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1. A Trial of Trimethoprim-Sulfamethoxazole in Pregnancy to Improve Birth Outcomes.
作者: Bernard Chasekwa.;Fortunate Munhanzi.;Lenin Madhuyu.;Gabriel Mbewe.;Vincent Mabika.;Dzivaidzo Chidhanguro.;Tendai Kofi.;Jonthan Munengiwa.;Hilda Mapfumo.;Mercy Musapa.;Sipho Shumba.;Elizabeth Hungwe.;Mary Nhokwara.;Nester Bushe.;Rudo Kufa.;Phatisiwe Mazula.;Muchaneta Chikombingo.;Alice Tengende.;Admire Zanga.;Asaph Ziruma.;Tsitsi Bere.;Success Munyengwa.;Charity Mudimbu.;Zvikomborero Murwira.;Shepherd Mudzingwa.;Eddington Mpofu.;Batsirai Mutasa.;Virginia Sauramba.;Elisha Masakadze.;Thompson Runodamoto.;Courage Chiorera.;Alfred Mushininga.;Claire D Bourke.;Ruairi C Robertson.;Jeniffer Perussolo.;Nikos Donos.;Chandiwana Nyachowe.;Mary Muchekeza.;Jefrey Chikunya.;Melanie Smuk.;Kuda Mutasa.;Naume V Tavengwa.;Lisa L Langhaug.;Robert Ntozini.;Stephen P Munjanja.;Andrew J Prendergast.
来源: N Engl J Med. 2025年392卷21期2125-2134页
Maternal infections underlie several adverse birth outcomes. Whether trimethoprim-sulfamethoxazole prophylaxis during pregnancy will improve birth outcomes is unknown.
2. Omitting Regional Nodal Irradiation after Response to Neoadjuvant Chemotherapy.
作者: Eleftherios P Mamounas.;Hanna Bandos.;Julia R White.;Thomas B Julian.;Atif J Khan.;Simona F Shaitelman.;Mylin A Torres.;Frank A Vicini.;Patricia A Ganz.;Susan A McCloskey.;Peter C Lucas.;Nilendu Gupta.;X Allen Li.;Beryl McCormick.;Benjamin Smith.;Rahul D Tendulkar.;Vivek S Kavadi.;Koji Matsumoto.;Samantha Andrews Seaward.;William J Irvin.;Jolinta Y Lin.;Robert W Mutter.;Thierry M Muanza.;Jannifer Stromberg.;Reshma Jagsi.;Anna C Weiss.;Walter J Curran.;Norman Wolmark.
来源: N Engl J Med. 2025年392卷21期2113-2124页
The benefit of regional nodal irradiation in the treatment of breast cancer is well established for patients with pathologically positive axillary nodes, but whether it is also beneficial for patients whose nodes become pathologically tumor free (ypN0) after neoadjuvant chemotherapy remains unclear.
3. Once-Weekly Mazdutide in Chinese Adults with Obesity or Overweight.
作者: Linong Ji.;Hongwei Jiang.;Yan Bi.;Hua Li.;Junhang Tian.;Dexue Liu.;Yuzhu Zhao.;Wei Qiu.;Chongbing Huang.;Lei Chen.;Shao Zhong.;Jie Han.;Yawei Zhang.;Qiufang Lian.;Ping Yang.;Lingchun Lv.;Jieyu Gu.;Zihan Liu.;Huan Deng.;Yanqi Wang.;Li Li.;Lijuan Pei.;Lei Qian.; .
来源: N Engl J Med. 2025年392卷22期2215-2225页
Evidence suggests that incretin-based dual agonist pharmacotherapy is helpful in persons with obesity. Mazdutide, a glucagon-like peptide-1 and glucagon receptor dual agonist, may have efficacy in persons with overweight or obesity.
4. Nerandomilast in Patients with Progressive Pulmonary Fibrosis.
作者: Toby M Maher.;Shervin Assassi.;Arata Azuma.;Vincent Cottin.;Anna-Maria Hoffmann-Vold.;Michael Kreuter.;Justin M Oldham.;Luca Richeldi.;Claudia Valenzuela.;Marlies S Wijsenbeek.;Emmanuelle Clerisme-Beaty.;Carl Coeck.;Hui Gu.;Ivana Ritter.;Arno Schlosser.;Susanne Stowasser.;Florian Voss.;Gerrit Weimann.;Donald F Zoz.;Fernando J Martinez.; .
来源: N Engl J Med. 2025年392卷22期2203-2214页
Nerandomilast (BI 1015550) is an orally administered preferential inhibitor of phosphodiesterase 4B with antifibrotic and immunomodulatory properties. Nerandomilast has been shown to slow the progression of idiopathic pulmonary fibrosis, but an assessment of its effects in other types of progressive pulmonary fibrosis is needed.
5. Nerandomilast in Patients with Idiopathic Pulmonary Fibrosis.
作者: Luca Richeldi.;Arata Azuma.;Vincent Cottin.;Michael Kreuter.;Toby M Maher.;Fernando J Martinez.;Justin M Oldham.;Claudia Valenzuela.;Emmanuelle Clerisme-Beaty.;Maud Gordat.;Daniel Wachtlin.;Yi Liu.;Christina Schlecker.;Susanne Stowasser.;Donald F Zoz.;Marlies S Wijsenbeek.; .
来源: N Engl J Med. 2025年392卷22期2193-2202页
Nerandomilast (BI 1015550) is an orally administered preferential inhibitor of phosphodiesterase 4B with antifibrotic and immunomodulatory effects. In a phase 2 trial involving patients with idiopathic pulmonary fibrosis, treatment with nerandomilast stabilized lung function over a period of 12 weeks.
6. Navigational Bronchoscopy or Transthoracic Needle Biopsy for Lung Nodules.
作者: Robert J Lentz.;Katherine Frederick-Dyer.;Virginia B Planz.;Tatsuki Koyama.;Matthew C Aboudara.;Sameer K Avasarala.;Jonathan D Casey.;George Z Cheng.;Pierre-François D'Haese.;Jennifer D Duke.;Eric L Grogan.;Todd C Hoopman.;Joyce Johnson.;James M Katsis.;Jonathan S Kurman.;See-Wei Low.;Kamran Mahmood.;Otis B Rickman.;Lance Roller.;Cristina Salmon.;Samira Shojaee.;Briana Swanner.;Momen M Wahidi.;Charla Walston.;Gerard A Silvestri.;Lonny Yarmus.;Najib M Rahman.;Fabien Maldonado.; .
来源: N Engl J Med. 2025年392卷21期2100-2112页
Each year, millions of pulmonary nodules are identified incidentally or through lung cancer screening, and many involve biopsy to distinguish cancer from benign processes. Both navigational bronchoscopy and computed tomography-guided transthoracic needle biopsy are commonly used in patients undergoing biopsies of peripheral pulmonary nodules, but the relative diagnostic accuracy of these two approaches is unclear.
7. Second-Line Antiretroviral Therapy for Children Living with HIV in Africa.
作者: Victor Musiime.;Mutsa Bwakura-Dangarembizi.;Alexander J Szubert.;Vivian Mumbiro.;Hilda A Mujuru.;Cissy M Kityo.;Abbas Lugemwa.;Katja Doerholt.;Chishala Chabala.;Shafic Makumbi.;Veronica Mulenga.;Helen McIlleron.;David Burger.;Eva Natukunda.;Clare Shakeshaft.;Kyomuhendo Jovia Linda.;Kusum Nathoo.;Lara Monkiewicz.;Ibrahim Yawe.;Monica Kapasa.;Mary Nyathi.;Joyce Lungu.;Bwendo Nduna.;Wedu Ndebele.;Annabelle South.;Mwate Mwamabazi.;Godfrey Musoro.;Anna Griffiths.;Khozya Zyambo.;Rashidah Nazzinda.;Kevin Zimba.;Yingying Zhang.;Simon Walker.;Anna Turkova.;A Sarah Walker.;Alasdair Bamford.;Diana M Gibb.; .
来源: N Engl J Med. 2025年392卷19期1917-1932页
Children living with human immunodeficiency virus (HIV) have limited options for second-line antiretroviral therapy (ART).
8. Oveporexton, an Oral Orexin Receptor 2-Selective Agonist, in Narcolepsy Type 1.
作者: Yves Dauvilliers.;Giuseppe Plazzi.;Emmanuel Mignot.;Gert Jan Lammers.;Rafael Del Río Villegas.;Ramin Khatami.;Mitsutaka Taniguchi.;Anson Abraham.;Yaming Hang.;Harisha Kadali.;Marta Lamberton.;Sarah Sheikh.;Ellie Stukalin.;Rachel Neuwirth.;Todd J Swick.;Shinichiro Tanaka.;Christian von Hehn.;Philipp von Rosenstiel.;Hao Wang.;Alice Cai.;Melissa Naylor.;Tina Olsson.
来源: N Engl J Med. 2025年392卷19期1905-1916页
Narcolepsy type 1 is a disorder of hypersomnolence caused by a loss of orexin neurons, which results in low orexin levels in the brain.
9. BCG Revaccination for the Prevention of Mycobacterium tuberculosis Infection.
作者: Alexander C Schmidt.;Lee Fairlie.;Elizabeth Hellström.;Angelique Luabeya Kany Kany.;Keren Middelkoop.;Kogieleum Naidoo.;Gonasagrie Nair.;Anele Gela.;Elisa Nemes.;Thomas J Scriba.;Amy Cinar.;Nicole Frahm.;Robin Mogg.;David Kaufman.;Michael W Dunne.;Mark Hatherill.; .
来源: N Engl J Med. 2025年392卷18期1789-1800页
In a previous phase 2 trial, bacille Calmette-Guérin (BCG) revaccination was not shown to provide protection from primary Mycobacterium tuberculosis infection but prevented sustained M. tuberculosis infection, defined by an initial conversion on a QuantiFERON-TB (QFT) test (an interferon-γ release assay) from negative to positive, followed by two additional positive QFT tests at 3 and 6 months after the initial conversion (a secondary end point). A vaccine efficacy of 45% (95% confidence interval [CI], 6 to 68) was observed.
10. Mepolizumab to Prevent Exacerbations of COPD with an Eosinophilic Phenotype.
作者: Frank C Sciurba.;Gerard J Criner.;Stephanie A Christenson.;Fernando J Martinez.;Alberto Papi.;Nicolas Roche.;Jean Bourbeau.;Stephanie Korn.;Mona Bafadhel.;MeiLan K Han.;Stefanie Kolterer.;Karen Miller.;Dalal Mouneimne.;Joanne Fletcher.;Bhabita Mayer.;Jeff Min.;Ian D Pavord.; .
来源: N Engl J Med. 2025年392卷17期1710-1720页
Mepolizumab is a humanized monoclonal antibody that targets interleukin-5, a cytokine that plays a central role in eosinophilic inflammation, which is present in 20 to 40% of patients with chronic obstructive pulmonary disease (COPD).
11. Phase 3 Trial of Semaglutide in Metabolic Dysfunction-Associated Steatohepatitis.
作者: Arun J Sanyal.;Philip N Newsome.;Iris Kliers.;Laura Harms Østergaard.;Michelle T Long.;Mette Skalshøi Kjær.;Anna M G Cali.;Elisabetta Bugianesi.;Mary E Rinella.;Michael Roden.;Vlad Ratziu.; .
来源: N Engl J Med. 2025年392卷21期2089-2099页
Semaglutide, a glucagon-like peptide-1 receptor agonist, is a candidate for the treatment of metabolic dysfunction-associated steatohepatitis (MASH).
12. Zongertinib in Previously Treated HER2-Mutant Non-Small-Cell Lung Cancer.
作者: John V Heymach.;Gerrina Ruiter.;Myung-Ju Ahn.;Nicolas Girard.;Egbert F Smit.;David Planchard.;Yi-Long Wu.;Byoung Chul Cho.;Noboru Yamamoto.;Joshua K Sabari.;Yanqiu Zhao.;Hai-Yan Tu.;Kiyotaka Yoh.;Ernest Nadal.;Behbood Sadrolhefazi.;Maren Rohrbacher.;Ute von Wangenheim.;Sabina Eigenbrod-Giese.;Jon Zugazagoitia.; .
来源: N Engl J Med. 2025年392卷23期2321-2333页
Innovative oral targeted therapies are warranted for patients with human epidermal growth factor receptor 2 (HER2)-mutant non-small-cell lung cancer (NSCLC). Zongertinib is an oral, irreversible, HER2-selective tyrosine kinase inhibitor that has been shown to have efficacy in persons with advanced or metastatic solid tumors with HER2 alterations in a phase 1 study.
13. Efficacy of Baloxavir Treatment in Preventing Transmission of Influenza.
作者: Arnold S Monto.;Klaus Kuhlbusch.;Corrado Bernasconi.;Bin Cao.;Herman Avner Cohen.;Emily Graham.;Aeron C Hurt.;Laurie Katugampola.;Takashi Kamezawa.;Adam S Lauring.;Barry McLean.;Takahiro Takazono.;Andreas Widmer.;Steffen Wildum.;Benjamin J Cowling.
来源: N Engl J Med. 2025年392卷16期1582-1593页
Baloxavir marboxil (baloxavir) rapidly reduces influenza virus shedding, which suggests that it may reduce transmission. Studies of treatment with neuraminidase inhibitors have not shown sufficient evidence that they prevent transmission to contacts.
14. Phase 3 Trial of the DPP-1 Inhibitor Brensocatib in Bronchiectasis.
作者: James D Chalmers.;Pierre-Régis Burgel.;Charles L Daley.;Anthony De Soyza.;Charles S Haworth.;David Mauger.;Michael R Loebinger.;Pamela J McShane.;Felix C Ringshausen.;Francesco Blasi.;Michal Shteinberg.;Kevin Mange.;Ariel Teper.;Carlos Fernandez.;Migdalia Zambrano.;Chunpeng Fan.;Xiangmin Zhang.;Mark L Metersky.; .
来源: N Engl J Med. 2025年392卷16期1569-1581页
In bronchiectasis, neutrophilic inflammation is associated with an increased risk of exacerbations and disease progression. Brensocatib, an oral, reversible inhibitor of dipeptidyl peptidase 1 (DPP-1), targets neutrophil serine proteases, key mediators of neutrophilic inflammation.
15. Lorundrostat Efficacy and Safety in Patients with Uncontrolled Hypertension.
作者: Luke J Laffin.;Branko Kopjar.;Carrie Melgaard.;Kathy Wolski.;Jessica Ibbitson.;Shivani Bhikam.;Matthew R Weir.;Elizabeth O Ofili.;Reena Mehra.;James M Luther.;Debbie L Cohen.;Ashish Sarraju.;Michael J Wilkinson.;John M Flack.;David Rodman.;Steven E Nissen.; .
来源: N Engl J Med. 2025年392卷18期1813-1823页
Aldosterone dysregulation contributes to hypertension. Lorundrostat is an aldosterone synthase inhibitor, but data on its efficacy and safety in patients with hypertension are limited.
16. Tecovirimat for Clade I MPXV Infection in the Democratic Republic of Congo.
作者: .;Rosine Ali.;Jules Alonga.;Jean-Luc Biampata.;Michael Kombozi Basika.;Irina Maljkovic Berry.;Nella Bisento.;Emily Blum.;Tyler Bonnett.;Katherine Cone.;Ian Crozier.;Richard Davey.;Ali Dilu.;Lori E Dodd.;Iman Gulati.;Dennis Hruby.;Augustin Ibanda.;Francis Isse.;Sylva Sivasingana Kasareka.;Gaby Kayembe.;Richard Kojan.;Esaie Kindombe Luzolo.;H Clifford Lane.;Leader Lawanga.;Laurens Liesenborghs.;Claude Shosongo Lunghe.;Yves Lula.;Mariano Lusakibanza.;Gaston Tona Lutete.;Placide Mbala-Kingebeni.;Alejandra Miranda.;Daniel Mukadi-Bamuleka.;Gael Mukendi.;Patrick Mutombo Lupola.;Jean-Jacques Muyembe-Tamfum.;Robin Ndungunu.;Bruce Nganga.;Nsengi Ntamabyaliro.;Veronique Nussenblatt.;Imoite Omulepu.;John Omalokoho Onosomba.;Michael Proschan.;Kevin Rubenstein.;Inga Saknite.;Adam Schechner.;Kathryn Shaw-Saliba.;Billy Sivahera.;Mary Smolskis.;Amy Tillman.;Eric Tkaczyk.;Celestin Tshimanga.;Olivier Tshiani Mbaya.;Antoine Tshomba.;Freddy Yemba Unda Tshomba.;David Vallee.;Susan Vogel.;Shera Weyers.
来源: N Engl J Med. 2025年392卷15期1484-1496页
Tecovirimat is available for the treatment of mpox (formerly known as monkeypox) in Europe and the United States, on the basis of findings from efficacy studies in animals and safety evaluations in healthy humans. Evidence from randomized, controlled trials of safety and efficacy in patients with mpox is lacking.
17. Tolebrutinib in Nonrelapsing Secondary Progressive Multiple Sclerosis.
作者: Robert J Fox.;Amit Bar-Or.;Anthony Traboulsee.;Celia Oreja-Guevara.;Gavin Giovannoni.;Patrick Vermersch.;Sana Syed.;Ye Li.;Wendy S Vargas.;Timothy J Turner.;Erik Wallstroem.;Daniel S Reich.; .
来源: N Engl J Med. 2025年392卷19期1883-1892页
Throughout the course of multiple sclerosis, gradually progressive neurologic impairment can occur, which has been called disability accrual. Current disease-modifying therapies for multiple sclerosis have limited effects on disability accrual unrelated to relapses, which is thought to be partially caused by chronic, nonresolving neuroinflammation within the central nervous system. Tolebrutinib is an oral, brain-penetrant Bruton's tyrosine kinase inhibitor that targets myeloid cells (including microglia) and B cells in both the periphery and central nervous system. There are no approved treatments for nonrelapsing secondary progressive multiple sclerosis.
18. Tolebrutinib versus Teriflunomide in Relapsing Multiple Sclerosis.
作者: Jiwon Oh.;Douglas L Arnold.;Bruce A C Cree.;Carolina Ionete.;Ho Jin Kim.;Maria Pia Sormani.;Sana Syed.;Yixin Chen.;Christina R Maxwell.;Patrick Benoit.;Timothy J Turner.;Erik Wallstroem.;Heinz Wiendl.; .
来源: N Engl J Med. 2025年392卷19期1893-1904页
Tolebrutinib is an oral, brain-penetrant, and bioactive Bruton's tyrosine kinase inhibitor that modulates peripheral inflammation and persistent immune activation within the central nervous system, including disease-associated microglia and B cells. More data are needed on its efficacy and safety in treating relapsing multiple sclerosis.
19. A Phase 3 Trial of Inebilizumab in Generalized Myasthenia Gravis.
作者: Richard J Nowak.;Michael Benatar.;Emma Ciafaloni.;James F Howard.;M Isabel Leite.;Kimiaki Utsugisawa.;John Vissing.;Mikhail Rojavin.;Qing Li.;Fengming Tang.;Yanping Wu.;Nishi Rampal.;Sue Cheng.; .
来源: N Engl J Med. 2025年392卷23期2309-2320页
Autoimmune generalized myasthenia gravis is a disease that manifests with fluctuating muscle weakness. Inebilizumab is a monoclonal antibody that depletes CD19+ B cells, which are central to disease pathogenesis.
20. A Phase 3 Trial of Upadacitinib for Giant-Cell Arteritis.
作者: Daniel Blockmans.;Sara K Penn.;Arathi R Setty.;Wolfgang A Schmidt.;Andrea Rubbert-Roth.;Ellen M Hauge.;Helen I Keen.;Tomonori Ishii.;Nader Khalidi.;Christian Dejaco.;Maria C Cid.;Bernhard Hellmich.;Meng Liu.;Weihan Zhao.;Ivan Lagunes.;Ana B Romero.;Peter K Wung.;Peter A Merkel.; .
来源: N Engl J Med. 2025年392卷20期2013-2024页
Giant-cell arteritis is a systemic vasculitis with limited treatment options. The efficacy and safety of upadacitinib - a selective Janus kinase (JAK) inhibitor that blocks the signaling of several cytokines, including interleukin-6 and interferon-γ - are unknown in patients with giant-cell arteritis.
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