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1. Spironolactone vs Amiloride for Resistant Hypertension: A Randomized Clinical Trial.
作者: Chan Joo Lee.;Sang-Hyun Ihm.;Dong-Ho Shin.;Jin-Ok Jeong.;Ju Han Kim.;Kyeong-Hyeon Chun.;JiWung Ryu.;Hae-Young Lee.;Seonghoon Choi.;Eun Mi Lee.;Jung Hyun Choi.;Kwang-Il Kim.;Jinho Shin.;Wook Bum Pyun.;Dae-Hee Kim.;Sungha Park.;Bryan Williams.
来源: JAMA. 2025年333卷23期2073-2082页
Amiloride has been proposed as an alternative to spironolactone for treating resistant hypertension. However, no randomized clinical trials have compared the efficacy of spironolactone and amiloride in patients with resistant hypertension.
2. Antihypertensive Medication Timing and Cardiovascular Events and Death: The BedMed Randomized Clinical Trial.
作者: Scott R Garrison.;Jeffrey A Bakal.;Michael R Kolber.;Christina S Korownyk.;Lee A Green.;Jessica E M Kirkwood.;Finlay A McAlister.;Raj S Padwal.;Richard Lewanczuk.;Michael D Hill.;Alexander G Singer.;Alan Katz.;Michael D Kelmer.;Armine Gayayan.;Farah N Campbell.;Ana Vucenovic.;Nathan R Archibald.;Jack M S Yeung.;Erik R E Youngson.;Kimberlyn McGrail.;Braden G O'Neill.;Michelle Greiver.;Donna P Manca.;Roni Y Kraut.;Ting Wang.;Braden J Manns.;Dee A Mangin.;Cathy MacLean.;James McCormack.;Sabrina T Wong.;Colleen Norris.;G Michael Allan.
来源: JAMA. 2025年333卷23期2061-2072页
Whether administration of blood pressure medications at bedtime instead of in the morning reduces cardiovascular risk is unknown, as findings from large clinical trials have not been consistent. There is also concern that bedtime antihypertensive use could induce glaucoma-related visual loss or other hypotensive/ischemic adverse effects.
3. Immunogenicity and Safety of Influenza and COVID-19 Multicomponent Vaccine in Adults ≥50 Years: A Randomized Clinical Trial.
作者: Amanda K Rudman Spergel.;Iris Wu.;Weiping Deng.;Jose Cardona.;Kimball Johnson.;Ivette Espinosa-Fernandez.;Melissa Sinkiewicz.;Veronica Urdaneta.;Lizbeth Carmona.;Kristin Schaefers.;Bethany Girard.;Yamuna D Paila.;Darshan Mehta.;Benoit Callendret.;Lusine Kostanyan.;Jintanat Ananworanich.;Jacqueline Miller.;Rituparna Das.;Christine A Shaw.
来源: JAMA. 2025年333卷22期1977-1987页
Uptake of recommended seasonal influenza and COVID-19 vaccines remains suboptimal.
4. Midurethral Sling vs OnabotulinumtoxinA in Females With Urinary Incontinence: The MUSA Randomized Clinical Trial.
作者: Heidi S Harvie.;Shawn A Menefee.;Holly E Richter.;Vivian W Sung.;Christopher J Chermansky.;David D Rahn.;Cindy L Amundsen.;Lily A Arya.;Evan Rhodes.;Donna Mazloomdoost.;Sonia Thomas.; .
来源: JAMA. 2025年333卷21期1887-1896页
Mixed urinary incontinence, which includes both stress and urgency urinary incontinence, adversely affects quality of life and can be difficult to manage. Studies comparing procedural-based treatments for mixed urinary incontinence are lacking.
5. Extended Caffeine for Apnea in Moderately Preterm Infants: The MoCHA Randomized Clinical Trial.
作者: Waldemar A Carlo.;Eric C Eichenwald.;Benjamin A Carper.;Edward F Bell.;Martin Keszler.;Ravi M Patel.;Pablo J Sánchez.;Ronald N Goldberg.;Carl T D'Angio.;Krisa P Van Meurs.;Anna Maria Hibbs.;Namasivayam Ambalavanan.;Shirley S Cosby.;Nancy S Newman.;Betty R Vohr.;Michele C Walsh.;Abhik Das.;Robin K Ohls.;Janell Fuller.;Matthew A Rysavy.;Sarvin Ghavam.;Luc P Brion.;Karen M Puopolo.;Ryan Moore.;Michelle L Baack.;Tarah T Colaizy.;Mariana Baserga.;Ahmed F Osman.;Stephanie L Merhar.;Brenda B Poindexter.;Sara B DeMauro.;Vasanth Kumar.;C Michael Cotten.; .
来源: JAMA. 2025年333卷24期2154-2163页
Hospitalization of moderately preterm infants may be prolonged while waiting for apnea of prematurity to resolve after discontinuing caffeine.
6. Metformin for Knee Osteoarthritis in Patients With Overweight or Obesity: A Randomized Clinical Trial.
作者: Feng Pan.;Yuanyuan Wang.;Yuan Z Lim.;Donna M Urquhart.;Mahnuma Mahfuz Estee.;Anita E Wluka.;Rory Wolfe.;Flavia M Cicuttini.
来源: JAMA. 2025年333卷20期1804-1812页
Preclinical and preliminary human evidence suggests that metformin, a first-line treatment for type 2 diabetes, reduces inflammation, preserves cartilage, and improves knee pain in knee osteoarthritis.
7. Varenicline for Youth Nicotine Vaping Cessation: A Randomized Clinical Trial.
作者: A Eden Evins.;Corinne Cather.;Harrison T Reeder.;Bryn Evohr.;Kevin Potter.;Gladys N Pachas.;Kevin M Gray.;Sharon Levy.;Nancy A Rigotti.;Vanessa Iroegbulem.;Jason Dufour.;Kelly Casottana.;Meghan A Costello.;Jodi M Gilman.;Randi M Schuster.
来源: JAMA. 2025年333卷21期1876-1886页
Electronic cigarette use (vaping) among adolescents and young adults is common. Few treatments have been tested in this population.
8. Intravenous Ferric Carboxymaltose in Heart Failure With Iron Deficiency: The FAIR-HF2 DZHK05 Randomized Clinical Trial.
作者: Stefan D Anker.;Tim Friede.;Javed Butler.;Khawaja M Talha.;Marius Placzek.;Monika Diek.;Anna Nosko.;Adriane Stas.;Stefan Kluge.;Dominik Jarczak.;Geraldine deHeer.;Meike Rybczynski.;Antoni Bayés-Genís.;Michael Böhm.;Andrew J S Coats.;Frank Edelmann.;Gerasimos Filippatos.;Gerd Hasenfuß.;Wilhelm Haverkamp.;Mitja Lainscak.;Ulf Landmesser.;Iain C Macdougall.;Bela Merkely.;Burkert M Pieske.;Fausto J Pinto.;Tienush Rassaf.;Jennifer K Visser-Rogers.;Giuseppe Rosano.;Maurizio Volterrani.;Stephan von Haehling.;Markus S Anker.;Wolfram Doehner.;Hüseyin Ince.;Friedrich Koehler.;Gianluigi Savarese.;Muhammad Shahzeb Khan.;Ursula Rauch-Kröhnert.;Tommaso Gori.;Teresa Trenkwalder.;Ibrahim Akin.;Christina Paitazoglou.;Iwona Kobielusz-Gembala.;Luca Kuthi.;Norbert Frey.;Manuela Licka.;Stefan Kääb.;Karl-Ludwig Laugwitz.;Piotr Ponikowski.;Mahir Karakas.
来源: JAMA. 2025年333卷22期1965-1976页
Uncertainty remains about the efficacy of intravenous iron in patients with heart failure and iron deficiency.
9. Prothrombin Complex Concentrate vs Frozen Plasma for Coagulopathic Bleeding in Cardiac Surgery: The FARES-II Multicenter Randomized Clinical Trial.
作者: Keyvan Karkouti.;Jeannie L Callum.;Justyna Bartoszko.;Kenichi A Tanaka.;Sigurd Knaub.;Sukhpal Brar.;Kamrouz Ghadimi.;Antoine Rochon.;Darren Mullane.;Etienne J Couture.;Yulia Lin.;Christopher Harle.;Michelle Zeller.;Diem T T Tran.;Cristina Solomon.;Vivek Rao.;Michael Law.;Amir L Butt.;Edward P Chen.;Maria Rosal Martins.;Tarit Saha.;Andrew W Shih.;Marie-Claude Vézina.;Fuad Moussa.;Raffael Pereira Cezar Zamper.;Summer Syed.;Hakan Buyukdere.;Sylvia Werner.;Deep Grewal.;Daniel Wong.;Kofi B Vandyck.;Robert Tanzola.;Bevan Hughes.;Olivier Royer.;Sophia Wong.;Jerrold H Levy.; .
来源: JAMA. 2025年333卷20期1781-1792页
Excessive bleeding is a common and prognostically important complication of cardiac surgery. For bleeding related to coagulation factor deficiency, frozen plasma is the most used therapy. Preliminary trials indicate that 4-factor prothrombin complex concentrate (PCC) may be a suitable alternative.
10. Microultrasonography-Guided vs MRI-Guided Biopsy for Prostate Cancer Diagnosis: The OPTIMUM Randomized Clinical Trial.
作者: Adam Kinnaird.;Ferdinand Luger.;Hannes Cash.;Sangeet Ghai.;L Felipe Urdaneta-Salegui.;Christian P Pavlovich.;Joseph Brito.;Neal D Shore.;Julian P Struck.;Martin Schostak.;Niklas Harland.;Moisés Rodriguez-Socarrás.;Wayne G Brisbane.;Giovanni Lughezzani.;Harry Toledano.;Mohammed Salah Ouertani.;Petr Macek.;Christopher Fung.;Wendy Tu.;Andreas Gusenleitner.;Karsten Günzel.;Peter F Incze.;Arvin K George.;José G Pereira.;Robert Jansen.;Joseph Renzulli.;Laurence Klotz.; .
来源: JAMA. 2025年333卷19期1679-1687页
High-resolution microultrasonography-guided biopsy is an alternative to MRI fusion-guided biopsy for prostate cancer diagnosis.
11. Inhaled Sedation in Acute Respiratory Distress Syndrome: The SESAR Randomized Clinical Trial.
作者: Matthieu Jabaudon.;Jean-Pierre Quenot.;Julio Badie.;Jules Audard.;Samir Jaber.;Benjamin Rieu.;Caroline Varillon.;Antoine Monsel.;François Thouy.;Julien Lorber.;Joël Cousson.;Stéphanie Bulyez.;Jérémy Bourenne.;Ghada Sboui.;Claire Lhommet.;Virginie Lemiale.;Belaïd Bouhemad.;Clément Brault.;Sigismond Lasocki.;François Legay.;Thomas Lebouvier.;Arthur Durand.;Julien Pottecher.;Alexandre Conia.;Delphine Brégeaud.;Lionel Velly.;Arnaud W Thille.;Fabien Lambiotte.;Erwan L'Her.;Mehran Monchi.;Antoine Roquilly.;Aziz Berrouba.;Franck Verdonk.;Russell Chabanne.;Thomas Godet.;Marc Garnier.;Raiko Blondonnet.;Jérémy Vernhes.;Vincent Sapin.;Lucile Borao.;Emmanuel Futier.;Bruno Pereira.;Jean-Michel Constantin.; .
来源: JAMA. 2025年333卷18期1608-1617页
Whether the use of inhaled or intravenous sedation affects outcomes differentially in mechanically ventilated adults with acute respiratory distress syndrome (ARDS) is unknown.
12. Atezolizumab in High-Risk Locally Advanced Squamous Cell Carcinoma of the Head and Neck: A Randomized Clinical Trial.
作者: Robert Haddad.;Jérôme Fayette.;Maria Teixeira.;Kumar Prabhash.;Ricard Mesia.;Andrzej Kawecki.;Arunee Dechaphunkul.;José Dinis.;Ye Guo.;Muneyuki Masuda.;Ching-Yun Hsieh.;Maria Grazia Ghi.;Claudia Vaz de Melo Sette.;Kevin Harrington.;Makoto Tahara.;Nabil F Saba.;Agnes Lau.;Tao Jiang.;Yibing Yan.;Marcus Ballinger.;Monika Kaul.;Christina Matheny.;Vaikunth Cuchelkar.;Deborah J Wong.
来源: JAMA. 2025年333卷18期1599-1607页
Treating locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) involves any combination of surgery, radiation, and chemotherapy, followed by routine monitoring for local recurrence or distant metastases. Given the poor patient outcomes, a significant unmet clinical need for improved treatment options remains.
13. Adjuvant PD-1 Blockade With Camrelizumab for Nasopharyngeal Carcinoma: The DIPPER Randomized Clinical Trial.
作者: Ye-Lin Liang.;Xu Liu.;Liang-Fang Shen.;Guang-Yuan Hu.;Guo-Rong Zou.;Ning Zhang.;Chuan-Ben Chen.;Xiao-Zhong Chen.;Xiao-Dong Zhu.;Ya-Wei Yuan.;Kun-Yu Yang.;Feng Jin.;Wei-Han Hu.;Fang-Yun Xie.;Ying Huang.;Fei Han.;Ling-Long Tang.;Yan-Ping Mao.;Li-Xia Lu.;Rui Sun.;Yu-Xiang He.;Yang-Ying Zhou.;Guo-Xian Long.;Jie Tang.;Lu-Si Chen.;Jing-Feng Zong.;Ting Jin.;Ling Li.;Jie Lin.;Jing Huang.;Xiu-Yun Gong.;Guan-Qun Zhou.;Lei Chen.;Wen-Fei Li.;Yu-Pei Chen.;Cheng Xu.;Li Lin.;Shao-Hui Huang.;Sai-Wei Huang.;Ya-Qin Wang.;Cheng-Long Huang.;Hui-Xia Feng.;Min Hou.;Chun-Hua Chen.;Su-Fen Zheng.;Ying-Qing Li.;Shu-Bin Hong.;Yu-Sheng Jie.;Hao Li.;Jing-Ping Yun.;Sheng-Bing Zang.;Song-Ran Liu.;Qing-Guang Lin.;Hao-Jiang Li.;Li Tian.;Li-Zhi Liu.;Hong-Yun Zhao.;Ji-Bin Li.;Ai-Hua Lin.;Na Liu.;Yuan Zhang.;Rui Guo.;Jun Ma.;Ying Sun.
来源: JAMA. 2025年333卷18期1589-1598页
Approximately 20% to 30% of patients with locoregionally advanced nasopharyngeal carcinoma (NPC) experience disease relapse despite definitive chemoradiotherapy. The programmed cell death 1 (PD-1) blockade camrelizumab has demonstrated considerable value in recurrent or metastatic NPC, while its role in locoregionally advanced NPC is unclear.
14. High-Dose Vitamin D in Clinically Isolated Syndrome Typical of Multiple Sclerosis: The D-Lay MS Randomized Clinical Trial.
作者: Eric Thouvenot.;David Laplaud.;Christine Lebrun-Frenay.;Nathalie Derache.;Emmanuelle Le Page.;Elisabeth Maillart.;Caroline Froment-Tilikete.;Giovanni Castelnovo.;Olivier Casez.;Marc Coustans.;Anne-Marie Guennoc.;Olivier Heinzlef.;Laurent Magy.;Chantal Nifle.;Xavier Ayrignac.;Agnès Fromont.;Nicolas Gaillard.;Nathalie Caucheteux.;Ivania Patry.;Jérôme De Sèze.;Romain Deschamps.;Pierre Clavelou.;Damien Biotti.;Gilles Edan.;William Camu.;Hanane Agherbi.;Dimitri Renard.;Christophe Demattei.;Pascale Fabbro-Peray.;Thibault Mura.;Manon Rival.; .
来源: JAMA. 2025年333卷16期1413-1422页
Vitamin D deficiency is a risk factor for multiple sclerosis (MS) and is associated with the risk of disease activity, but data on the benefits of supplementation are conflicting.
15. Effects of Combining Coronary Calcium Score With Treatment on Plaque Progression in Familial Coronary Artery Disease: A Randomized Clinical Trial.
作者: Nitesh Nerlekar.;Sheran A Vasanthakumar.;Kristyn Whitmore.;Cheng Hwee Soh.;Jasmine Chan.;Vinay Goel.;Jacqueline Ryan.;Catherine Jones.;Tony Stanton.;Geoffrey Mitchell.;Andrew Tonkin.;Gerald F Watts.;Stephen J Nicholls.;Thomas H Marwick.; .
来源: JAMA. 2025年333卷16期1403-1412页
Coronary artery calcium (CAC) scoring provides prognostic information, especially in patients at intermediate risk for coronary artery disease (CAD). However, the benefit of combining CAC score with a primary prevention strategy has not been tested in a randomized trial.
16. First-Line Sugemalimab Plus Chemotherapy for Advanced Gastric Cancer: The GEMSTONE-303 Randomized Clinical Trial.
作者: Xiaotian Zhang.;Jufeng Wang.;Gang Wang.;Yanqiao Zhang.;Qingxia Fan.;Chuangxin Lu.;Changlu Hu.;Meili Sun.;Yiye Wan.;Sanyuan Sun.;Junye Wang.;Li Zhang.;Yongqian Shu.;Jie Luo.;Dan Zhu.;Zhenwei Shen.;Sheng Yao.;Qingmei Shi.;Jason Yang.;Lin Shen.; .
来源: JAMA. 2025年333卷15期1305-1314页
Gastric cancer, including gastroesophageal junction cancer, is one of the most commonly diagnosed cancers worldwide, with high mortality. Sugemalimab is a fully human anti-programmed death-ligand 1 (PD-L1) antibody. The combination of sugemalimab and chemotherapy showed promising antitumor activity and safety in a phase 1b study among patients with treatment-naive, unresectable, locally advanced or metastatic gastric or gastroesophageal junction adenocarcinoma. This combination was further evaluated in the GEMSTONE-303 phase 3 trial.
17. Evaluation of a Clinical Decision Support System for Imaging Requests: A Cluster Randomized Clinical Trial.
作者: Stijntje W Dijk.;Claudia Wollny.;Joerg Barkhausen.;Olav Jansen.;Peter Mildenberger.;Moritz C Halfmann.;Jonas Stroeder.;Dimitris Rizopoulos.;M G Myriam Hunink.;Thomas Kroencke.
来源: JAMA. 2025年333卷14期1212-1221页
Given the widespread use of medical imaging, evaluating the effectiveness of interventions to improve appropriateness is crucial for optimizing health care resources and patient outcomes.
18. Simvastatin and Rifaximin in Decompensated Cirrhosis: A Randomized Clinical Trial.
作者: Elisa Pose.;César Jiménez.;Giacomo Zaccherini.;Daniela Campion.;Salvatore Piano.;Frank Erhard Uschner.;Koos de Wit.;Olivier Roux.;Kohilan Gananandan.;Wim Laleman.;Cristina Solé.;Sonia Alonso.;Berta Cuyàs.;Xavier Ariza.;Adrià Juanola.;Ann T Ma.;Laura Napoleone.;Jordi Gratacós-Ginès.;Marta Tonon.;Enrico Pompili.;Jordi Sánchez-Delgado.;Andrew S Allegretti.;Manuel Morales-Ruiz.;Marta Carol.;Martina Pérez-Guasch.;Núria Fabrellas.;Judit Pich.;Claudia Martell.;María Joyera.;Gemma Domenech.;José Ríos.;Ferrán Torres.;Miquel Serra-Burriel.;Rubén Hernáez.;Elsa Solà.;Isabel Graupera.;Hugh Watson.;Germán Soriano.;Rafael Bañares.;Rajeshwar P Mookerjee.;Claire Francoz.;Ulrich Beuers.;Jonel Trebicka.;Paolo Angeli.;Carlo Alessandria.;Paolo Caraceni.;Víctor M Vargas.;Juan G Abraldes.;Patrick S Kamath.;Pere Ginès.; .
来源: JAMA. 2025年333卷10期864-874页
There are no useful treatments to prevent the development of severe complications of liver cirrhosis. Simvastatin and rifaximin have shown beneficial effects in liver cirrhosis.
19. Palliative Care Program for Community-Dwelling Individuals With Dementia and Caregivers: The IN-PEACE Randomized Clinical Trial.
作者: Greg A Sachs.;Nina M Johnson.;Sujuan Gao.;Alexia M Torke.;Susan E Hickman.;Amy Pemberton.;Andrea Vrobel.;Minmin Pan.;Jennifer West.;Kurt Kroenke.
来源: JAMA. 2025年333卷11期962-971页
Care management benefits community-dwelling patients with dementia, but studies include few patients with moderate to severe dementia or from racial and ethnic minority populations, lack palliative care, and seldom reduce health care utilization.
20. Health System, Community-Based, or Usual Dementia Care for Persons With Dementia and Caregivers: The D-CARE Randomized Clinical Trial.
作者: David B Reuben.;Thomas M Gill.;Alan Stevens.;Jeff Williamson.;Elena Volpi.;Maya Lichtenstein.;Lee A Jennings.;Rebecca Galloway.;Jenny Summapund.;Katy Araujo.;David Bass.;Lisa Weitzman.;Zaldy S Tan.;Leslie Evertson.;Mia Yang.;Katherine Currie.;Aval-Na'Ree S Green.;Sybila Godoy.;Sitara Abraham.;Jordan Reese.;Rafael Samper-Ternent.;Roxana M Hirst.;Pamela Borek.;Peter Charpentier.;Can Meng.;James Dziura.;Yunshan Xu.;Eleni A Skokos.;Zili He.;Sherry Aiudi.;Peter Peduzzi.;Erich J Greene.; .
来源: JAMA. 2025年333卷11期950-961页
The effectiveness of different approaches to dementia care is unknown.
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