NEJM.org

Treatment for myeloproliferative neoplasms focuses on alleviating symptoms, preventing thrombotic complications, controlling myeloproliferation, and restoring physiologic cell counts, given that these factors strongly affect quality of life and mortality. Learn more: https://nej.md/4wD0AWG

In a trial involving couples with unexplained infertility, four cycles of intrauterine insemination with ovarian stimulation was not noninferior to one complete cycle of IVF with respect to the cumulative live-birth rate. Full FIIX trial results: https://nej.md/4zjmDnL

Shazia Siddique, MD, MSHP, explains how the common belief that race is biological in nature is now being challenged on the grounds that race is instead socially constructed. Watch the full Perspective Roundtable: https://nej.md/4ivgrCN

𝐍𝐨𝐰 𝐚𝐯𝐚𝐢𝐥𝐚𝐛𝐥𝐞 𝐢𝐧 𝑵𝑬𝑱𝑴 𝑬𝒗𝒊𝒅𝒆𝒏𝒄𝒆! A new Public Health Alerts report, published in partnership with @cidrap.bsky.social: Colorectal Cancer among U.S. Adults, 2000–2023 https://eviden.cc/4jCoSxi #Oncology #Gastroenterology

𝐍𝐨𝐰 𝐚𝐯𝐚𝐢𝐥𝐚𝐛𝐥𝐞 𝐢𝐧 𝑵𝑬𝑱𝑴 𝑬𝒗𝒊𝒅𝒆𝒏𝒄𝒆! A new Public Health Alerts report, published in partnership with @cidrap.bsky.social: Domestic Measles Importations in Washington State, January 2026 https://eviden.cc/4sIU8gN #InfectiousDisease

Figure 4 from a new Review Article shows the algorithm for empirical 𝘏. 𝘱𝘺𝘭𝘰𝘳𝘪 treatment. Rifabutin-based triple therapy has been suggested as a first-line treatment option in the United States; however, it is generally reserved as a third-line rescue therapy. Learn more: https://nej.md/4Bj3O58

A man presented with a 3-month history of cough, dyspnea, and fatigue. CT showed a pleural effusion with thickening and enhancement of the parietal and visceral pleura. Examination of pleural fluid showed cholesterol crystals. Read the full case details: https://nej.md/3U6SloO

In patients with 𝘌𝘎𝘍𝘙-mutated and MET-altered non–small-cell lung cancer that had progressed during osimertinib therapy, osimertinib plus savolitinib (a MET tyrosine kinase inhibitor) led to longer survival than platinum–pemetrexed. Full phase 3 SAFFRON trial results: https://nej.md/4hXdueb #ESMO26

In patients with previously treated advanced non–small-cell lung cancer with a 𝘒𝘙𝘈𝘚 G12C mutation, median progression-free survival was 9.8 months with the KRAS G12C inhibitor divarasib and 5.7 months with sotorasib or adagrasib. Full phase 3 Krascendo 1 trial results: https://nej.md/4BiCvbk #ESMO26

Among patients with PD-L1–negative advanced nonsquamous NSCLC, progression-free survival was longer with sacituzumab tirumotecan plus pembrolizumab than with chemotherapy plus pembrolizumab (15.0 vs. 5.7 months). Full phase 3 OptiTROP-Lung06 trial results: https://nej.md/4Bo3liu #ESMO26

Joseph L. Wright, MD, MPH, describes how a critique of a clinical practice guideline on urinary tract infections in young children led to a broader re-examination of race in clinical guidance. Watch the full Perspective Roundtable: https://nej.md/4ivgrCN

Small-cell lung cancer is one of the most aggressive and lethal cancers worldwide. Although treatments have improved overall survival, most patients ultimately have disease progression. Research findings from the TAISHAN-302 trial are summarized in a new Quick Take video. https://nej.md/4hZz1CY

In a prespecified interim analysis of a phase 3 trial involving patients with extensive-stage SCLC, the median overall survival was 21.1 months with tarlatamab–durvalumab maintenance therapy and 12.7 months with durvalumab alone. Full DeLLphi-305 trial results: https://nej.md/4iveIgW #ESMO26

In patients with muscle-invasive bladder cancer, event-free survival at 24 months was 63.5% with perioperative durvalumab plus neoadjuvant enfortumab vedotin as compared with 45.1% with surgery alone. Full phase 3 VOLGA trial results: https://nej.md/4z7dQFm #ESMO26

A 19-year-old man who had undergone splenectomy at 5 years of age for hereditary spherocytosis presented to the emergency department with a 1-day history of sharp pain in the right wall of the chest. Read the full case details and submit your answer: https://nej.md/IC10222026

Among patients with HER2-positive advanced breast cancer, the HER2-targeted bispecific antibody anbenitamab plus albumin-bound docetaxel led to 24-month progression-free survival of 58.5%, as compared with 34.4% with standard therapy. Full HEALER trial results: https://nej.md/4BcWlF3 #ESMO26

Among patients with salvageable tissue 24 to 72 hours after stroke, physical function at 90 days was better with thrombectomy than with medical care alone, but intracerebral hemorrhage and death were more common with thrombectomy. Full LATE-MT trial results: https://nej.md/3VWTUpV

Among patients with mild stroke from large-vessel occlusion, 69.4% had a favorable functional outcome at 90 days with endovascular therapy plus medical management, as compared with 50.0% with medical management alone. Full MILD-MT trial results: https://nej.md/4hWstFc

A new Perspective Roundtable explores the history, rationale, process, and effects of eliminating the inappropriate and inequitable use of race in clinical algorithms. View the full video and transcript: nej.md/4ivgrCN

A new study develops and externally validates an AI-enhanced digital auscultation system for detecting left ventricular dysfunction using prospective multicenter data. Learn more: https://nejm.ai/3W3zag4

There are currently no approved therapies available for Sjögren’s disease, and trials of multiple biologic and targeted approaches have been negative or inconclusive. Research findings are summarized in a new Quick Take video. https://nej.md/4BcjQxL

Among participants with IgA nephropathy, povetacicept, a dual inhibitor of B-cell activating factor and a proliferation-inducing ligand, led to a significantly greater reduction in proteinuria than placebo. Full phase 3 RAINIER AIS-D08 trial results: https://nej.md/3VWcGh6 #KidneyWk

An interim analysis of a phase 3 randomized trial involving adults with IgA nephropathy showed that ravulizumab, a terminal complement inhibitor, led to a significantly greater reduction in proteinuria than placebo. Full I CAN trial results: https://nej.md/4iwTFdS #KidneyWk

In a new NEJM Voices blog post, Dr. Kemi Doll writes that being the first to do something differently is not a comfortable position, but this is how unspoken norms change in the workplace. Learn more and sign up for email alerts: https://nej.md/3WFMFCR

Does adding milvexian to antiplatelet therapy after acute coronary syndrome reduce cardiovascular death, myocardial infarction, or ischemic stroke? Research findings are summarized in a new Quick Take video. https://nej.md/4BjwM56

Case Records of the MGH: A 52-year-old man with metastatic small-cell lung cancer was evaluated in the ophthalmology clinic because of vision loss in the left eye. A blood cytomegalovirus DNA viral load was 348 IU per milliliter. A diagnosis was made. Full case details: https://nej.md/4iudbYq

In a phase 3, double-blind, randomized trial involving patients with IgA nephropathy, sibeprenlimab stabilized the eGFR slope over 24 months, consistent with a reduced risk of kidney-function decline. Full VISIONARY trial results: https://nej.md/4z3QsZg #KidneyWk | @asnkidney.bsky.social

In patients with IgA nephropathy, atacicept, a human TACI–Fc fusion protein that modulates B-cell activity, slowed and stabilized the decline in the eGFR as compared with placebo. Full phase 3 ORIGIN 3 trial results: https://nej.md/4dJYTAo #KidneyWk | @asnkidney.bsky.social

New in NEJM: Milvexian after Acute Coronary Syndrome Event Ianalumab for Sjögren’s Disease Response-Tailored Antibiotic Treatment for Endocarditis Tambotatug Pelitecan in Small-Cell Lung Cancer Explore the full issue: https://nej.md/current-issue

A 36-year-old woman presented with a 6-year history of gradually worsening low back pain and intermittent night sweats. On examination, she had a sharp, kyphotic angulation of the lower spine. Read the full case details: https://nej.md/4yZSdX9

The discovery of 𝘏. 𝘱𝘺𝘭𝘰𝘳𝘪 has advanced the prevention and treatment of gastritis, peptic ulcers, and gastric cancer. Progress has been made in the research of 𝘏. 𝘱𝘺𝘭𝘰𝘳𝘪 infection. These advances are discussed in a new review. Read the full review: https://nej.md/4Bj3O58

NEPTUNUS-1 and NEPTUNUS-2: In 2 trials involving patients with active Sjögren’s disease, decreases in disease activity at 48 weeks were greater with monthly ianalumab than with placebo, but differences in response rates and symptom scores were not significant. Full results: https://nej.md/3VU4TAp

“I have been asked, many times, to say the things to a patient that will make them understand they cannot drink anymore. I have told those families quite honestly that I wished I knew those words.” Friday’s @nejm.org Voices voices.nejm.org/doi/full/10....

Full adherence to daily antiretroviral therapy for HIV can be challenging. In a phase 3b trial in Kenya, South Africa, and Uganda, a long-acting ART regimen was noninferior to daily ART use. Full IMPALA trial results and Research Summary: https://nej.md/4jWdqMY

Vo and colleagues report AAV integration in a paraspinal neoplasm after gene therapy. The integrated sequence retained a CAG promoter–enhancer and activated a developmental transcription factor. Read the full report: https://nej.md/4jVtf6z

On AI Grand Rounds, Dr. Michal Nedoszytko of Abridge explains how AI can help physicians gather better information before an encounter, improve the quality of conversations with patients, and prototype solutions to problems that clinicians experience every day. Listen now: https://nejm.ai/ep47

A new article summarizes the assessment and treatment of adult attention deficit–hyperactivity disorder, with an emphasis on common psychiatric and medical coexisting conditions and combined pharmacologic and psychosocial care. Full article with interactive graphic: https://nej.md/4s25aNL