Clinical

From Crohn disease to uncomplicated urinary tract infections and beyond, the FDA issued several high-impact drug approvals last month.

Panelists discuss how American Urological Association (AUA) guidelines for recurrent uncomplicated urinary tract infections (UTIs) in women recommend culture-confirmed diagnosis, prophylactic antibiotics, nonantibiotic prevention, self-initiated treatment, and behavioral modifications while noting pivmecillinam’s recent FDA approval. Pivmecillinam features a penicillin-binding protein 2 inhibition mechanism with 85% to 95% efficacy against gram-negative uropathogens, including extended-spectrum β-lactamase producers; minimal intestinal flora disruption; low resistance rates; and primarily mild gastrointestinal adverse effects.

Panelists discuss how treatment failure in uncomplicated urinary tract infections (UTIs) creates substantial economic burden through direct costs of additional health care visits, repeated diagnostic tests, and rescue medications alongside indirect costs from productivity losses, with implications including progression to complicated infections such as pyelonephritis, increased emergency department use, antimicrobial resistance development threatening broader public health, psychological impacts on patients, and strain on health care resources that could be mitigated through more effective initial treatment strategies.

Panelists discuss how effective communication about amyloid-targeting therapies requires transparent discussions of modest cognitive benefits alongside potential risks, particularly events related to amyloid-related imaging abnormalities (ARIA), while addressing practical considerations including treatment burden, infusion center logistics, monitoring requirements, costs, insurance coverage, and caregiver involvement to help patients and families make fully informed decisions aligned with their values and circumstances.

Intellectual disabilities, food allergies, and asthma were all more common in children who took multiple courses of antibiotics before the age of 2 years.

Recurrence-free survival rates were similar, even when patients quit adjuvant immunotherapy early, according to a new report.

Black and American Indian women with ovarian cancer were less likely to have elevated cancer antigen 125 (CA-125) levels at diagnosis, resulting in delayed chemotherapy initiation and highlighting the need for more inclusive guidelines.

Systemic immune inflammation index, neutrophil-to-lymphocyte ratio, and systemic inflammation response index levels may offer a noninvasive method to identify individuals at increased risk of developing overactive bladder.

Raj Chovatiya, MD, PhD, MSCI, highlights the long-term effectiveness of lebrikizumab across diverse patients, including those with prior biologic use, positioning it as a potential first-line treatment for moderate to severe atopic dermatitis.

The electronic health record (EHR)–based symptom inventory identified symptom prevalence and associated comorbidities, but no ovarian cancers were diagnosed during the study period.

Abstracts featured at the National Kidney Foundation Spring Clinical Meeting highlighted the renoprotective benefits of SGLT2 inhibitors in heart failure and diabetic kidney disease while emphasizing the need for strategies to increase their uptake in primary care.

Patients with chronic spontaneous urticaria experienced a long delay in diagnosis, a substantial impact on their quality of life, and often received inadequate treatment, highlighting the need for better management and understanding of the condition.

Galen Shearn-Nance, BS, and Johnie Rose, MD, PhD, of Case Western Reserve University, acknowledge key limitations of their study and prioritize areas for further research.

Panelists discuss how diagnostic challenges in immunoglobulin A (IgA) nephropathy lead to delayed identification, missed treatment windows, and increased risk of irreversible kidney damage due to the requirement for invasive biopsy, nonspecific symptoms, and variable disease presentation.

A panelist discusses how real-world evidence from a large cohort study (n = 31521) presented at AAD 2025 reveals notable differences in treatment patterns, discontinuation rates, persistence, and adherence among psoriasis patients treated with different biologics including tildrakizumab, risankizumab, guselkumab, and ustekinumab, with implications for clinical decision-making based on early versus late disease onset and prior biologic exposure.

Panelists discuss how patients with immunoglobulin A (IgA) nephropathy typically present with microscopic or gross hematuria, often during upper respiratory infections, along with variable proteinuria and sometimes hypertension or decreased kidney function.

No significant differences in treatment or outcomes were found between most Medicare Advantage (MA) and fee-for-service (FFS) beneficiaries with breast cancer, but Black patients with FFS Medicare were less likely to receive standard treatment.

Data from a meta-analysis of 8 observational studies accounting for more than 26 million people across the globe were evaluated in a new review.

Experts at leading health care conferences last month called for further research into the health effects of microplastics and prompted immediate action to limit exposure.

None of the eteplirsen-treated patients reached a left ventricular ejection fraction below 50% compared with 22.1% of patients in the control group.

Panelists discuss how hesitancy in prescribing amyloid-targeting therapies stems from multiple factors including concerns about ARIA adverse effects, modest clinical efficacy data, high treatment costs and limited insurance coverage, logistical challenges of regular infusions and monitoring, infrastructure requirements for specialized imaging, uncertainty about long-term benefits, and the need for careful patient selection within appropriate disease stages.

Panelists discuss how significant gaps in current uncomplicated urinary tract infection (UTI) therapies include insufficient nonantibiotic preventive strategies, limited options for multidrug-resistant pathogens, inadequate personalized treatment approaches, minimal focus on biofilm disruption, lack of rapid point-of-care diagnostics to guide targeted therapy, poor understanding of the urinary microbiome’s role in infection susceptibility, and insufficient research into immunomodulatory interventions that could address the underlying mechanisms of recurrence and resistance development.

Panelists discuss how ideal candidates for amyloid-targeting therapy typically present with biomarker-confirmed early-stage Alzheimer disease, demonstrate positive amyloid PET scans or CSF biomarkers, exhibit mild cognitive impairment or mild dementia, lack contraindications such as significant cerebrovascular disease or anticoagulant use, have adequate support systems for monitoring and managing potential adverse effects, and would benefit from comprehensive pretreatment evaluations including brain MRI and APOE genotyping.

Panelists discuss how fluoroquinolones are generally reserved for uncomplicated urinary tract infections (UTIs) only when first-line options are contraindicated or pathogen resistance is confirmed, with treatment duration ranging from single-dose fosfomycin to 3 to 5 days for most antibiotics and 7 to 10 days for nitrofurantoin, noting shorter regimens typically achieve 85% to 95% adherence rates compared with 60% to 75% for longer courses, significantly affecting treatment success, particularly when patient factors such as adverse effects, dosing complexity, and lifestyle disruptions are considered.

A series of new studies from the National Kidney Foundation Spring Clinical Meeting exhibit the association between impaired kidney function and prolonged hospital stays, higher charges, and greater resource utilization.

As Medicare Advantage (MA) enrollment grows, Johnie Rose, MD, PhD, Case Western Reserve University School of Medicine, underscores the importance of ongoing research into outcomes for MA beneficiaries vs fee-for-service (FFS) Medicare beneficiaries.

Vegetables, fish oil, fruit, and high-fiber foods have anti-inflammatory effects, while low-fiber bread and animal fats are associated with pro-inflammatory effects. Diets heavier on these pro-inflammatory foods may be associated with higher risks of brain disorders.

This article appears in the April issue of Evidence-Based Oncology.

Patients with chronic lymphocytic leukemia (CLL) who experience Richter transformation have a poor prognosis, but ibrutinib may help boost the efficacy of chimeric antigen receptor T-cell therapies.

A new technology for management of diabetes is cost-effective for patients in the US with type 1 diabetes compared with traditional treatments.