong>Recommendations: </strong>This synopsis highlights key recommendations for lipid management that are new or differ from other guideline recommendations. This update recommends the Predicting Risk of Cardiovascular Disease EVENTs (PREVENT) calculator for risk estimation in primary prevention and removes a previous recommendation against routine lipid monitoring. Two new risk refinement strategies were added: Coronary artery calcium testing is suggested for patients with clinical uncertainty and intermediate-to-high calculated risk, and one-time lipoprotein(a) testing is recommended to identify patients with enhanced cardiovascular risk. For primary prevention, moderate-intensity statins remain the recommended treatment for those at higher risk and should be considered for those at intermediate risk. A new recommendation suggests moderate-intensity statins for adults living with HIV even when 10-year risk is low. This update shifts toward more intensive lipid-lowering therapy for secondary prevention. For very high-risk patients with atherosclerotic cardiovascular disease, the guideline now suggests combination therapy with high-intensity or maximally tolerated statins plus ezetimibe and/or proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors. For statin-intolerant patients, alternatives include bempedoic acid, ezetimibe, fibrates, or PCSK9 monoclonal antibody inhibitors.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"1460-1472"},"PeriodicalIF":17.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966121","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":"Expediting Access to Biosimilars: Assessing the U.S. Food and Drug Administration's Revised Approach on Comparative Efficacy.","authors":"Parthay H Rokad, Joseph T Kannarkat, Umesh R Desai","doi":"10.7326/ANNALS-26-02063","DOIUrl":"10.7326/ANNALS-26-02063","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"1492-1493"},"PeriodicalIF":17.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787098","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":"N-Terminal Pro-B-Type Natriuretic Peptide in Older Adults: Biomarker and Barometer of Biological Aging.","authors":"Karen P Alexander","doi":"10.7326/ANNALS-26-02897","DOIUrl":"10.7326/ANNALS-26-02897","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"1500-1501"},"PeriodicalIF":17.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787330","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":"In primary membranous nephropathy, obinutuzumab increased the likelihood of complete remission vs. tacrolimus at 104 wk.","authors":"Medha Airy, Wolfgang C Winkelmayer","doi":"10.7326/ANNALS-26-03622-JC","DOIUrl":"10.7326/ANNALS-26-03622-JC","url":null,"abstract":"<p><strong>Clinical impact ratings: </strong>GIM/FP/GP: [Formula: see text] Nephrology: [Formula: see text].</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"JC114"},"PeriodicalIF":17.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103174","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":"Efficacy and Safety of Glucagon-like Peptide-1 Receptor Agonists and Co-agonists for Weight Loss Among Adults Without Diabetes : An Updated Systematic Review.","authors":"Areesha Moiz, Kristian B Filion, Aaron E Samuels, Michael A Tsoukas, Oriana H Y Yu, Tricia M Peters, Mark J Eisenberg","doi":"10.7326/ANNALS-25-05519","DOIUrl":"10.7326/ANNALS-25-05519","url":null,"abstract":"<p><strong>Background: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used for weight management.</p><p><strong>Purpose: </strong>To update our prior systematic review evaluating the efficacy and safety of GLP-1 RAs and co-agonists among adults with overweight or obesity without diabetes.</p><p><strong>Data sources: </strong>MEDLINE, Embase, and Cochrane Central Register of Controlled Trials from 5 October 2024 through 25 March 2026.</p><p><strong>Study selection: </strong>Randomized controlled trials ([RCTs] treatment duration ≥16 weeks).</p><p><strong>Data extraction: </strong>Two reviewers independently extracted data.</p><p><strong>Data synthesis: </strong>Thirty-eight RCTs (<i>n</i> = 25 816) were included, adding 14 new trials (<i>n</i> = 11 000) to the prior review. Among commercially available therapies, placebo-subtracted weight loss reached up to -5.8% (95% CI, -8.0% to -3.6%) for liraglutide, -14.8% (CI, -16.2% to -13.4%) for subcutaneous semaglutide, -14.3% (CI, -17.2% to -11.4%) for oral semaglutide, -12.4% (CI, -15.1% to -9.7%) for orforglipron, and -19.0% (CI, -21.6% to -16.4%) for tirzepatide. Numerically greater placebo-subtracted reductions were seen with emerging multiagonists, including -23.9% (CI, -29.3% to -18.5%) with amycretin and -22.1% (CI, -24.9% to -19.3%) with retatrutide. Gastrointestinal adverse events (AEs) remained common (GLP-1 RA vs. placebo: 76.0% vs. 40.1%). Discontinuation due to AEs was generally low (10.7% vs. 3.4%) but numerically higher with some oral agents. Serious AEs (6.5% vs. 5.2%) and deaths (0.1% vs. 0.0%) were rare, with no new safety signals identified. Head-to-head data showed greater weight loss with semaglutide and JNJ-64565111 than liraglutide and greater weight loss with tirzepatide and cagrilintide-semaglutide (CagriSema; Novo Nordisk) than semaglutide.</p><p><strong>Limitations: </strong>Heterogeneity precluded quantitative synthesis. Safety outcomes were inconsistently reported.</p><p><strong>Conclusion: </strong>Glucagon-like peptide-1 receptor agonists demonstrate substantial weight loss in adults without diabetes, with an expanding range of therapeutic options, including oral and multiagonist therapies.</p><p><strong>Primary funding source: </strong>None. (PROSPERO: CRD42024505558).</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"1412-1429"},"PeriodicalIF":17.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863342","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":"Health Inequities Training Threatened by Revised Liaison Committee on Medical Education Standards.","authors":"Iman Hassan, Ariana Thompson-Lastad","doi":"10.7326/ANNALS-26-01654","DOIUrl":"10.7326/ANNALS-26-01654","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"1496-1497"},"PeriodicalIF":17.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811786","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":"Artificial Intelligence and the Risk of Self-fulfilling Prophecies.","authors":"David M Maslove","doi":"10.7326/ANNALS-26-02011","DOIUrl":"10.7326/ANNALS-26-02011","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"1498-1499"},"PeriodicalIF":17.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811819","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}