NEJM This Week

This week, we explore a phase 3 trial of finerenone in type 1 diabetes and chronic kidney disease and guidance on timing of nonculprit-lesion PCI after STEMI. We cover an investigational therapy for Dravet syndrome and neoadjuvant treatment for high-risk intrahepatic cholangiocarcinoma. We review the effects of radiotherapy on normal tissue, a puzzling case of progressive neurologic decline after suspected foodborne illness, and Perspectives on private equity, the AHEAD model, and medical credit cards.

This week, we explore a new standard of care for high-risk HER2-positive early breast cancer, long-acting therapy for people with HIV facing adherence challenges, a first-in-class trial of a p53 reactivator, and tecovirimat for mpox. We review group B streptococcal disease and a revealing case of prosthetic joint infection. Perspectives examine the role of folate therapy, Medicare drug-price negotiation, AI in medical education, and incidental findings.

This week, we highlight major advances in multiple myeloma, gene therapy for cystinosis, and experimental treatments for myotonic dystrophy. We review long-term outcomes of aortic-valve replacement, strategies for secondary stroke prevention, and a revealing diagnostic case of eosinophilic disease in an older adult. A Sounding Board explores FDA approval standards. Perspectives delve into tobacco cessation, influenza evolution, and the uncertainty patients and clinicians share when facing life-altering diagnoses.

This week includes studies on promising new therapies for IgA nephropathy, evolving antithrombotic strategies after coronary stenting, and the inciting antigen in rare vaccine-related clotting syndromes. We review the urgent challenge of mucormycosis and follow the case of a young woman with headaches and hypertension. We discuss human-subjects research. Perspectives examine rural health, data interoperability, drug labels in the courts, and a pediatrician’s dilemma.

This week, we look at new evidence on oral cholesterol-lowering therapy, the evolving role of beta-blockers after myocardial infarction, and advances in breast and prostate cancer treatment. We review the inherited risk of coronary disease. We also work through a revealing diagnostic case in a young woman and reflect on science under pressure, corporatized insurance, the reach of FDA law, and what it means to live with life-sustaining technology.