Secondary endpoint analyses in the NHS-Galleri randomized controlled trial, testing a multi-cancer early detection test added to usual care, provide insights on the performance of the blood-based test...

Objective To compare the risk of renal deterioration under treatment with glucagon-like peptide-1 (GLP-1) receptor agonists or sodium-glucose contransporter-2 (SGLT-2) inhibitors versus other second l...

Objectives To investigate associations between current use of menopausal hormone therapy and development of venous thromboembolism, ischaemic stroke, and myocardial infarction. Design Nationwide nest...

IgG4-related disease is a chronic fibroinflammatory condition that can affect virtually any organ system. Glucocorticoid agents are a cornerstone of therapy but are limited by toxic effects, and re...

Once-daily, single-tablet regimens have transformed care for persons living with human immunodeficiency virus type 1 (HIV-1); however, challenges to adherence continue to limit effective treatment....

The effectiveness and safety of statins for the primary prevention of cardiovascular events and the extension of disability-free survival among older adults remain uncertain. We conducted a double-...

BACKGROUND: Giant cell arteritis is associated with increased cardiovascular risk, potentially related to systemic inflammation, vascular injury, and glucocorticoid exposure. Whether steroid-sparing therapies differentially influence cardiovascular outcomes in giant cell arteritis remains uncertain. METHODS: We conducted a nationwide observational cohort study emulating a target trial using the French National Health Data System from January 1, 2012, to December 31, 2024. We included patients hospitalized for incident giant cell arteritis who initiated tocilizumab or methotrexate within 6 months after discharge. The primary outcome was the first major adverse cardiovascular event, defined as any coronary event, ischemic stroke, or all-cause death. Treatment effects were estimated with a clone-censor-weight approach with inverse probability of censoring weighting. We estimated 2-year cumulative incidences, absolute risk differences, and hazard ratios with 95% CIs. RESULTS: In 1997 patients with incident giant cell arteritis (mean age, 73.1±8.3 years; 70.4% women), 1095 initiated tocilizumab and 902 initiated methotrexate within 6 months after discharge. At 2 years, the cumulative incidence of major adverse cardiovascular events was 6.4% (95% CI, 4.9%–7.9%) with tocilizumab and 10.7% (95% CI, 8.4%–12.9%) with methotrexate (risk difference, −4.3% [95% CI, −6.6% to −1.7%]). Tocilizumab initiation was associated with a lower risk of major adverse cardiovascular events (hazard ratio, 0.60 [95% CI, 0.48–0.75]), driven by fewer coronary events (hazard ratio, 0.55 [95% CI, 0.37–0.84]) and all-cause deaths (hazard ratio, 0.53 [95% CI, 0.36–0.74]). Results were consistent in sensitivity analyses using alternative grace periods, corticosteroid dose thresholds, restriction to the 2017 to 2024 period, and a per-protocol–analogous approach. Negative control outcomes did not differ meaningfully between treatment strategies. CONCLUSIONS: In this nationwide target trial emulation of incident giant cell arteritis, initiation of tocilizumab was associated with a lower risk of major adverse cardiovascular events compared with methotrexate, primarily through a reduction in coronary events and all-cause deaths. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT07459335. Graphical Abstract

Raynaud phenomenon (RP), a vascular disorder affecting the small arteries and arterioles of the extremities, is characterized by episodic vasospastic attacks. In primary RP (PRP), these episodes cause...

AIM: The “2026 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery” provides recommendations to guide clinicians in the perioperative ca...

PURPOSEExcess weight is a key modifiable risk factor for breast cancer. Glucagon-like peptide-1 receptor agonists (GLP-1) promote weight loss and improve metabolic health, but their effect on breast cancer risk remains unclear.METHODSWe conducted a ...

Anitocabtagene autoleucel (anito-cel), a B-cell maturation antigen (BCMA)–directed autologous chimeric antigen receptor (CAR) T-cell therapy with a synthetic d-domain binder (ddBCMA), may have effi...

Narcolepsy type 1 is characterized by excessive daytime sleepiness, cataplexy, disrupted sleep, sleep paralysis, and hypnagogic or hypnopompic hallucinations. Oveporexton (TAK-861), an oral orexin ...

Current U.S. and European guidelines recommend oral anticoagulation as a class IIa indication in patients with atrial fibrillation at intermediate risk for stroke; however, evidence from randomized...

In stable patients with previous myocardial infarction, left ventricular ejection fraction ≥40%, no heart failure, and no other indication for β-blocker therapy, discontinuation met the non-inferiorit...

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Metabolic acidosis is common in critically ill patients and is associated with organ dysfunction and death. Sodium bicarbonate is used to correct acidemia, but its benefit in patients with metaboli...

More evidence is needed to inform recommendations for intervals of colonoscopy surveillance after polyp removal. In this ongoing noninferiority trial conducted in eight European countries, we rando...

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This cohort study examines the absolute risk of progression to cognitive impairment and rates of cognitive decline per the blood-based biomarker plasma phosphorylated tau 217 (p-tau217) among cognitiv...

BACKGROUND: Patients with peripheral artery disease (PAD) are at high risk of major adverse limb events (MALE) and major adverse cardiovascular events (MACE). Recently, bempedoic acid was shown to red...

Clostridioides difficile infection is a common cause of clinically significant diarrhea, often becomes recurrent, and can be fatal when severe or fulminant. The purpose of this America Gastroenterolog...

Mitapivat significantly reduced the transfusion burden and was generally well tolerated, showing a favourable benefit–risk profile. These findings support mitapivat as the first oral disease-modifying...

Catheter ablation did not demonstrate superiority over a sham procedure for improving atrial fibrillation-related quality of life at 6 months.

The hereditary adenomatous colorectal polyposis syndromes are incurable, systemic, cancer risk predisposition syndromes with substantial morbidity...

Studies of obinutuzumab, a type II anti-CD20 antibody, have shown efficacy in the treatment of hematologic cancers and autoimmune diseases. An evaluation of the efficacy and safety of obinutuzumab ...

Complete coronary-artery revascularization is recommended in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease, but the preferred strategy for identifying non...

Induction chemotherapy has long been a key component of curative therapy for fit patients with acute myeloid leukemia (AML), despite its frequently severe side effects and substantial health care u...

This randomized clinical trial evaluates whether initiating dapagliflozin, compared with placebo, 1 day prior to elective cardiac surgery reduces the incidence of acute kidney injury at 7 days after s...

Caffeine is one of the most commonly consumed drugs in the world. It is found in various naturally occurring substances and can be ingested in a synthetically derived pure form. The majority of human subject–based research is observational and has focused on beverages and foods that contain caffeine. The relationships between caffeine and cardiovascular risk factors and diseases are complex, exhibiting heterogeneity depending on the nature of the caffeine consumed and individual-level propensities. Acute versus chronic caffeine-associated cardiovascular effects are often different. Most studies suggest an inverse J-shaped relationship between consumption of naturally occurring caffeinated products and blood pressure. Data on relationships between caffeine and diabetes are not consistent, but habitual coffee consumption has been associated with a lower risk of incident type 2 diabetes. Whereas no clear relationship between caffeine and blood lipids is evident, unfiltered coffee raises low-density lipoprotein cholesterol. Caffeine, studied primarily in the context of coffee, has been shown either to have no relationship or to be associated with a lower risk of coronary artery disease and heart failure. Randomized controlled trial data among regular caffeinated coffee drinkers showed that caffeinated coffee decreases the risk of atrial fibrillation occurrence but increases the frequency of premature ventricular contractions. Data are fairly consistent that moderate caffeine consumption, again studied primarily in the setting of coffee consumption, was associated with a lower risk of stroke. Data on high doses of caffeine such as that found in energy drinks are limited and generally suggest cardiovascular harm.