Inflammation Runs Through Every Quadrant

This long-term extension of the prospective European NISSC1 study followed all 80 patients who had autologous haematopoietic stem-cell transplantation for severe progressive systemic sclerosis, with a median follow-up of 9.2 years. Progression-free survival was 72% at 5 years and 60% at 10 years, and 34 of 80 patients (43%) stayed in remission without immunosuppressive treatment. Transplant-related deaths occurred in 5 of 80 patients (6%).

A French nationwide cohort of 72,291 adults with psoriasis, psoriatic arthritis or spondyloarthritis starting a biologic compared major cardiovascular events across drug classes. Among patients without prior cardiovascular disease, weighted hazard ratios versus TNF inhibitors were 0.90 for IL-12/23, 1.12 for IL-23 and 1.07 for IL-17 inhibitors, none statistically significant. A non-significant signal with IL-17 inhibitors in the first 6 months and in higher-risk subgroups needs further study.

A target trial emulation across 5 University of California medical centers matched 70,982 adults with type 2 diabetes starting a GLP-1 receptor agonist or an active comparator, screening 181 outcomes over up to 5 years. GLP-1 drug initiation was linked to lower risk of acute myocardial infarction (HR 0.53) and nephritis/nephrosis (HR 0.73). It was also linked to higher risk of osteoarthritis (HR 1.48), stress fractures (HR 1.68), sleep-wake disorders and menopausal disorders.

The prospective LITMUS study compared 12 single markers and 18 multimarker panels against centrally scored biopsies in 1,590 adults with MASLD across 13 countries. A proteomic panel (SomaSignal) best identified at-risk MASH (AUC 0.83) and advanced fibrosis (AUC 0.92), while FibroMeter-VCTE performed best for cirrhosis (AUC 0.94). Single markers alone showed variable and limited performance.

ATTAIN-J randomized 238 Japanese adults with obesity disease to one of three doses of once-daily oral orforglipron or placebo for 72 weeks. Mean body weight fell by 5.9% to 8.7% across orforglipron groups versus 0.6% with placebo, and up to 60.8% of participants reached at least 5% weight loss versus 15.2% with placebo. Side effects were mostly mild-to-moderate gastrointestinal symptoms.

Among 210,839 UK Biobank participants, higher Dietary Inflammatory Index scores were associated with more incident thyroid disease, hypothyroidism and hyperthyroidism. Each 1-point rise in the energy-adjusted index was linked to a 4% higher risk of overall thyroid disease (HR 1.04) and a 10% higher risk of hyperthyroidism (HR 1.10). CRP, neutrophil and platelet counts and IGF-1 partly mediated the associations.

This post hoc analysis of the ASPREE randomized trial tracked an intrinsic capacity index (cognition, locomotion, vitality, psychological well-being) in 18,581 adults aged 65 and older over 5 years. Lower intrinsic capacity correlated with epigenetic clocks such as DunedinPACE and predicted shorter disability-free survival. Low-dose aspirin did not prevent decline, and women on aspirin showed a small but significantly faster decline.

Automated bone density software was applied to low-dose CT scans of 21,856 heavy smokers in the National Lung Screening Trial. Two-year vertebral fracture incidence was 0.9% with normal bone mass, 2.0% with low bone mass and 5.9% with osteoporosis (adjusted relative risk 3.40). Osteoporotic bone density was also linked to higher mortality in men (HR 1.24).