- N Engl J Med 2022; 387:790-798
During the 2022 clinical rollout of nirmatrelvir in Israel, most patients (78%) had previous SARS-CoV-2 immunity. Benefit was seen in patients at highest risk for Covid-19 progression, such as those 65 years of age or older.
- N Engl J Med 2022; 387:810-823
A randomized trial of bedaquiline–pretomanid–linezolid for highly drug-resistant tuberculosis assessed the use of linezolid at 600 or 1200 mg for 9 or 26 weeks; the 600-mg dose for 26 weeks had a favorable profile.
- N Engl J Med 2022; 387:799-809
In this study involving 1257 pregnancies among persons treated for HIV-1 infection during pregnancy, dolutegravir was better at suppressing viral loads than other regimens, without evident safety concerns.
- N Engl J Med 2022; 387:779-789
In a randomized trial of fractional flow reserve versus IVUS to guide PCI, the use of FFR resulted in fewer coronary interventions and was noninferior to IVUS with respect to clinical outcomes at 2 years.
In a randomized trial involving patients who had undergone percutaneous coronary intervention, routine functional testing did not improve clinical outcomes at 2 years.
In a prospective global study, extravascular implantable cardioverter–defibrillators with a substernal lead were implanted safely and were able to detect and terminate induced ventricular arrhythmias at the time of implantation.
Among patients with rheumatic heart disease and atrial fibrillation who received a vitamin K antagonist or rivaroxaban, the rate of stroke, systemic embolism, MI, or death from vascular or unknown causes was lower with a VKA, without increased bleeding.
In a trial involving patients with heart failure and a mildly reduced or preserved ejection fraction, dapagliflozin reduced the risk of worsening heart failure or cardiovascular death.
In comatose patients after out-of-hospital cardiac arrest, the incidence of death or severe disability was similar regardless of whether a restrictive or a liberal oxygenation strategy was used.
Among older men in Denmark, the incidence of death from any cause at a median follow-up of 5.6 years was not significantly lower among those randomly invited to undergo screening for subclinical cardiovascular disease.
In a randomized trial involving patients with a low LVEF and viable myocardium who received optimal medical therapy, PCI did not lead to a lower incidence of death or hospitalization for heart failure.
In a randomized, placebo-controlled trial, patients with acute decompensated heart failure and volume overload who received intravenous acetazolamide plus a loop diuretic had a higher incidence of decongestion.
This trial showed no significant difference in the percentage of patients who died or had severe disability or coma when higher or lower blood-pressure targets were used after an out-of-hospital cardiac arrest.
- Original ArticleAug 26, 202210.1056/NEJMoa2208275
Among patients with recent MI, therapy with a polypill containing aspirin, ramipril, and atorvastatin led to a lower incidence of major adverse cardiovascular events at a median of 3 years than usual care.
- N Engl J Med 2022; 387:692-703
Some insurance companies mandate a form of step therapy, which involves initial use of an inexpensive drug, bevacizumab, to treat diabetic macular edema. This trial compared two treatments: step therapy and use of a more expensive drug.
- N Engl J Med 2022; 387:715-726
In patients with rheumatoid arthritis, the monoclonal antibody against interleukin-6, olokizumab, was superior to placebo and noninferior to adalimumab at 12 weeks.
- N Engl J Med 2022; 387:679-691
In this report, 528 cases of monkeypox across 16 countries are described. Rash, mucosal lesions, fever, lethargy, and lymphadenopathy were common clinical findings. Few patients were hospitalized.
- N Engl J Med 2022; 387:704-714
In two parallel randomized trials in patients with MS, ublituximab resulted in lower relapse rates and fewer brain lesions on MRI than teriflunomide over a period of 96 weeks but did not affect disability.
- N Engl J Med 2022; 387:587-598
Pregnant women were assigned to be evaluated with lower or higher glycemic criteria for the diagnosis of gestational diabetes. Lower criteria did not reduce the risk of a large-for-gestational-age infant.
- N Engl J Med 2022; 387:611-619
From January through April 2022, a total of 44 children with acute hepatitis were referred to a liver-transplantation center in the U.K., and 6 underwent liver transplantation; these numbers were higher than those in previous years.