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61. Patient-Centered Prescription Opioid Tapering Methods : A Randomized Clinical Trial.
作者: Beth D Darnall.;Luzmercy Perez.;Ming-Chih Kao.;Kate Lorig.;Aram S Mardian.;Pamela Flood.;Ting Pun.;Eric R Hanson.;William Brose.;Chwen-Yuen A Chen.;Matthias Cheung.;Luana Colloca.;Korina De Bruyne.;Naomi Edelson.;Eileen Kim.;Mark McGovern.;Nathaniel Moore.;Bruce D Nicholson.;Joel Porter.;Heather Poupore-King.;Vafi Salmasi.;Richard L Stieg.;Lanja S Sinjary.;Jiapeng Xu.;Juliette Hong.;Lu Tian.;Sean C Mackey.
来源: Ann Intern Med. 2026年
Evidence is needed on tapering long-term prescription opioids in outpatient settings.
62. In mechanically ventilated ICU patients, low vs. high physical restraint use did not differ for days free of delirium or coma at 14 d.
GIM/FP/GP: [Formula: see text] Critical Care: [Formula: see text] Pulmonology: [Formula: see text].
65. In HIV-1, bictegravir-lenacapavir was noninferior to continued complex regimens for maintaining viral suppression at 48 wk.
GIM/FP/GP: [Formula: see text] Infectious Disease: [Formula: see text].
66. In patients with asthma, macrolides vs. placebo or standard care reduce severe exacerbations and improve symptom control at ≤48 wk.
GIM/FP/GP: [Formula: see text] Allerg & Immunol: [Formula: see text] Pulmonology: [Formula: see text].
67. The Comparative Effectiveness of Carvedilol Versus Other Nonselective β-Blockers in Cirrhosis.
作者: Tracey G Simon.;Yichi Zhang.;Anna Kehoe.;Raymond T Chung.;Kueiyu Joshua Lin.
来源: Ann Intern Med. 2026年
In cirrhosis, nonselective β-blockers (NSBBs; carvedilol, nadolol, and propranolol) reduce hepatic portal pressure and have demonstrated benefit versus placebo for preventing decompensation. Although carvedilol has emerged as the preferred NSBB, direct evidence remains limited about its effectiveness for preventing decompensation and death versus other NSBBs.
69. In moderate or severe PTS with iliac-vein obstruction, adding EVT to SC reduced PTS severity and increased bleeding at 6 mo.
GIM/FP/GP: [Formula: see text] Hematology: [Formula: see text].
71. In atherosclerotic CVD, intensive vs. conventional LDL-C level targeting reduced a composite of CV events at a median 3 y.
GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text].
72. In intermediate-risk PE, adding US-CDT to anticoagulation reduced a composite adverse clinical outcome within 7 d.
Emergency Med: [Formula: see text] GIM/FP/GP: [Formula: see text] Hematology: [Formula: see text].
74. In acute hypoxemic respiratory failure, high-flow vs. standard oxygen therapy did not reduce mortality at 28 d.
Emergency Med: [Formula: see text] GIM/FP/GP: [Formula: see text] Critical Care: [Formula: see text] Pulmonology: [Formula: see text].
76. Adverse Events After Same-Day COVID-19 and Influenza Vaccination Versus Influenza Vaccination Alone : A Target Trial Emulation.
Safety studies of the COVID-19 vaccine have identified some adverse events. Yet newer variant-updated formulations, along with increased hybrid immunity, may change these risks. Early-era safety data may not reflect experience with updated formulations in more immune-experienced populations.
77. Leveraging Real-World Evidence to Inform Regulatory, Clinical, and Coverage Decisions Related to Glucagon-Like Peptide-1-Based Therapies: Synopsis of a National Institute of Diabetes and Digestive and Kidney Diseases Workshop.
作者: David Arterburn.;Lesley H Curtis.;Sengwee Toh.;Marie C Bradley.;David D'Alessio.;Noelia Duchovny.;David Hines.;Kimberly Narain.;Anand Parekh.;Asheley Skinner.;Christina C Wee.;John B Wong.;Davene R Wright.;Stavroula K Osganian.;Craig Hales.
来源: Ann Intern Med. 2026年
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have transformed obesity and diabetes management, with rapidly expanding indications and use among U.S. adults. Despite their promise, key questions remain about optimal treatment pathways, long-term safety, effectiveness across diverse populations, adherence, and economic impact. Real-world evidence (RWE) derived from electronic health records, claims, and other data sources could address these gaps, but unique challenges complicate its use, such as inconsistent insurance coverage, high discontinuation rates, medication shortages, compounded formulations, and off-label prescribing. To explore these issues, the National Institute of Diabetes and Digestive and Kidney Diseases convened a workshop in May 2025 with experts from regulatory agencies, guideline committees, payers, and academia. Discussions focused on identifying knowledge gaps in GLP-1RA use, evaluating how RWE informs practice, assessing limitations of real-world data, and strategies to reduce bias in RWE. Presentations emphasized RWE's potential to complement randomized trials by capturing rare adverse events, long-term outcomes, and effectiveness in routine care. However, persistent challenges include data reliability, confounding, and incomplete capture of medication use and outcomes, particularly in pediatric and underserved populations. Coverage decisions remain heterogeneous across Medicare, Medicaid, and private payers and across time, underscoring the need for rigorous cost-benefit analyses. The workshop concluded that robust RWE is essential for developing value-based coverage policies and optimizing GLP-1RA use. Continued investment in high-quality data infrastructure and analytic methods will be critical to inform regulatory, clinical, and economic decisions as utilization expands.
78. Methodological Approaches to Real-World Evidence Generation for Glucagon-like Peptide-1-Based Therapies: Synopsis of a National Institute of Diabetes and Digestive and Kidney Diseases Workshop.
作者: Lesley H Curtis.;David Arterburn.;Sengwee Toh.;Jingchuan Guo.;Miguel A Hernán.;Esti Iturralde.;Ania Jastreboff.;Kristina H Lewis.;Jennifer L Lund.;Matthew L Maciejewski.;Rozalina G McCoy.;Kathleen M McTigue.;Kimberly Narain.;Christina C Wee.;Stavroula K Osganian.;Craig Hales.
来源: Ann Intern Med. 2026年
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have reshaped the clinical approach to managing obesity and type 2 diabetes. As approved indications have expanded, use of GLP-1RAs has increased rapidly in the United States. Although randomized trials demonstrate strong efficacy, many questions remain about their optimal use in clinical practice. Real-world data (RWD) from electronic health records, registries, insurance claims, and other sources offer a promising avenue to address these questions. However, concerns about data quality, selection bias, and incomplete ascertainment of medication use and outcomes pose significant challenges to the validity of the resulting evidence. In May 2025, the National Institute of Diabetes and Digestive and Kidney Diseases convened experts from regulatory agencies, payer organizations, and academia to explore these challenges. This second of 2 synopsis articles on the workshop summarizes the discussion around the strengths and limitations of various RWD sources and methodological approaches to strengthen causal inference and generalizability. Presenters highlighted pragmatic clinical trials and target trial emulation as strategies to generate stronger real-world evidence (RWE) that is relevant to both clinical practice and policy. The workshop underscored that careful attention to study design, data limitations, and analytic approach is essential to yield RWE that informs clinicians, patients, payers, and policymakers.
79. Weekly and Biweekly Treatment With Bofanglutide Versus Semaglutide in Chinese Patients With Type 2 Diabetes : A Phase 2b Randomized Clinical Trial.
作者: Ming Liu.;Zhifeng Cheng.;Li Lu.;Hanqing Cai.;Jingyu Liu.;Jinling Liu.;Yueyue Zheng.;Su Wang.;Jing Zhao.;Wei Yang.;Tian Xie.;Yue Li.;Anshun He.;Helena W Rodbard.;Wei Chen.
来源: Ann Intern Med. 2026年
Bofanglutide is a novel glucagon-like peptide-1 receptor agonist under development for type 2 diabetes mellitus (T2DM) and overweight and obesity.
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