During 2025, new data emerged that are important to internal medicine specialists and subspecialists who frequently encounter and manage patients with common cardiovascular conditions. Among these conditions, the landscape of therapy is changing with regard to hypertension, heart failure, and anticoagulation in atrial fibrillation. Management of acute cardiovascular diseases often involves collaboration between specialists and generalists. The choice of initial imaging modality in patients with suspected coronary artery disease, whether β-blockers are routinely indicated after myocardial infarction, and the role of invasive versus conservative management in older patients after myocardial infarction are all addressed in this article. Also reviewed are articles highlighting groundbreaking therapies in more specialized areas, such as obstructive hypertrophic cardiomyopathy and advanced treatment of hyperlipidemia. As these newer therapies become more widely disseminated, generalists will need to know about them. Finally, regarding a topic of perennial interest to many physicians and patients, an article addresses coffee drinking in patients with atrial fibrillation and suggests that it might be safer than previously believed.

During 2025, gastroenterology and hepatology experienced advances in treatment and surveillance of common diseases. Technological innovations have been reported that may positively affect patients worldwide. New drug options for treatment of metabolic dysfunction-associated steatohepatitis are emerging, and old drugs have new indications and patterns of use for common gastroenterologic diseases. The 9 articles featured here were selected because they represent important information for clinicians who are not gastroenterologists but who often diagnose, treat, and follow patients with gastroenterologic conditions. Two randomized trials address potential overtreatment of patients with Barrett esophagus without high-grade dysplasia and patients with severe alcohol-associated hepatitis. For clinicians who care for patients with malignant gastric outlet obstruction, 2 new randomized trials now provide evidence that a new endoscopic approach is a good alternative to traditional surgical gastroenterostomy or duodenal stenting. Aspirin is emerging as promising adjuvant therapy for patients with colorectal cancer that is positive for PI3K pathway alterations, and fecal microbiota transplantation has been shown to be noninferior to standard vancomycin for patients with a first episode of Clostridioides difficile infection. Finally, a randomized trial showed that structured exercise and training for patients with colon cancer after surgery and adjuvant oncologic treatment reduce recurrence and increase survival.

Cirrhosis affects millions of U.S. adults and costs the U.S. health care system upward of $6 billion annually. Cirrhosis is underrecognized, and the only cure is transplantation. Complications, including bleeding, infection, ascites, and renal injury, contribute to high rates of hospitalization, readmission, and mortality in this population. Evidence-based practices and guidelines offer quality recommendations for clinicians, but many of these guidelines have changed recently. This article provides an update on the current guidelines for the inpatient management of cirrhosis.

This article highlights some important nephrology studies published in 2025 that are relevant for many nonnephrologist physicians. Two studies examined aspects of acute kidney injury (AKI), including the use of sodium bicarbonate infusion to treat severe metabolic acidemia and the use of artificial intelligence models to predict AKI onset, severity, and complications. Three studies examined factors that may influence kidney function, including high-intensity long-term physical exercise, pregnancy, and the combined use of finerenone and empagliflozin. Three studies examined interventions to address common problems among patients receiving maintenance dialysis, including cognitive behavioral therapy for chronic pain, factor Xa inhibitors for atrial fibrillation, and fish oil for cardiovascular events.

Migraine headaches are highly prevalent and, for women below the age of 50, the leading cause of years lived with disability. Migraines disproportionately affect persons of lower socioeconomic status and those who are uninsured, and they result in millions of office and emergency department visits annually. Migraines are also responsible for billions of dollars in lost productivity and health care expenses each year. Medication classes traditionally used for migraine headache treatment have included nonsteroidal anti-inflammatory drugs, acetaminophen, antihypertensive drugs, antiseizure drugs, antidepressant drugs, and botulinum toxin. In recent years, triptans have come into widespread use for acute treatment, and calcitonin gene-related peptide antagonists, including gepants and monoclonal antibodies, have been used for both acute treatment and prevention. In 2025, the International Headache Society and the American College of Physicians published guidelines on pharmacotherapy for migraine headaches covering both acute and preventive treatments. Here, 2 experts in this field, a primary care physician and a neurologist and headache specialist, debate how to manage the case of a patient with frequent migraine headaches. They discuss the diagnostic considerations and the acute and preventive treatment challenges in the care of this population.

Oncology care increasingly necessitates collaboration with physicians in other specialties. This article highlights 10 studies published in 2025 that we believe are important for nononcologists who participate in the care of patients with cancer. The articles selected provide updates on advancements that influence the full spectrum of oncology care. Several studies present therapeutic developments for lung, colorectal, and breast cancer. A major theme of the 2025 literature is evidence-based de-escalation, including reducing mammographic surveillance in older breast cancer survivors and omitting autologous stem cell transplant in patients with multiple myeloma who achieve measurable residual disease negativity. Another study addresses reduced-dose apixaban for extended cancer-associated thrombosis management and the validation of elinzanetant for nonhormonal management of vasomotor symptoms. These studies collectively move the field toward highly personalized, biomarker-driven interventions that require integrated care models to optimize patient outcomes.

This article highlights clinical trials on infectious diseases published in 2025 that we believe are highly relevant to internal medicine physicians who are not infectious diseases specialists. Selected studies address prevention and treatment strategies across infectious diseases. We highlight 2 studies of sexually transmitted infections (STIs): one examining the effectiveness of treating male partners to reduce recurrence of bacterial vaginosis and another study of doxycycline as postexposure prophylaxis against bacterial STI. A strategy for using methanamine hippurate to prevent recurrent urinary tract infections (UTIs) in older women is included in our review. We review the updated evidence supporting the effectiveness of COVID-19, respiratory syncytial virus, and influenza vaccines for the 2025-2026 season, and a modified messenger RNA influenza vaccine, which showed superior efficacy with an acceptable safety profile. In HIV care, a study of dual antiretroviral maintenance therapy showed that dolutegravir and lamivudine was noninferior to triple therapy at 48 weeks. A meta-analysis supporting shorter antibiotic courses for pyelonephritis and complicated UTIs provides important information for antibiotic stewardship strategies. In serious infections, dalbavancin was noninferior to standard therapy for Staphylococcus aureus bacteremia, whereas cefiderocol expanded treatment options for gram-negative bloodstream infections without clear superiority, particularly in carbapenem-resistant pathogens. Finally, a study found that elevated C-reactive protein identifies patients most likely to benefit from adjunctive corticosteroids in community-acquired pneumonia.

Internal medicine physicians are often the first physicians from whom patients with rheumatic conditions seek guidance, and they collaborate with rheumatologists when caring for these patients. Here, we summarize 6 studies published in the rheumatology literature in 2025 of relevance to internal medicine specialists and subspecialists who are not rheumatologists. The first study concerns the treat-to-target urate strategy for gout. The second study compared the benefits of a very-low-calorie diet and exercise compared with exercise alone in patients with hip osteoarthritis. The investigators of the third study examined the step counts of purposeful walking and incidence of symptomatic knee osteoarthritis. The fourth study explored the burden of nonarticular pain on quality of life in patients with early rheumatoid arthritis. The fifth study suggested that metformin showed promise in improving knee pain, stiffness, and function in patients with knee osteoarthritis. The last study compared nonsteroidal anti-inflammatory drugs with colchicine in preventing gout exacerbation when initiating urate-lowering therapy. These articles offer new insights for the management of rheumatic conditions that internal medicine physicians often manage.

Research in pulmonology generated several landmark publications over the past year. We screened more than 900 studies published in 2025 and selected 8 articles that highlight novel treatments and possible practice-changing evidence in several respiratory conditions. Two articles studied therapeutic options in interstitial lung disease, including a novel antifibrotic agent for pulmonary fibrosis and first-line methotrexate use in sarcoidosis. Two articles outlined the role of corticosteroids in community-acquired pneumonia and selecting patients who may benefit most. One article described evidence for an alternate agent for smoking cessation in patients with or without chronic obstructive pulmonary disease (COPD), while another article studied the use of mepolizumab in patients with eosinophilic COPD. We also reviewed the first head-to-head trial comparing biologic medications in asthma and chronic rhinosinusitis with nasal polyps. Finally, we summarized the latest evidence of a first-in-class therapeutic agent that reduced exacerbations in patients with bronchiectasis.

Shorter antibiotic courses for community-acquired pneumonia (CAP) may reduce adverse effects and resistance. However, real-world data supporting very short durations remain limited.

During 2025, endocrinology witnessed the expansion of pharmacotherapeutic options for type 2 diabetes (T2DM), obesity, and metabolic dysfunction-associated steatohepatitis (MASH); increasing complexity of treatment algorithms, including choices for intensification of therapy; and heightened concern about emerging side effects of commonly used medications. From the wealth of studies published in 2025, this article notes 9 studies that offer critical information for clinicians who manage or comanage patients with endocrine and metabolic disorders, including T2DM, obesity, and MASH. One of the 9 articles reviews the effectiveness of diabetes self-management education and support interventions, an important component of diabetes care, in improving hemoglobin A1c (HbA1c). Another is focused on comparing HbA1c lowering when escalating the dose of dulaglutide versus switching to tirzepatide in people with T2DM. Two of the 9 articles are focused on potential side effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs), including gastrointestinal side effects and nonarteritic anterior ischemic optic neuropathy. One article summarizes the risk for life-threatening pituitary immune-related adverse events caused by immune checkpoint inhibitors; another explores the use of GLP-1RAs in MASH. One additional study explores the risk for urogenital infections in patients with diabetes receiving sodium-glucose cotransporter-2 inhibitors (SGLT-2is) versus GLP-1RAs. Another study explores cardiovascular, kidney, and safety outcomes with canagliflozin (an SGLT-2i). The last article explores the efficacy and safety of finerenone in T2DM. The results of each study have a direct effect on clinical care for patients who often present to physicians who are not endocrinologists.

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Screening tools for interpersonal firearm violence (FV) are needed to facilitate prevention.