Pooja Singhal, MD, is a gastroenterologist, hepatologist, and obesity medicine specialist at Oklahoma Gastro Health and Wellness.

Pooja Singhal, MD | Image Credit: Oklahoma Gastro Health and Wellness

 published a Commission establishing an official definition and diagnostic criteria for 

, aiming to alter the way the condition is approached in 

The central conceit of the Commission was the difference between clinical and preclinical obesity, which is described as the presence or absence of objective clinical manifestations. These primarily include altered organ function or the impairment of a patient’s ability to conduct daily activities. A lens this specific allows clinicians to account for patients who are technically obese but exhibit no comorbidities, outwardly appearing to be in good health.

Additionally, the Commission provided suggestions for altering the diagnostic process for obesity, encouraging the abandonment of the body mass index (BMI) as the sole indicator. Instead, the commissioners suggest the utilization of ≥2 individual anthropometric criteria, such as waist circumference, or direct fat measurement when possible. This should prevent the rampant overdiagnosis of obesity that was predicted by the Commission.

To address how the Commission’s decision has influenced endocrinology since its publication, the editorial team at 

 spoke with Pooja Singhal, MD, a gastroenterologist, hepatologist, and obesity medicine specialist at Oklahoma Gastro Health and Wellness, in the following Q&A:

: How has the move toward formally defining obesity as a disease shaped the landscape of obesity care?

: I think defining obesity as a disease was truly transformational. It helped establish a scientific and moral basis for treating obesity directly. You know, in the past, we used to treat the complications – sleep apnea, diabetes, hypertension, cardiovascular disease, MASLD. Now it has helped us to have a newer approach, which is that obesity itself is a disease, and we need to treat that and prevent complications. I think this reframing has been revolutionary and has really redefined how we approach obesity in general. It’s validated that obesity should be treated. It is a disease, and it should be treated before complications arise. It also helped reduce this kind of moral blame on patients by defining it as a true disease that exists on its own, in its own right. It has promoted earlier intervention proactiveness to seek help, and I also think it’s going to help and already has helped early intervention in pediatric obesity, because that’s what we have seen more and more of. I think the whole Commission’s work is helping us in all these ways.

: To what extent has defining obesity as a disease opened the door to broader acceptance of pharmacologic treatment, especially GLP-1s?

: I think GLP-1s have fit perfectly into this new narrative of biological disease. Because it’s really when people see results, when they see that a medication that works neurohormonally can lead to appetite curbing and lead to the weight loss that people were absolutely not able to achieve, no matter what they tried. It has changed that narrative and acceptance as a community, as a society, even globally, that obesity is truly a disease and regulation of appetite signaling has a big role in it. So, I think the timing of the GLP-1s and the results have also been very much a boon to this biologic narrative of obesity as a disease without that disease framing, where GLP-1s would not have been culturally accepted.

: What other details can you provide around clinicians’ views of obesity following the Commission?

: It’s also led to the clinician’s view of obesity has changed too. Before, it was kind of episodic treatment, if you will. Now there’s more willingness to view pharmacotherapy as a first-line option of obesity for many patients. In the past, it was all about diet and exercise and lifestyle changes. Now, more and more clinicians understand that obesity is a disease, and early prevention and treatment could lead to preventing some very serious complications. So I do also love the fact that it has informed clinician behavior as well and promoted chronic management approach rather than episodic weight loss attempts.

Rubino F, Cummings DE, Eckel RH, et al. Definition and diagnostic criteria of clinical obesity. 

Livingston R. The Lancet Commission on Obesity: Redefining Endocrinology’s Most Notorious Condition. 

. December 18, 2025. Accessed December 19, 2025. 

https://www.hcplive.com/view/the-lancet-commission-on-obesity-redefining-endocrinology-s-most-notorious-condition

Articles

The Lancet Diabetes & Endocrinology Commission has redefined obesity by distinguishing between clinical and preclinical obesity, focusing on objective clinical manifestations. This new definition encourages moving beyond BMI as the sole diagnostic tool, advocating for multiple anthropometric criteria. The reclassification of obesity as a disease has transformed its treatment, promoting early intervention and reducing patient stigma. It has also facilitated the acceptance of pharmacologic treatments like GLP-1s, shifting clinician perspectives towards chronic management rather than episodic interventions.

Singhal discusses the multi-pronged impact of the Commission’s definition of obesity and how it effects clinicians, patients, and the treatment structure itself.

News

news page, resources on the topics of disease- and specialty-specific medical news and expert insight can be found. Content includes articles, interviews, videos, podcasts, and breaking news on health care research, treatment, and drug development.

Clinical

clinical page is a resource for content on every specialty, disease, and topic available on our medical news site.

Endocrinology

The HCPLive endocrinology page is a comprehensive resource for clinical news and insights on endocrine system conditions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for diabetes, hormonal disease, and more.

Obesity Management

Obesity Management condition center page, resources on the topics of medical news and expert insight into clinical weight management can be found. Content includes articles, interviews, videos, podcasts, and breaking news on obesity research, treatment, and drug development.

Impacts of the Lancet Commission on Obesity Treatment, With Pooja Singhal, MD

Tim Smith joined the MJH Life Sciences team in 2022 and is currently an associate editor for HCPLive. He is also the executive producer of two podcasts: Skin of Color Savvy and The Medical Sisterhood. Previously, he was the producer of the Lungcast podcast. He graduated from UC Berkeley and worked in multimedia journalism as a staff writer prior to joining MJH. You can contact him at tsmith@mjhlifesciences.com.

Inflammatory bowel disease (IBD) and increased body mass index (BMI) are causally linked to patients’ risk of hidradenitis suppurativa (HS), new findings suggest.

These new findings and their analysis were published in 

, with Rune Kjærsgaard Andersen, MD, PhD, from the Department of Dermatology and Allergy at Herlev and Gentofte Hospital in Denmark, as the corresponding author. Andersen et al highlighted the previous connections drawn between obesity and smoking to HS development, pointing to what had previously been a lack of a causal connection fully developed by researchers.

“To investigate our primary objective, the causal effect of the environmental exposures on HS, we performed 2-sample MR analyses of body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) and smoking on HS,” Andersen and colleagues wrote.

As a secondary aim, the investigators set out to assess a potential connection between HS and 3 inflammatory conditions: psoriasis, IBD, and systemic sclerosis (SSc).

The investigative team performed their Mendelian randomization (MR) analysis to assess the aforementioned 5 traits and HS as the study's outcome. Their analysis leveraged large genome-wide association study (GWAS) datasets which they noted were made up of individuals of White European ancestry for all phenotypes. Andersen et al noted their primary analyses were carried out in May 2024 and later given updates in May 2025.

Genetic correlation (rg), which ranges from −1 to 1 and reflects the extent of shared genetic architecture between 2 traits, was calculated by the investigators between HS and each exposure via the use of cross-trait linkage disequilibrium (LD) score regression. These analyses incorporated association statistics from approximately 1.2 million well-imputed genetic variants. Andersen and colleagues derived LD information from precomputed scores for White European populations provided by the Broad Institute.

Genome-wide significant single-nucleotide variants (SNVs) identified in the largest publicly available GWAS previously, or in consortium datasets, were implemented by the investigative team as instrumental variables for each exposure phenotype. The team collected HS data from a meta-analysis including 4814 individuals with HS and 1,216,105 control participants from Iceland, Denmark, Finland, the UK, and the US. The necessary BMI estimates were based on a White European–restricted meta-analysis of roughly 700,000 participants from the UK Biobank and the GIANT consortium.

For SSc, Andersen and coauthors used a publicly available meta-analysis of 9095 cases and 17,584 control participants of White European descent was used. Data on psoriasis came from a meta-analysis including 39,498 cases and 286,769 controls. Smoking-related genetic instruments were derived from a large analysis which looked into ever-regular smokers with never-regular smokers, encompassing 1,232,091 subjects. IBD data were sourced from the International IBD Genetics Consortium and included 38,155 cases and 48,485 controls.

Overall, the investigative team's genetic correlation analyses demonstrated significant shared genetic liability between HS and all exposures except SSc. They found positive correlations for BMI (rg = 0.36, 

 < .001), smoking (rg = 0.33, P < .001), and psoriasis (rg = 0.34, 

 < .001). Conversely, the correlation with SSc was shown not to be statistically significant (rg = 0.33, 

Andersen et al's MR results supported a causal link between increased BMI and higher risk of HS, with the investigators pointing to an estimated effect size of β = 0.87, corresponding to an OR of 1.20 per unit increase in BMI (95% CI, 1.17–1.23; 

 < .001). In their sensitivity analyses, Andersen and colleagues did not identify evidence of directional pleiotropy (slope β = 0.91, 

 = .76). They also noted smoking initially demonstrated a significant causal estimate (β = 0.59, 

 < .001), but added the link was attenuated and became less definitive in sensitivity analyses.

Among the remaining immune-mediated conditions assessed by Andersen and coauthors, the data supported a causal role for IBD in development of HS (β = 0.18; OR = 1.20; 95% CI, 1.15–1.24; 

 < .001), and there was no indication of pleiotropic bias.

“Although initial MR analysis also found a causal effect of smoking on HS, this disappeared during subsequent sensitivity analysis,” the team concluded.

“However, because none of the sensitivity analyses revealed signs of pleiotropic effects, the MR should be viewed as inconclusive rather than proof of no causal effect.”

Kjærsgaard Andersen R, Riis PT, Zachariae C, et al. Hidradenitis Suppurativa and Smoking, Obesity, Psoriasis, Inflammatory Bowel Disease, and Systemic Sclerosis: Results From A 2-Sample Mendelian Randomization Study. JAMA Dermatol. Published online December 17, 2025. 

Mintoff D, Agius R, Pace NP, et al. Obesity and hidradenitis suppurativa: targeting meta-inflammation for therapeutic gain. Clin Exp Dermatol. 2023 Aug 25;48(9):984-990. doi: 10.1093/ced/llad182. PMID: 37171791.

Happle R, König A. A lesson to be learned from Karl Marx: smoking triggers hidradenitis suppurativa. Br J Dermatol. 2008 Jul;159(1):255-6; author reply 256-7. doi: 10.1111/j.1365-2133.2008.08604.x. Epub 2008 Jul 1. PMID: 18489595.

New research indicates a causal link between inflammatory bowel disease (IBD), increased body mass index (BMI), and the risk of hidradenitis suppurativa (HS). The study utilized Mendelian randomization (MR) analysis, leveraging large genome-wide association study datasets. Significant genetic correlations were found between HS and BMI, IBD, smoking, and psoriasis, but not systemic sclerosis (SSc). The findings suggest a causal role for increased BMI and IBD in HS development, while the initial causal link between smoking and HS was not supported in sensitivity analyses.

This study explored the potential impact of body mass index (BMI) and smoking on patients’ risk of developing hidradenitis suppurativa.

Hidradenitis Suppurativa

Hidradenitis Suppurativa condition center page, audiences can find a variety of coverage mediums for medical news and updates, including articles, video interviews, podcasts, and breaking news on dermatology research, treatment, and drug development.

Dermatology

The HCPLive dermatology page is a resource for medical news and expert insights on skin disease. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for dermatologic conditions, and more.

BMI, Inflammatory Bowel Disease Both Show Causal Effect on HS Development

Abigail Brooks is an assistant managing editor for 

She joined MJH Life Sciences in August 2023 shortly after graduating from Monmouth University where she earned her BA in Communication with a concentration in Public Relations/Journalism and later an MA in Interactive Digital Media. She enjoys traveling, running, and reading books. She can be reached at abrooks@mjhlifesciences.com.

The US Food and Drug Administration has approved Cytokinetics’ aficamten (Myqorzo) 5 mg, 10 mg, 15 mg, 20 mg tablets for the treatment of adults with symptomatic obstructive hypertrophic cardiomyopathy (oHCM) to improve functional capacity and symptoms.

According to a December 19, 2025, press release from the Company, the approval is based on positive results from the phase 3 SEQUOIA-HCM clinical trial demonstrating robust efficacy, safety, and clinically meaningful benefits across symptoms, exercise capacity, hemodynamics, and biomarker endpoints. Of note, the full US Prescribing Information for aficamten includes a Boxed Warning for the risk of heart failure.

“HCM is a heart muscle disease associated with a significant symptom burden. This approval of a new drug, [aficamten], represents a meaningful addition to the treatment options available for symptomatic obstructive HCM patients,” Martin Maron, MD, Director, Hypertrophic Cardiomyopathy Center, Lahey Hospital and Medical Center, and Principal Investigator of SEQUOIA-HCM, said in a statement.

 “In SEQUOIA-HCM, [aficamten] improved exercise capacity and reduced symptoms while also being well-tolerated. For these reasons, [aficamten] represents an important step forward in how we care for people living with obstructive HCM.”

Aficamten is an allosteric and reversible inhibitor of cardiac myosin motor activity. In patients with oHCM, myosin inhibition with aficamten reduces cardiac contractility and left ventricular outflow tract (LVOT) obstruction.

Results from SEQUOIA-HCM showed treatment with aficamten for 24 weeks significantly improved exercise capacity compared to placebo, increasing peak oxygen uptake (pVO2) measured by cardiopulmonary exercise testing (CPET) by 1.8 mL/kg/min compared to baseline in patients treated with aficamten versus 0.0 mL/kg/min in patients treated with placebo (least square mean (LSM) difference, 1.74 mL/kg/min; 95% CI, 1.04-2.44]; 

= .000002). The treatment effect of aficamten was consistent across all prespecified subgroups, including age, sex, patient baseline characteristics, and in patients receiving or not receiving background beta-blocker therapy.

In the trial, aficamten was well-tolerated with no instances of worsening heart failure or treatment interruptions due to low LVEF. Treatment emergent serious adverse events occurred in 5.6% of patients on aficamten and 9.3% of patients on placebo.

Core laboratory echocardiographic LVEF was observed to be <50% in 5 patients (3.5%) on aficamten compared to 1 patient (0.7%) on placebo. Hypertension (8% vs 2%) was the only adverse reaction occurring in >5% of patients and more commonly on aficamten than on placebo. Aficamten-associated increases in blood pressure are consistent with relief of LVOT obstruction and improved cardiac output.

As described in the press release, aficamten includes a Boxed Warning for the risk of heart failure. Cytokinetics notes aficamten reduces LVEF and can cause heart failure due to systolic dysfunction. Therefore, echocardiogram assessments are required prior to and during treatment with aficamten to monitor for systolic dysfunction, and initiation of aficamten in patients LVEF <55% is not recommended.

The release instructs providers to decrease the dose of aficamten if LVEF <50% and ≥40% and to interrupt the dose of aficamten if LVEF <40% or if the patient experiences heart failure symptoms or worsening clinical status due to systolic dysfunction. Because of the risk of heart failure due to systolic dysfunction, aficamten is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the MYQORZO REMS Program.

“Living with symptomatic obstructive HCM means managing physical limitations and burdensome symptoms every day of your life,” said Lisa Salberg, Founder and CEO of the Hypertrophic Cardiomyopathy Association.

 “For far too long, we’ve had few options to address our needs, and the approval of [aficamten] is a long-awaited and major addition to bring new hope to patients living with oHCM. We are so grateful to the team at Cytokinetics for listening to the patient community and working in true partnership to bring this therapy to so many in need.”

Cytokinetics. Cytokinetics Announces FDA Approval of MYQORZO™ (aficamten) for the Treatment of Adults with Symptomatic Obstructive Hypertrophic Cardiomyopathy to Improve Functional Capacity and Symptoms. December 19, 2025. Accessed December 19, 2025. 

https://ir.cytokinetics.com/press-releases/press-release-details/2025/Cytokinetics-Announces-FDA-Approval-of-MYQORZO-aficamten-for-the-Treatment-of-Adults-with-Symptomatic-Obstructive-Hypertrophic-Cardiomyopathy-to-Improve-Functional-Capacity-and-Symptoms/default.aspx

Campbell P. Aficamten Showcases oHCM Benefit in Phase 3 SEQUOIA-HCM Trial. HCPLive. May 13, 2024. Accessed December 19, 2025. 

https://www.hcplive.com/view/aficamten-showcases-ohcm-benefit-in-phase-3-sequoia-hcm-trial

The FDA has approved Cytokinetics' aficamten for treating symptomatic obstructive hypertrophic cardiomyopathy (oHCM) in adults, enhancing functional capacity and symptoms. This approval follows positive phase 3 SEQUOIA-HCM trial results, demonstrating significant improvements in exercise capacity and symptom reduction. Aficamten, an allosteric inhibitor of cardiac myosin, reduces cardiac contractility and LVOT obstruction. Despite its efficacy, aficamten carries a Boxed Warning for heart failure risk, necessitating echocardiogram monitoring. It is available through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS).

The approval is based on phase 3 SEQUOIA-HCM clinical trial. The full US Prescribing Information includes a Boxed Warning for the risk of heart failure.

Cardiomyopathy

Cardiology

Cardiology condition center page is a comprehensive resource for clinical news and insights on cardiovascular and cardiometabolic diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for heart disease and cardiovascular events, as well as associated diabetes, renal failure, and more...

FDA News

FDA Approves Aficamten (Myqorzo) for Symptomatic Obstructive Hypertrophic Cardiomyopathy

Alex Hillenbrand is an assistant editor for 

. She earned her BA in English from Lafayette College in 2023 and went on to write for pop culture, entertainment, and sports media outlets before joining MJH Life Sciences in 2025. In her free time, Alex enjoys cooking, going on walks, and meeting new people. Contact her at mjhlifesciences.com.

, new research suggests renal transplantation is associated with significantly decreased risks of sleep disorders compared to dialysis.

These findings suggest renal transplantation may improve sleep quality in patients with ESRD, reducing the risk of sleep disorders like insomnia, excessive daytime sleepiness, obstructive sleep apnea, and restless legs syndrome (RLS).

“This study highlights the negative effects of ESRD on sleep disorders in affected patients,” wrote study investigator Hamdan AL-Jahdali, a professor

 at King Saud bin Abdulaziz University for Health Sciences,

 and colleagues. “It reinforces existing research demonstrating the benefits of renal transplantation in lowering the risk of obstructive sleep apnea, insomnia, and RLS, while also improving overall sleep quality.”

The most common sleep disorders in patients with chronic kidney disease (CKD), such as ESRD, include insomnia, RLS, and periodic limb movement disorder. The detection and management of these disorders can be difficult, considering the symptomatology frequently coincides with general CKD symptoms.

In patients with ESRD, those on dialysis often experience poor sleep quality, which has been linked to increased morbidity and mortality. Post-transplant patients may have sleep disturbances, mainly related to immunosuppressive therapy, pain, or psychological factors. Until now, direct comparisons of the outcomes of sleep quality between the groups have been limited.

In a clinic-based cross-sectional study, investigators compared the association between sleep disorders and patients with post-organ transplant and those with ESRD on dialysis. They collected demographic data and administered structured sleep questionnaires, including the Epworth Sleepiness Scale (ESS), Berlin Questionnaire (BQ), STOP-BANG questionnaire, Pittsburgh Sleep Quality Index (PSQI), and questionnaires for insomnia and RLS.

The study included 386 participants ≥ 18 years of age. Of these, 58.8% were patients with ESRD on dialysis (n = 227), and 41.2% had undergone renal transplants (n = 159).

Unmatched analysis revealed renal transplantation patients had significantly decreased odds of sleep disorders compared to those with ESRD on dialysis.

In matched analysis, investigators observed that this association remained significant among the following sleep disorders:

Insomnia (Odds Ratio [OR], 0.083; 95% Confidence Interval [CI], 0.030-0.231)

Excessive daytime sleepiness (OR, 0.034; 95% CI, 0.005-0.253)

Poor sleep quality (OR, 0.265; 95% CI, 0.127-0.552)

The likelihood of increased risk for obstructive sleep apnea using BQ (OR, 0.217; 95% CI, 0.119-0.395)

Increased risk for obstructive sleep apnea using STOP-BANG criteria (OR, 0.122; 95% CI, 0.063-0.236).

“A significant limitation is the lack of objective assessment of obstructive sleep apnea through formal sleep studies, and the use of a historical dialysis cohort may introduce bias due to changes in patient management or population characteristics over time,” concluded study investigators. “This limitation should be acknowledged, as the reliance on subjective evaluations can result in inaccuracies or misrepresentations in obstructive sleep apnea diagnosis.”

Alharbi T, Salman A, Turki A, et al. Sleep disorders in renal patients: a comparative analysis of dialysis and post-renal transplant outcomes. 

. Published online December 14, 2025. doi:

https://doi.org/10.1038/s41598-025-28159-3

‌Gopal A, Farragher J, Jassal SV, Mucsi I. Sleep Disorders in CKD. 

https://doi.org/10.1053/j.ajkd.2024.12.010

Renal transplantation in patients with end-stage renal disease (ESRD) is linked to a significant reduction in sleep disorders compared to those on dialysis. This improvement in sleep quality encompasses conditions such as insomnia, excessive daytime sleepiness, obstructive sleep apnea, and restless legs syndrome (RLS). A clinic-based cross-sectional study involving 386 participants highlighted these findings, using various sleep assessment tools. However, the study's reliance on subjective evaluations and historical dialysis cohorts may introduce bias, underscoring the need for objective assessments in future research.

A cross-sectional study compares renal transplantation with dialysis, highlighting an improved sleep quality in end-stage renal disease.


Nephrology

The HCPLive nephrology page is a resource for medical news and expert insights on kidney disease. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments in nephrology, and more.

Chronic Kidney Disease

Renal Transplantation May Lower Sleep Disorder Risk Versus Dialysis

Hanny Al-Samkari, MD, is the Peggy S. Blitz Endowed Chair in hematology and oncology at the Massachusetts General Hospital and an associate professor of medicine at Harvard Medical School.

Systemic Bevacizumab Improves Chronic Bleeding from GI Lesions, With Hanny Al-Samkari, MD

Systemic bevacizumab has proven its safety and efficacy in treating 

 from gastrointestinal (GI) vascular lesions across a variety of non-hereditary hemorrhagic telangiectasia (HHT) etiologies – including idiopathic angiodysplasia, esophageal varices, and von Willebrand disease – among adult and elderly patients, according to data from a recent observational study.

Previous case studies have investigated systemic bevacizumab for various forms of GI bleeding. A patient with HHT and a massive transfusion dependence saw drastic improvement in required red blood cell (RBC) transfusions after 12 months of treatment with bevacizumab. Another patient, a 69-year-old man with severe 

 as a result of small bowel angioectasia bleeding, demonstrated improved hemoglobin levels after several months of bevacizumab treatment.

67th American Society of Hematology (ASH) Annual Meeting and Exposition

 in Orlando, Florida, by Hanny Al-Samkari, MD, the Peggy S. Blitz Endowed Chair in hematology and oncology at the Massachusetts General Hospital and associate professor of medicine at Harvard Medical School, these data may provide a more efficient and longer-lasting method of treating severe chronic bleeding compared to surgical interventions.

“Right now, the standard of care is to go in and do local ablation with argon plasma, coagulation, clipping, and things like this to the lesions,” Al-Samkari told 

. “But all these conditions have an underlying angiogenic dysregulation such that there’s excessive angiogenic signal. And the more tissue injury you do, the more lesions you provoke to grow. You go in, you cauterize, you do whatever you can, but then a few months later, the bleeding is back, and often worse than before.”

Al-Samkari and colleagues conducted an observational study of patients with non-HHT severe chronic bleeding from GI vascular lesions of any etiology refractory to standard therapies, who had been treated with off-label systemic bevacizumab. The primary endpoint was hematologic support requirements, such as RBC transfusions and intravenous (IV) iron infusions, measured in RBC unit equivalents (1 RBC unit equivalent = 1 RBC unit or 250 mg IV elemental iron). Secondary endpoints included hemoglobin, IV iron, and RBC transfusions measured independently, as well as safety.

A total of 23 patients with chronic, severe bleeding received bevacizumab. The median age was 78 years (range, 42-90), and all but 1 patient was ≥60 years. All patients began treatment at 5 mg/kg daily (77%) or 2.5 mm/kg daily (23%) and were infused every 2 weeks for 4 treatments, followed by 2.5-5 mg/kg daily every 4 weeks. Treatment lasted for up to 4.2 years.

Ultimately, hematologic support required substantially improved from 6 months pretreatment (median 14.2 RBC unit equivalents [interquartile range [IQR] 10-23.9]) during months 1-6 (4.1 [2-7.1] RBC unit equivalents; 

 = .0003) and further improved during months 7-12 (0.6 [0-3.5] RBC unit equivalents; 

 >.001). These improvements coincided with improvements in median (IQR) hemoglobin, measured at 8.2 (7.7-9.4) g/dL at baseline, 10.1 (8.6-12.9) g/dL at month 3, 12.2 (9.6-13) g/dL at month 6, 10.6 (8.8-13.1) g/dL at month 9, and 10.4 (8.9-13.3) g/dL at month 12 of bevacizumab treatment (

Additionally, patients in the cohort required 60 emergency department visits or hospital admissions specifically for GI vascular lesion bleeding in the 12 months prior to initiation, compared to 21 in the 12 months after the initiation. The median number of visits and admissions per patient improved from 3.5 (IQR, 1-5) to 1 (0-1.25) (

 – .0049). Proteinuria was the most common treatment-emergent adverse event (TEAE), occurring in 7 patients (30%), followed by hypertension in 6 (26%) and fatigue in 3 (13%). No venous or arterial thromboembolic events occurred, and no fatal TEAEs were noted. Ultimately, 3 patients discontinued for TEAEs, all of which were grade 3 proteinuria, and 5 discontinued for inadequate treatment effect.

“Not only did bevacizumab trigger a dramatic improvement in Hematologic Support Score, it reduced hospitalizations and emergency department visits, specifically due to vascular GI bleeding in these patients, by >50% in the year after versus the year before starting bevacizumab,” Al-Samkari said. “And it did it pretty safely; most patients were able to deal with the side effects and stay out of the hospital with monthly to every 2-month low-dose bevacizumab infusions.”

Editor’s Note: Al-Samkari reports disclosures with Pharmacosmos, Agios, Amgen, Vaderis, Novartis, Sobi, and others.

Ayad N, Al-Samkari H. Long-term safety and effectiveness of systemic bevacizumab for chronic severe bleeding in idiopathic gastrointestinal angiodysplasia, esophageal varices, and angiodysplasia of von Willebrand disease and acquired von Willebrand syndrome. Abstract presented at the 67th American Society of Hematology Annual Meeting. Orlando, FL. December 6-9, 2025.

Ou G, Galorport C, Enns R. Bevacizumab and gastrointestinal bleeding in hereditary hemorrhagic telangiectasia. World J Gastrointest Surg. 2016;8(12):792-795. 

Compare D, Sgamato C, Rocco A, et al. Long-term bevacizumab is safe and effective in managing small bowel angioectasias bleeding refractory to conventional treatments: a case report. Gastroenterol Rep (Oxf). 2024;12:goae070. Published 2024 Jul 6. 

Videos

Al-Samkari discusses a potentially novel use for bevacizumab in improving outcomes for patients with lesions from non-HHT etiologies.

Hematology

Conference

 conference coverage page features articles, videos, and expert-led live coverage from major medical meetings throughout the year.

The decision makes nerandomilast the first and only PDE4B inhibitor with immunomodulatory and antifibrotic effects approved in this indication.

Pulmonology

Infectious Disease condition center page is a comprehensive resource for clinical news and insights on respiratory health. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for asthma, COPD, interstitial lung disease, COVID-19, and more.

FDA Approves Nerandomilast (Jascayd) Tablets for Progressive Pulmonary Fibrosis

Chelsie Derman is an associate editor for 

who covers psychiatry, sleep medicine, geriatrics, migraine, and allergy. She joined MJH Life Sciences in September 2023 after graduating from The College of New Jersey with a bachelor’s degree in journalism and professional writing. In her free time, she enjoys creative writing and reading.

Patients with gout frequently experience kinesiophobia and central sensitization, which were independently linked to greater pain intensity.

Gout

On the HCPLive gout page, resources on the topics of medical news and expert insight into gouty arthritis can be found. Content includes articles, interviews, videos, podcasts, and breaking news on gout, and more.

Rheumatology

Rheumatology condition center page is a comprehensive resource for clinical news and insights on rheumatologic disease. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for arthritis, gout, nr-AxSpA, and more.

Fear of Movement, Central Sensitization May Worsen Outcomes in Gout

Positive topline results from the phase 2b IMPACT trial show statistically significant improvements in key noninvasive tests with pemvidutide.

Hepatology

MASH / MASLD

The HCPLive MASH & MASLD page is a comprehensive resource for clinical news and insights on metabolic dysfunction-associated steatotic liver disease and steatohepatitis. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for fatty liver disease, steatohepatitis, and more.

Pemvidutide Shows Continued Antifibrotic Activity for MASH, Progresses to Phase 3 Trial

Grifols’ fibrinogen concentrate is now approved for acute bleeding episodes in pediatric and adult patients with congenital fibrinogen deficiency.

FDA Approves Fibrinogen, Human-chmt (Fesilty) for Congenital Fibrinogen Deficiency

The panel discusses the importance of monitoring and supporting vitamin status in patients receiving ATTR-CM therapies, particularly those on transthyretin silencers that reduce hepatic production of TTR. Because TTR transports retinol-binding protein, lowering TTR levels can affect vitamin A transport. The clinicians explain that when silencing therapy is used, patients should receive vitamin A supplementation, but at the appropriate physiologic dose, not excess replacement. They caution that high-dose vitamin A can be harmful and stress the need to avoid overcorrection, particularly in older adults.
The panel also notes that education is essential, as patients may assume all supplements are beneficial or may take additional over-the-counter vitamins without disclosing them. Clear counseling helps ensure patients understand what to take, what to avoid, and why. Overall, the discussion emphasizes thoughtful, monitored supplementation as part of comprehensive care, rather than a standalone intervention.


Video Series

The Role of Vitamin Supplementation in Patients Receiving ATTR-CM Therapies

In this episode, the panelists focus on evaluating the safety profile of IL-17 inhibitors in psoriatic disease. The experts explain that IL-17 therapies are generally well tolerated and offer a favorable safety profile compared with older systemic agents like TNF inhibitors and methotrexate, which require frequent lab monitoring. They note that while all IL-17 inhibitors share certain class effects, the most commonly observed adverse event is mucosal or oral candidiasis, which is typically mild, manageable, and tends to decrease over time. The panelists emphasize careful patient selection, avoiding IL-17 inhibitors in individuals with a history of inflammatory bowel disease (IBD), given the risk of exacerbation. They briefly discuss safety observations from dual IL-17A and IL-17F blockade, noting reports of liver enzyme elevation and mood changes, though these lack strong mechanistic evidence. Overall, the experts conclude that IL-17 inhibitors provide a safe, targeted, and effective option for long-term psoriasis and PsA management.

Evaluating the Safety Profile of IL-17 Inhibitors in Psoriatic Disease

Panelists discuss the questions below in this video. 
ESK-001, another highly selective TYK2 inhibitor, has advanced into phase 3 trials in plaque psoriasis. How does its mechanism of action and emerging phase 2 data compare with deucravacitinib and zasocitinib, and what features might distinguish it within the TYK2 inhibitor class?

Other Emerging TYK2 Inhibitors in Psoriasis

Panelists discuss the questions below in this video. 
How do you see emerging TYK2 inhibitors, such as zasocitinib and ESK-001, fitting into the psoriasis treatment landscape, if approved? Building on IMMpulse findings that earlier biologic use in moderate psoriasis can improve outcomes, what opportunities do you see for TYK2 inhibitors to be used earlier in appropriate patients? 

Opportunities for TYK2 Inhibition in Moderate Psoriasis

The panel discusses the role of transthyretin (TTR) stabilizers in the management of ATTR-CM, focusing on tafamidis and acoramidis. They explain that both agents work by stabilizing the TTR tetramer to prevent dissociation and subsequent amyloid fibril formation. Tafamidis is highlighted as the first approved stabilizer with demonstrated benefit in reducing morbidity and mortality in ATTR-CM. Clinicians note that many patients experience stable disease over time with tafamidis, and its favorable tolerability profile, with minimal need for laboratory monitoring, is especially helpful for older adults seeking consistent, manageable treatment.
The discussion then shifts to acoramidis, which is designed to strongly stabilize the TTR protein. The panel describes clinical impressions that acoramidis has shown promising results in trials and represents an important emerging option. They emphasize that having multiple stabilizers broadens therapeutic choice and may help align treatment selection with patient needs and disease characteristics, reinforcing the importance of earlier diagnosis and appropriate therapy initiation.


Efficacy and Safety of Transthyretin Stabilizers in ATTR-CM

In this episode, the panelists discuss long-term IL-17 data and real-world evidence on preventing psoriatic arthritis (PsA) in patients with psoriasis. They highlight results from the five-year secukinumab study presented at ACR Convergence 2025, which showed that 97.9% of psoriasis patients treated with secukinumab did not develop PsA over the study period. The experts view this as compelling evidence supporting the disease-modifying potential of IL-17 inhibition. They also reference real-world data which compared PsA incidence across biologic classes and found that IL-17 and IL-23 inhibitors were associated with a lower PsA risk than TNF inhibitors or methotrexate. The panelists emphasize that IL-17 inhibitors not only achieve durable skin clearance but also offer a favorable safety profile and reduced need for lab monitoring. Overall, they interpret these findings as reinforcing the role of targeted IL-17 blockade in preventing PsA progression in high-risk psoriasis patients.

Latest News

Impacts of the Lancet Commission on Obesity Treatment, With Pooja Singhal, MD

BMI, Inflammatory Bowel Disease Both Show Causal Effect on HS Development

FDA Approves Aficamten (Myqorzo) for Symptomatic Obstructive Hypertrophic Cardiomyopathy

Renal Transplantation May Lower Sleep Disorder Risk Versus Dialysis

Systemic Bevacizumab Improves Chronic Bleeding from GI Lesions, With Hanny Al-Samkari, MD