A 56-year-old woman was hospitalized with gait instability. Eight weeks earlier, she had noticed ascending symmetric sensations of painful “pins and needles” that had begun in her feet; she later had memory impairment and irritability. Full case details: https://nej.md/4xXmJB5

3 newsworthy items in June: 1️⃣ The latest season of Intention to Treat ("The Race Equation") featured on WBUR's "Here & Now" https://nej.md/4vzT6UK 2️⃣ A report on Bundibugyo virus in the DRC cited in MedPage Today https://nej.md/442R3MX 3️⃣ ASCERTAIN-V trial in HealthDay https://nej.md/4eT7RuS

Among patients with intermediate coronary stenosis, whether a physiological assessment with an angiography-guided strategy is noninferior to a pressure-wire–guided strategy is unknown. Research findings from the ALL-RISE are summarized in a new Quick Take video. https://nej.md/3QN1AZE

NEJM Editorial Fellow Katerina Lin, MD, describes the key signs of AOM and when antibiotics might be more effective than watchful waiting. Learn more: https://nej.md/4iewDVV

New in the July 2, 2026, issue of NEJM: Angiography-Derived FFR to Guide PCI (ALL-RISE trial) nej.md/4lSbtjQ Angiography to Guide Coronary Revascularization (FAST III trial) nej.md/41rkAyp Pembrolizumab and Belzutifan for Renal-Cell Carcinoma (phase 3 LITESPARK-022 trial) nej.md/4y03AhE

A new review summarizes advances in the treatment of multiple sclerosis, with emphasis on effective disease-modifying therapies for relapsing disease and the need for better treatments to prevent progression and rebuild myelin. Read the full review: https://nej.md/3SDJGcn

Amanda Randles, PhD, describes the scientific foundations of two trials comparing how noninvasive and invasive assessments of fractional flow reserve affect clinical outcomes. Learn more about the science behind the study: https://nej.md/4xUKlGx

Among patients with newly diagnosed relapsing multiple sclerosis, rituximab was noninferior to ocrelizumab in preventing new or enlarging lesions on MRI. The risk of serious adverse events was similar in the two groups. Full phase 3 OVERLORD-MS trial results: https://nej.md/3QJuaep

In patients with resected clear-cell renal-cell carcinoma, pembrolizumab plus belzutifan led to higher disease-free survival than pembrolizumab alone but with an increased risk of grade 3 or higher adverse events. Full phase 3 LITESPARK-022 trial results: https://nej.md/4y03AhE

I have NO clear plan on how to optimally incorporate AI in patients care-- but there are times when AI isn't enough. Don't forget to sign up for email alerts so you never miss a piece- no subscription to @NEJM required- access is free! voices.nejm.org/doi/full/10....

Among participants with rifampicin-resistant tuberculosis, a 6-month treatment strategy consisting of bedaquiline, linezolid, delamanid, and levofloxacin or clofazimine was noninferior to the standard treatment. Full phase 3 BEAT Tuberculosis trial results: https://nej.md/4w7aekw

In a new blog post, Dr. Michelle Kittleson (@mkittlesonmd.bsky.social) writes that AI can be a helpful tool for physicians, but only if you know what questions to ask. Read “Authentic Intelligence” and sign up for email alerts: https://voices.nejm.org/doi/full/10.1056/VOICESpost2600022

𝐍𝐞𝐰 𝐢𝐧 𝑵𝑬𝑱𝑴 𝑪𝒂𝒕𝒂𝒍𝒚𝒔𝒕 𝑰𝒏𝒏𝒐𝒗𝒂𝒕𝒊𝒐𝒏𝒔 𝒊𝒏 𝑪𝒂𝒓𝒆 𝑫𝒆𝒍𝒊𝒗𝒆𝒓𝒚! HealthPartners’ Antimicrobial Stewardship Program demonstrates the potential of centralized complex outpatient antibiotic therapy programs to optimize patient care. Learn more: https://nej.md/4uEs79k Explore the July issue: https://nej.md/3QMDUo2

Video surveillance captured an episode of syncope from ventricular arrhythmia in a 47-year-old man with heart failure with a reduced ejection fraction and an implantable cardioverter–defibrillator for the primary prevention of sudden cardiac death. Full case details: https://nej.md/4w1yfJM

In a cluster-randomized trial involving patients having major noncardiac surgery, tranexamic acid reduced the need for red-cell transfusion during hospitalization and was noninferior to placebo for venous thromboembolism within 90 days. Full TRACTION trial results: https://nej.md/4e8QKF4

The outbreak of Bundibugyo virus disease in 2026 was officially recognized after the severe illness and death of a nurse from Mongbwalu, Ituri Province. Subsequent epidemiologic investigations suggested that transmission had probably begun several weeks earlier. Learn more: https://nej.md/4wdVpNn

Peanuts should be introduced at 4 to 6 months of age in infants at high risk for allergy and at approximately 6 months of age in other infants. For infants with peanut allergy, early immunotherapy is safer and more effective.  Learn more: https://nej.md/3SKV5Hf

Which patients should clinicians screen for metabolic dysfunction-associated steatotic liver disease (MASLD)? On Beyond Journal Club from @coreimpodcast.bsky.social and NEJM Group, the hosts unpack the evolving language of the disease and look at two major trials. Listen now: https://nej.md/4anqJki

In patients with persistent atrial fibrillation, first-line treatment with pulsed field ablation reduced the recurrence of atrial arrhythmias at 12 months as compared with antiarrhythmic drugs. Full AVANT GUARD trial results and Research Summary: https://nej.md/3QnSpya

In children with peanut allergy, the increase in reactivity to peanut that comes with age is mirrored by an increase in Ara h 2–specific IgE levels and expansion in the size of wheals from a peanut skin-prick test, which persist despite strict dietary avoidance. Learn more: https://nej.md/3SKV5Hf

Phase 3 BEAT Tuberculosis trial: Safer, more effective treatment regimens are needed for patients with rifampicin-resistant tuberculosis. Research evaluating the efficacy and safety of a 6-month treatment strategy is summarized in a short video. https://nej.md/3SJtPsC

In a phase 3, randomized trial involving children with achondroplasia (3 to 17 years of age), once-daily oral infigratinib for 1 year significantly increased the annualized height velocity as compared with placebo. Full PROPEL 3 trial results: https://nej.md/4w8vTJc #ICCBH2026

B-Well 1 and B-Well 2: In two phase 3 trials, 19% of patients with chronic hepatitis B infection had a functional cure with the antisense oligonucleotide bepirovirsen, 24 weeks after stopping all HBV treatment; functional cure was not seen with placebo. Full results: https://nej.md/4fKe9ib

NEJM Editorial Fellow Katerina Lin, MD, summarizes the diagnosis and treatment of complex regional pain syndrome (CRPS), a rare limb-pain disorder. Learn more about this disorder in a December 10, 2025, Clinical Practice article: https://nej.md/3MSMW0n

With the supply of blood components increasingly constrained, new strategies are needed to reduce transfusion demand among patients undergoing major noncardiac surgery. Research findings from the TRACTION trial are summarized in a new Quick Take video. https://nej.md/4w9Dg37

A 47-year-old man with heart failure with a reduced ejection fraction and an ICD for the primary prevention of sudden cardiac death presented with an unheralded syncopal event, which had been captured by video surveillance at work. Read the full case details: https://nej.md/4w1yfJM

A rapid response to crizotinib after failure of chemotherapy in a patient with infantile fibrosarcoma with a 𝘛𝘍𝘎::𝘔𝘌𝘛 fusion underscores the value of molecular profiling in atypical disease. This approach could enable limb sparing. Read the full report: https://nej.md/4w7abFm

A previously healthy 4-year-old boy presented to the emergency department with leg pain and an inability to bear weight on his left side. Read the full case details and submit your answer or see how others responded: https://nej.md/IC06252026

For persistent atrial fibrillation, a trial of antiarrhythmic drugs is recommended before catheter ablation. Whether pulsed field ablation might be preferable as first-line therapy is unclear. Research findings from the AVANT GUARD trial are summarized in a short video. https://nej.md/4w8yUJE

A new Public Health Alerts report describes the public health response to a travel-associated case of mpox in New Hampshire with exposures in congregate living, health care, and household settings. Read the full report: https://eviden.cc/4alzYkU #InfectiousDisease

Case Record of the Massachusetts General Hospital: A 53-year-old man was admitted to the hospital with weight loss, progressive pain, and leg weakness. The glycated hemoglobin level was greater than 14.0%. A diagnosis was made. Full case details: https://nej.md/4wdVnoJ

How is the current anti-DEI climate reshaping scientific research and the future of the medical workforce? Learn more in the latest episode of Intention to Treat: https://nej.md/ITTs2e8

Peanuts should be introduced at 4 to 6 months of age in infants at high risk for allergy and at approximately 6 months of age in other infants. For infants with peanut allergy, early immunotherapy is safer and more effective. Learn more: https://nej.md/3SKV5Hf

New in the June 25, 2026, issue of NEJM: Bepirovirsen for Chronic Hepatitis B Virus Infection (B-Well 1 and B-Well 2 trials) nej.md/4fKe9ib Pulsed Field Ablation for Atrial Fibrillation (AVANT GUARD trial) nej.md/3QnSpya

Among 38 patients who received CAR T-cell therapy for refractory or relapsed B-cell lymphomas, lymphoma-free survival at 10 years was 32% for large B-cell lymphomas and 47% for follicular lymphoma. Full study results: https://nej.md/43Q63h4

Among participants with rifampicin-resistant tuberculosis, a 6-month treatment strategy consisting of bedaquiline, linezolid, delamanid, and levofloxacin or clofazimine was noninferior to the standard treatment. Full phase 3 BEAT Tuberculosis trial results: https://nej.md/4w7aekw

Bundibugyo virus, a filovirus, is currently spreading in the Democratic Republic of Congo. This report presents early data on symptoms and illness severity as well as diagnostic challenges. Read the full report: https://nej.md/4vZG8zi

A new review by Nancy J. Sullivan, ScD, summarizes the current state of the 2026 filovirus disease outbreak in the Democratic Republic of Congo, as well as the principles and approaches that are informing the response. Read the full review: https://nej.md/4wdVpNn

In a new blog post, Dr. Paul Sax (@paulsaxmd.bsky.social) writes that a year after the SNAP trial results were presented at a scientific meeting, the peer-reviewed publications confirm the practice-changing findings. Learn more: voices.nejm.org/doi/full/10....

In the SNAP trial, cefazolin was noninferior to flucloxacillin or cloxacillin with respect to 90-day mortality in patients with methicillin-susceptible Staphylococcus aureus bacteremia and had fewer nephrotoxic effects. Read the full trial results and Research Summary: https://nej.md/4vL0M6m 

The clinical benefits of checkpoint inhibitors in the treatment of cancer often wane. A preclinical study points to a potential strategy for a more durable effect. Learn more about the study: https://nej.md/4uBjfkV Try AI Companion to surface key details from this article instantly.

GLP-1s and Pancreatitis: New Data NEJM Clinician Editor-in-Chief Raja-Elie Abdulnour, MD, shares some key results of a recent analysis of a VA database on the relation between GLP-1s and pancreatitis. Read more from Dr. David Weisman: https://jwat.ch/4e1gHr7

Our latest video in our partnership with @glaucomflecken.bsky.social summarizes the TRIDENT trial that evaluated the efficacy and safety of a triple-antihypertensive pill after intracerebral hemorrhage. Read the full study for free: https://nej.md/DrG43 #neurology

Among patients with traumatic hemorrhage, prehospital transfusion of whole blood did not result in lower 30-day mortality than transfusion of plasma or red cells. Outcomes did not differ according to the storage age of blood. Full TOWAR trial results and Research Summary: https://nej.md/4uPFGn0

𝐍𝐨𝐰 𝐚𝐯𝐚𝐢𝐥𝐚𝐛𝐥𝐞 𝐢𝐧 𝑵𝑬𝑱𝑴 𝑬𝒗𝒊𝒅𝒆𝒏𝒄𝒆! A new Public Health Alerts report, published in partnership with @cidrap.bsky.social: Outbreak of Legionnaires’ Disease Associated with Cooling Tower Systems in Central Harlem https://eviden.cc/4gyRxBF #InfectiousDisease

Among patients with traumatic hemorrhage, prehospital whole-blood transfusion was not superior to standard transfusion with red-cell and plasma components in reducing the risk of death or massive transfusion. Full phase 3 SWiFT trial results and Research Summary: https://nej.md/4ozfB9Q 

𝐍𝐨𝐰 𝐚𝐯𝐚𝐢𝐥𝐚𝐛𝐥𝐞 𝐢𝐧 𝑵𝑬𝑱𝑴 𝑬𝒗𝒊𝒅𝒆𝒏𝒄𝒆! A new Public Health Alerts report, published in partnership with @cidrap.bsky.social: Measles Outbreak in Cook County, Illinois, September–October 2025 https://eviden.cc/4xH2dVd #InfectiousDisease #Pediatrics

Case Record of the MGH: A 74-year-old man with a recent orthotopic heart transplantation was admitted to the hospital because of persistent pancytopenia that resulted in serial transfusions of packed red cells. A diagnosis was made. Full case details: https://nej.md/4uBjfRX

Images in Clinical Medicine: Immunosuppression-Associated Peripheral T-Cell Lymphoma https://nej.md/4uBjgW1 #Hematology #Gastroenterology

Dorothy Roberts, JD, a professor of law and sociology at the University of Pennsylvania (@upenn.edu), speaks on why "approving BiDil as a race-based drug is bad medicine." Go deeper in episode 5 of the Intention to Treat podcast.