A new review updates the pathophysiology and disease course of acromegaly, focusing on the general clinician’s key role in early diagnosis and management. Read the Review Article “Acromegaly” by Andrea Giustina, MD, and Annamaria Colao, MD, PhD: nej.md/3JPVdBg #MedSky

Personalized therapies hold tremendous promise but challenge traditional models of drug and biologic development. The @fda.gov outlines a path to market entry for products where a randomized trial is not feasible. Learn more: nej.md/4nUQdcl

The authors of a new review provide practical suggestions for clinical educators to reinvigorate the teaching and practice of bedside clinical skills in the modern health care environment. Learn more: nej.md/4nUirnP #MedSky #MedEd

What is the biggest frustration for medical trainees? Ben Davis, MD, director of the Swedish First Hill Family Medicine Residency program in Seattle, addresses that question in this video clip. #MedSky #MedEd

The benefit of chest-wall irradiation after mastectomy in intermediate-risk breast cancer has been uncertain. Research findings from the SUPREMO phase 3 trial are summarized in a new Quick Take video. nej.md/4om4ik6 #MedSky #Oncology

In a phase 1 trial in the United States and Liberia, a replication-competent recombinant vesicular stomatitis virus–vectored vaccine against Lassa fever had acceptable safety and was immunogenic over a wide dose range. Full trial results and Research Summary: nej.md/47pstZ9 #MedSky

Despite their frequent use, opioids have limited benefits in managing noncancer pain. Avoiding long-term opioid use, reducing the opioid dose, or replacing opioids with nonopioid alternatives may reduce the risk of opioid-related harm. Learn more: nej.md/4oL3fu2 #MedSky #NeuroSky

Lassa fever has pandemic potential. However, no vaccines are approved. An rVSV Lassa fever vaccine has been developed, but data on its safety and immunogenicity are limited. Research findings are summarized in a new Quick Take video. nej.md/4nzCYO7 #MedSky #IDSky

In the ATTAIN-1 phase 3, randomized trial, the use of orforglipron, an oral glucagon-like peptide-1 receptor agonist, led to significant mean body-weight reductions in patients with #obesity, as compared with placebo. Full trial results and Research Summary: nej.md/4n1nSl2 #MedSky #EndoSky

For a woman with symptomatic carotid-artery stenosis, would you recommend surgical carotid endarterectomy or percutaneous carotid-artery stenting? Read the case vignette, treatment options, and vote: nej.md/43fbIxg #MedSky #MedEd

A follow-up report showed that the overall benefit of machine perfusion over cold storage in kidney graft survival remained present 10 years after transplantation. Read the full report: nej.md/4hDQNK4 #MedSky #Nephrology #Surgery

For moderate-to-severe plaque psoriasis, biologic therapies are highly effective but are available only by injection, and current oral therapies are often less effective. Research findings from the ATTAIN-1 phase 3 trial are summarized in a new Quick Take video. nej.md/47Upat0 #MedSky #EndoSky

In moderate-to-severe plaque psoriasis, oral icotrokinra led to a skin-clearance response in 50%–65% of patients at week 16, as compared with 4%–8% with placebo. The incidence of adverse events was similar in the two groups. Full ICONIC-LEAD trial results & Research Summary: nej.md/3WDM6qg

Tobevibart plus elebsiran and tobevibart alone both lowered HDV RNA and ALT levels. The combination resulted in a high incidence of undetectable HDV RNA and an HBsAg level below 10 IU/ml at week 48. Full SOLSTICE phase 2 trial results: nej.md/4qIXpuM @aasldnews.bsky.social | #TLM25

A 1-week-old full-term baby boy was brought to the hospital for evaluation of discharge from his navel. A growth of pink tissue at the umbilicus that seeped yellow liquid was noted. Read the full case details: nej.md/4hLNwIQ #MedSky #Neonatology @chugrenoblealpes.bsky.social

In a meta-analysis of 17,801 patients with myocardial infarction and preserved LVEF (≥50%), beta-blockers did not reduce death, MI, or heart failure over a median 3.6 years of follow-up. Full results: nej.md/43U5Ppo #AHA25

A previously healthy 8-year-old boy was brought to clinic with a 7-day history of an itchy rash on his cheeks and a lacy rash on his chest and arms. He reported no recent fever, runny nose, or malaise. What is the most likely etiology of the rash? nej.md/IC11062025

In patients with atrial fibrillation after successful ablation, rivaroxaban therapy did not lead to a significantly lower incidence of a composite of stroke, systemic embolism, or new covert embolic stroke than aspirin therapy. Full OCEAN trial results: nej.md/3LsRJ86 #AHA25

ADAPT AF-DES trial: In patients with atrial fibrillation and a drug-eluting stent placed at least 1 year earlier, monotherapy with a non–vitamin K antagonist oral anticoagulant was noninferior to combination therapy with clopidogrel for net adverse clinical events. nej.md/4nH8DgK #AHA25

In an interim analysis, sibeprenlimab, a humanized IgG2 monoclonal antibody that inhibits the proliferation-inducing ligand APRIL (a key driver of IgA nephropathy), reduced proteinuria as compared with placebo. nej.md/493Xtza @asnkidney.bsky.social | #KidneyWk

Among patients with atherosclerosis or diabetes but no previous myocardial infarction or stroke, evolocumab led to a lower risk of major adverse cardiovascular events than placebo. Full VESALIUS-CV trial results: nej.md/4oWrIN6 #AHA25

Presented at #AHA25: In a phase 1 trial, single-dose CRISPR-Cas9 gene editing targeting ANGPTL3 led to reductions in ANGPTL3 protein levels, with few adverse events. Full trial results: nej.md/43doGvu

In the CORE-TIMI 72a and CORE2-TIMI 72b phase 3 trials involving patients with severe hypertriglyceridemia, olezarsen led to a significantly greater reduction in the triglyceride level and in acute pancreatitis events than placebo. Full results: nej.md/491XG5V #AHA25

In intermediate-risk breast cancer, postmastectomy chest-wall irradiation did not improve 10-year overall survival as compared with no chest-wall irradiation. Full SUPREMO phase 3 trial results and Research Summary: nej.md/3Jxd3sI #MedSky #Oncology

Ben Davis, MD, director of the Swedish First Hill Family Medicine Residency program in Seattle, discusses the biggest shift he has seen among trainees in the past decade in terms of the career paths they are choosing. #MedSky #MedEd

In the PISCES trial involving participants receiving hemodialysis, fish oil (n−3 fatty acids) was compared with corn-oil placebo. The rate of serious cardiovascular events was lower with daily fish-oil supplementation. Full trial results: nej.md/49zWuqo @asnkidney.bsky.social | #KidneyWk

For moderate-to-severe plaque psoriasis, biologic therapies are highly effective but are available only by injection, and current oral therapies are often less effective. Research findings from the ICONIC-LEAD phase 3 trial are summarized in a Quick Take video. nej.md/47o15uv #MedSky #DermSky

A 20-year-old man with Graves’ disease presented to the ED with a 2-hour history of confusion. A goiter, bounding carotid pulses, and bruits over the thyroid (shown in videos) were noted on physical examination. Read the full case details: nej.md/3XcXjy2 #MedSky #EndoSky

In the latest episode of the Not Otherwise Specified podcast, host Lisa Rosenbaum, MD, and her guests explore the fraught relationship between medical training and primary care — and why even trainees who once aspired to be PCPs are changing course midstream.   #MedSky

An 83-year-old man presented to the ED with generalized pruritus that had begun the previous night. One month earlier, he had been evaluated in the neurology department for a unilateral peripheral facial-nerve palsy. Read the full case details: nej.md/47pvyIL #MedSky #NeuroSky

ORIGIN phase 3 trial: In an interim analysis of a clinical trial, atacicept, a fusion protein that binds and inhibits two cytokines thought to be central to the pathophysiology of IgA nephropathy, significantly reduced proteinuria. nej.md/3JEq8QL @asnkidney.bsky.social | #KidneyWk

New in the November 6, 2025, issue of NEJM: Survival after Chest-Wall Irradiation in Breast Cancer (SUPREMO phase 3 trial) nej.md/3Jxd3sI Oral Icotrokinra for Plaque Psoriasis (ICONIC-LEAD phase 3 trial) nej.md/3WDM6qg #MedSky

Opioid deprescribing is advised when risks of opioid use outweigh benefits. A tailored, patient-centered plan with gradual dose reduction, monitoring, and support can improve outcomes and reduce harm. Learn more: nej.md/4oL3fu2 #MedSky @sydney.edu.au

In a phase 1 trial in the United States and Liberia, a replication-competent recombinant vesicular stomatitis virus–vectored vaccine against Lassa fever had acceptable safety and was immunogenic over a wide dose range. Full trial results: nej.md/47pstZ9 #MedSky #IDSky

In moderate-to-severe plaque psoriasis, oral icotrokinra led to a skin-clearance response in 50 to 65% of patients at week 16, as compared with 4 to 8% with placebo. The incidence of adverse events was similar in the two groups. Full ICONIC-LEAD phase 3 trial results: nej.md/3WDM6qg #MedSky

In intermediate-risk breast cancer, postmastectomy chest-wall irradiation did not improve 10-year overall survival as compared with no chest-wall irradiation. Full SUPREMO phase 3 trial results: nej.md/3Jxd3sI #MedSky #Oncology

In a Perspective essay, the authors of write that in the face of Israel’s ongoing assault on Gaza’s health system and the catastrophic famine caused by the devastation, U.S. physicians have an ethical obligation to respond and support immediate changes. Full Perspective: nej.md/4ns9yCi

Prostate cancer mortality continues to rise globally. The European Randomized Study of Screening for Prostate Cancer, initiated in 1993, has previously reported reduced mortality with PSA-based screening. Updated research findings are summarized in a new Quick Take video. nej.md/49w67Gy

“I do not trust machine learning.” On NEJM AI Grand Rounds, Dr. Jonathan Chen reminds clinicians that real care needs reliability, not vibes. Listen to the full episode: nejm.ai/ep35 #AI #MedSky #MLSky

In a trial in healthy U.K. adults who were challenged with S. Paratyphi A in a controlled human infection model, two doses of the candidate vaccine CVD 1902 led to protection against S. Paratyphi A infection. Full VASP phase 2b trial results and Research Summary: nej.md/3Lypfd5  #MedSky

“Ah, it's your first gastroenteritis. It gets easier.” The latest video in our partnership with @glaucomflecken.bsky.social summarizes recent research on the effects of ondansetron after emergency visits in children with gastroenteritis-associated vomiting. 👉 nej.md/DrG29

The authors of a new review discuss how the use of noninvasive tests can change clinical practice across all settings and prepare clinicians to manage the increasing burden of liver disease in the years to come. Learn more: nej.md/4hwZMgj #MedSky #GastroSky

In the TeMPO trial, reduction in knee pain at 3 months was similar in participants assigned to home exercise alone and those assigned to home exercise, motivational text messages, and standard physical therapy. Full trial results and Research Summary: nej.md/4ofjqQt  #MedSky

A previously healthy man presented with a 10-day history of blood dripping from one nostril. Twenty days earlier, he had washed his face with mountain spring water. A leech was found on nasal endoscopy (shown in a video). Read the full case details: nej.md/3J6IZUD #MedSky #Otolaryngology

Excited to share the results of the TeMPO (Treatment of Meniscal Problems in Osteoarthritis) trial, published today in NEJM: www.nejm.org/doi/full/10.... A labor of love from the #BWH #oracore team, with partners in Buffalo, Pittsburgh, and Cleveland. 879 randomized with the COVID in the middle!

Among patients who survived 2 years after transcatheter arterialization of the deep veins, the majority had limb salvage with wound healing and improved pain scores. Full results of the PROMISE I and PROMISE II studies: nej.md/42YZE35 #MedSky #CardioSky

In advanced non–small-cell lung cancer with 𝘌𝘎𝘍𝘙 mutations, amivantamab–lazertinib led to longer overall survival than osimertinib but was associated with an increased risk of adverse events of grade 3 or higher. Full MARIPOSA phase 3 trial results and Research Summary: nej.md/4p6j53k

Case Record of the Massachusetts General Hospital: A 56-year-old man was admitted to the hospital because of left lower abdominal pain and anemia. He had a 1-year history of recurrent diarrhea and an enterocolonic fistula. A diagnosis was made. Read the full case details: nej.md/43AZeQv

VASP phase 2b trial: No vaccine against Salmonella enterica serovar Paratyphi A is currently available. Research findings involving a candidate vaccine are summarized in a new Quick Take video. nej.md/43Gbmjc #MedSky #IDSky

At 23 years of follow-up, population-based PSA screening of asymptomatic men led to a sustained reduction in prostate cancer mortality, although overdiagnosis remains a concern. Full ERSPC study results and Research Summary: nej.md/42YYsg7  #MedSky #Oncology