Frances Lee, MD, is an assistant professor of medicine in the division of liver diseases at Mount Sinai.

Future Advancements in PBC Care: Innovations on the Horizon

In the final episode, “Future Advancements in PBC Care: Innovations on the Horizon,” the panelists explore current gaps in care and new treatments that are trying to close those gaps.

Led by the moderator, the panelists examine the following critical questions:

Looking ahead towards the future of primary biliary cholangitis care, what ongoing trials or emerging treatments do you feel are promising or practice-changing?

What is one final pearl you would like to share about the management of primary biliary cholangitis and the future ahead?

Throughout the conversation, the experts provide a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

Thank you for watching this Peer Exchange series on PBC. Please subscribe to our newsletter for information on upcoming video series.

Videos

Discussing GLP-1 or Dual Incretin Therapies in IL-17 Mediated Disease, With Neal Bhatia, MD

 seen in patients with moderate-to-severe psoriasis and obesity or overweight treated with combined ixekizumab (Taltz) and tirzepatide (Zepbound), released by Eli Lilly and Company, the 

 team spoke in an interview with trial investigator and director of Clinical Dermatology at Therapeutics Clinical Research, Neal Bhatia, MD.

 about these new phase 3b TOGETHER-PsO trial data and their significance for patients with psoriasis and elevated body mass index (BMI).

 He had touched on the potential of GLP-1 agonists on immune pathways. Beyond psoriasis, Bhatia was later asked whether he sees a potential role for GLP-1 or dual incretin therapies in other interleukin (IL)-17–mediated conditions such as hidradenitis suppurativa (HS).

“There are some diseases that are BMI dependent, and there are some that kind of go along with those methods [where you see if you can] improve their disease by improving their weight or by improving their BMI,” Bhatia said. “I think again, the sky's the limit in the opportunities with the inflammatory cascade.”

Bhatia highlighted the benefits observed in the IL-17 pathway. However, he noted it is not yet clear for conditions such as lichen simplex chronicus (LSC) or prurigo nodularis. The efficacy and the strength of such inhibition would have to be more elucidated, but he described research into topical steroids versus topical steroids with the GLP-1 agonists as a potentially useful comparison.

The increasing level of discussion seen in dermatology regarding adipose tissue as an active inflammatory organ was also highlighted. Bhatia was asked in this interview how such a concept could reshape the way in which dermatologists think about treating patients with obesity and chronic inflammatory skin disease.

“We're seeing that adipose tissue can be a strong source of inflammatory mediators,” Bhatia explained. “I think the sky's the limit of what we can discover by, again, changing someone's body mass index, for example, or adding these therapies to treatments that might not be successful.”

The quotes in this video summary were edited for clarity.

Bhatia has reported serving as an advisor, consultant, and investigator for AbbVie, Almirall, Arcutis Biotherapeutics, Beiersdorf, Biofrontera, Boehringer Ingelheim, Bristol Myers Squibb, Cara Therapeutics, Dermavant Sciences, EPI Health, Ferndale, Galderma, Incyte, ISDIN, Johnson & Johnson, La Roche-Posay, LEO Pharma, Lilly, Ortho Dermatologics, Pfizer, Regeneron Pharmaceuticals, Sanofi, Sun Pharma, and Verrica Pharmaceuticals.

Lilly's Taltz (ixekizumab) and Zepbound (tirzepatide) used together delivered superior efficacy in first-of-its-kind Phase 3b trial for adults with psoriasis and obesity or overweight. Eli Lilly. February 18, 2026. Accessed March 2, 2026. 

https://investor.lilly.com/news-releases/news-release-details/lillys-taltz-ixekizumab-and-zepbound-tirzepatide-used-together-0

Bhatia N. Discussing Promising New Findings on GLP-1 Use in Psoriasis Management, With Neal Bhatia, MD. HCPLive. February 26, 2026. Accessed March 2, 2026. 

https://www.hcplive.com/view/discussing-promising-new-findings-glp-1-use-psoriasis-management-neal-bhatia-md

Neal Bhatia, MD, speaks on new data on ixekizumab and tirzepatide for weight loss and psoriasis, as well as the implications of these data regarding GLP-1 use.

Plaque Psoriasis

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

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Clinical

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

Medical student at John Sealy School of Medicine, University of Texas in Galveston

Addressing ICS Hesitancy in Pediatric Asthma Care, With Lynchi Nguyen

Inhaled corticosteroids (ICS) did not increase fracture risk in children with asthma according to new data from a retrospective cohort analysis presented at the 

American Academy of Allergy, Asthma & Immunology (AAAAI)

 2026 Annual Meeting held in Philadelphia, Pennsylvania on February 27-March 2.

The study included more than 210,000 pediatric asthma patients in the TriNetX United States Collaborative Network. Investigator Lynchi Nguyen, medical student at John Sealy School of Medicine, University of Texas Medical Branch in Galveston, sat down with 

during the meeting to discuss the findings. 

Nguyen emphasized that children treated with short-acting beta agonist (SABA) monotherapy had an 18% higher fracture risk compared with those receiving ICS-only regimens (RR, 1.18; 95% CI, 1.11–1.26). No significant differences in fracture risk were observed between ICS + LABA therapy and SABA-only treatment (RR, 1.05; 95% CI, 0.95–1.15), or between ICS + LABA and ICS-only regimens (RR, 0.97; 95% CI, 0.86–1.09).

The findings, which focused specifically on pediatric-relevant fractures, including Salter-Harris, torus, greenstick, and bent bone fractures occurring at least one year after medication initiation, directly address a longstanding patient concern in pediatric asthma management. While systemic corticosteroids are known to adversely affect bone density in growing children, inhaled corticosteroids have often been viewed with similar suspicion by families and even some clinicians.

Nguyen explained that this misconception may contribute to persistent reliance on SABA monotherapy, despite international guidelines that recommend early incorporation of ICS-containing regimens and movement toward SMART therapy strategies. The new data reinforce that ICS use does not confer the skeletal risks associated with systemic steroids and may even be protective, potentially by reducing exacerbations and limiting systemic steroid bursts.

Beyond reassuring families, the study also offers clinicians flexibility in treatment selection. Because no fracture risk differences were seen between ICS-only and ICS + LABA regimens, providers can tailor therapy based on access, cost, insurance coverage, and disease severity without concern for differential skeletal effects.

Looking ahead, Nguyen suggested that future research should shift toward examining prescribing trends and adherence patterns to determine whether safety data such as these are translating into greater guideline adherence. The larger goal is clear: improving asthma outcomes by confidently incorporating ICS early and consistently in pediatric care.

“If patients are getting diagnosed at a young age, there shouldn't be any hesitancy to start [ICS, or] worrying if this will affect their growth, worrying about their bone density or bone health. I think our study can help clarify that there is no proven increased risk of, you know, detrimental effects to bone health,” Nguyen said.

Nguyen had no relevant disclosures to report.

Reference
Nguyen L, Lee A, Carmichael K, Acevado JA. Fracture Risk Among Pediatric Asthma Patients Treated With Inhaled Corticosteroids: A Retrospective Cohort Study. Presented at: AAAAI 2026 Annual Meeting, February 27-March 2, Philadelphia, Pennsylvania. Poster #L04

Nguyen discussed how her study findings can help alleviate inhaled corticosteroid hesitancy for families.

Conference

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Asthma

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Jose Clemente, PhD, associate professor of Genetics and Genomics and Immunology at the Icahn School of Medicine at Mount Sinai

Early Microbiome Shifts May Define a Critical Window for Allergy Risk, With Jose Clemente, PhD

New ACTIVATE data found that vaginal seeding in cesarean-delivered infants was associated with altered early gut microbiome patterns and differences in 

Jose Clemente, PhD, associate professor of genetics and genomics and immunology at the Icahn School of Medicine at Mount Sinai, presented these late-breaking findings at the 2026 American Academy of Allergy, Asthma, & Immunology (AAAAI) in Philadelphia from February 27 to March 2. ACTIVATE, a double-blind, randomized trial, evaluated whether exposure to maternal vaginal microbiota at birth can influence food allergen sensitization in cesarean-delivered infants at high risk for allergic disease.

The study enrolled 39 vaginally delivered infants, 37 cesarean-delivered infants who received placebo seeding, and 37 cesarean-delivered infants who underwent vaginal seeding, along with their mothers. Vaginal seeding in the study involved placing sterile gauze in the maternal vagina approximately 1 hour before cesarean delivery, and then immediately after birth, using the gauze to swab the infant’s mouth, face, and body.

, abundant in maternal vaginal samples, was enriched in the stool of infants who received vaginal microbial transfer compared with placebo immediately after birth (

 =.002). At 3 months, infants who underwent vaginal seeding had stool microbiomes more similar to vaginally delivered infants than placebo-treated infants (similarity 0.876 ± 0.07 vs 0.9 ± 0.06;

 =.169); this effect was partial and waned over time. The analysis also showed that maternal vaginal microbiome composition itself was not associated with food sensitization at 12 months (

 =.86), but specific infant gut microbes identified at 12 months were associated with allergen sensitization (

during AAAAI, Clemente emphasized that even temporary microbial shifts may influence long-term immune trajectories.

“We see differences for the first few months, but then after a while, those differences, at least looking at the microbes…disappear,” Clemente said. “It doesn't matter if you've been exposed to the microbes or not when the babies are 1 year of age. We don't see differences anymore, but we think it's really those first few months when it’s critical to intervene if we want to lower [allergy] risk. I think a harder problem that comes out of it is, well, what happens if you have a child that already has an allergy? That's a much harder problem to tackle because we know that it's during these first few months when we can modulate the microbiome and modulate the immune development based on those interventions.”

Clemente J, Bu K, Cantor A, et al. Microbiome Associations with Food Sensitization in the ACTIVATE Trial: Exposure to Vaginal Microbiome in C-section Infants at High-risk for Allergies. 

Journal of Allergy and Clinical Immunology

doi:https://doi.org/10.1016/j.jaci.2025.12.935

Early gut microbiome changes in c-section infants linked to food sensitization at 12 months, highlighting a potential critical intervention window.

Allergy

Allergy condition center page is a comprehensive resource for clinical news and insights on allergic and inflammatory diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for food and seasonal allergies, as well as allergic asthma and related conditions.

Food Allergy

Vaginal Seeding Partially Modifies Infant Microbiome in ACTIVATE, With Jose Clemente, PhD

Vaginal seeding in cesarean-delivered infants was associated with altered early gut microbiome patterns and differences in 

 at 12 months, according to late-breaking ACTIVATE trial data presented at the 2026 American Academy of Allergy, Asthma & Immunology (AAAAI) Annual Meeting in Philadelphia.

The Journal of Allergy and Clinical Immunology had published a report on the link between delivery mode and allergy risk had been reported > 2 decades ago. However, as cesarean delivery rates continue to rise in the United States and globally, rising from 7% in 1990 to 21% in 2025, interest has intensified around how birth mode influences early immune development and allergy risk.

 spoke with Jose Clemente, PhD, associate professor of Genetics and Genomics and Immunology at the Icahn School of Medicine at Mount Sinai, who discussed the biologic rationale behind the trial and what the findings may mean for clinicians.

“A few years ago, we thought, okay… c-section is associated with different type of colonization with microbes. Maybe if we restore microbes in this c-section babies, we can hopefully modulate the risk for allergies,” Clemente said. “That's the whole idea behind…this particular trial.”

ACTIVATE is a double-blind, placebo-controlled, randomized clinical trial evaluating whether exposure to maternal vaginal microbiota at birth can influence food allergen sensitization in cesarean-delivered infants at high risk for allergic disease.

The study enrolled 39 vaginally delivered infants, 37 cesarean-delivered infants who received placebo seeding, and 37 cesarean-delivered infants who underwent vaginal seeding, along with their mothers.

Vaginal seeding in ACTIVATE involved placing sterile gauze in the maternal vagina approximately 1 hour prior to cesarean delivery. Immediately after birth, the gauze was used to swab the infant’s mouth, face, and body in an effort to approximate microbial exposure during vaginal birth.

Shotgun metagenomic sequencing confirmed microbial transfer. Lactobacillus, abundant in maternal vaginal samples, was enriched in the stool of infants who received vaginal microbial transfer compared with placebo immediately after birth (

At 3 months, the stool microbiome of infants who underwent vaginal seeding more closely resembled that of vaginally delivered infants than infants who underwent placebo seeding (similarity indices 0.876 ± 0.07 vs 0.9 ± 0.06;

 =.169), though the effect was partial and diminished over time. By 12 months, global microbiome composition differences between groups were no longer apparent.

Clemente emphasized that this partial modification is biologically meaningful. Vaginal seeding does not replicate the full microbial exposure of vaginal delivery, but even limited early colonization may act as a developmental primer, influencing downstream microbial succession and immune programming.

“When you're born, you're essentially born with no microbes,” Clemente said. “We think that this first exposure is important because it sets the baby on the correct developmental pathway. It sets the baby to acquire microbes then are going to lead to a transition to other microbes that might also be eventually beneficial, in terms of risk against risk of allergies.”

Maternal vaginal microbiome composition itself was not associated with food sensitization at 12 months (P =.86). Instead, specific infant gut microbes identified at 12 months were associated with allergen sensitization, including 

 = 0.013, 0.032, and 0.006, respectively). Infants with vagina seeding exhibited lower levels of R. gnavus, a microbe previously implicated in inflammatory pathways.

The investigators demonstrated that among infants who underwent vaginal seeding and in whom microbial transfer was effective, rates of sensitization were lower compared with placebo-seeded counterparts, although Clemente characterized the trial as exploratory and not yet practice-changing.

“It's important to remember that the activate trial is a pilot trial,” Clemente said. “One of the ideas behind the trial is to determine whether the procedure is safe, and that is the case, the procedure is not associated with increased adverse events. Two, whether we see a measurable benefit, and that's what we have shown that there is a measurable benefit, but it's not quite yet ready to be developing in clinic.”

McKeever TM, Lewis SA, Smith C, Hubbard R. Mode of delivery and risk of developing allergic disease. 

. 2002;109(5):800-802. doi:https://doi.org/10.1067/mai.2002.124046

Trial data show early microbiome shifts after vaginal microbial transfer in cesarean-delivered infants, with differences in food sensitization at 12 months.

Nguyen emphasized the safety of inhaled corticosteroids vs SABA-only therapy in pediatric asthma.

Alleviating Pediatric Fracture Risk Concerns With Asthma ICS, With Lynchi Nguyen

Matthew Krantz, MD, from Vanderbilt University Medical Center

HLA-A*32:01 carrier screening may identify patients at elevated risk for lamotrigine-induced eosinophilia and systemic symptoms, Krantz says at AAAAI 2026.

HLA-A*32:01 Carrier Screening Feasibility Before Lamotrigine, With Matthew Krantz, MD

Victoria Johnson joined the MJH Life Sciences in 2020 and has written for NeurologyLive, CGTLive, and now HCPLive. You can reach her at vjohnson@mjhlifesciences.com

Articles

A new study stratified patients by longitudinal BEC patterns to assess whether variability in eosinophil levels influences response.

COPD

COPD condition center page, resources on the topics of medical news and expert insight into chronic obstructive pulmonary disease can be found. Content includes articles, interviews, videos, podcasts, and breaking news on COPD research, treatment, and drug development.

Mepolizumab Reduces Type 2 COPD Exacerbations Across Variable BEC Levels

Prospective case-control data presented at AAAI 2026 demonstrate a 12-fold increased odds of DRESS among lamotrigine-treated HLA-A*32:01 carriers.

HLA-A*32:01 Linked to Lamotrigine DRESS Risk, With Matthew Krantz, MD

Gerald Appel, MD, is a professor of clinical medicine, director of clinical nephrology, and director of the Glomerular Disease Center at Columbia University.

On Rare Disease Day 2026, clinicians share their perspective on the evolving landscape for IgAN and C3G. 

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.

C3 Glomerulopathy

The HCPLive C3 glomerulopathy page is a resource for medical news and expert insights on C3G. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments in C3G, and more.

IgA Nephropathy

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

Rare Disease Day 2026: Kidney Diseases Enter Optimistic Therapeutic Era

Retrospective analysis presented at AAAAI 2026 found 12%–15% risk reductions in asthma exacerbations over 3 years among patients without diabetes with overweight and obesity.

GLP-1s Linked to Reduced Asthma Exacerbations, With Ruchi Patel, MD

Sicherer discussed how the study might shift clinical thinking in pediatric food allergy. 

What CAFETERIA Means for Long-Term OIT Goals, with Scott Sicherer, MD

Navepegritide, to be marketed as YUVIWEL, is the only FDA-approved treatment providing continuous CNP exposure over its weekly dosing interval.

FDA News

Family Medicine

Family Medicine condition center page, resources on the topics of medical news and expert insight into family care can be found. Content includes articles, interviews, videos, podcasts, and breaking news on Family medicine research, treatment, and drug development.

FDA Grants Accelerated Approval to Navepegritide for Achondroplasia in Children Aged 2 Years and Older

an internal medicine and pediatrics-trained allergist practicing in Mobile, Alabama.

Once-daily VTAMZA delivers week-one sleep gains and lasting itch control in atopic dermatitis, with safety consistent across studies.

Atopic Dermatitis

Atopic Dermatitis 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 dermatitis research, treatment, and drug development.

Dermatology

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What to Expect for Sleep Improvement With Tapinarof in AD, With Druhan Howell, MD

UChicago GI faculty bring expert endoscopy and IBD care closer to you, with seamless hospital follow-up and cutting-edge clinical trials.

Latest News

Future Advancements in PBC Care: Innovations on the Horizon

Discussing GLP-1 or Dual Incretin Therapies in IL-17 Mediated Disease, With Neal Bhatia, MD

Addressing ICS Hesitancy in Pediatric Asthma Care, With Lynchi Nguyen

Early Microbiome Shifts May Define a Critical Window for Allergy Risk, With Jose Clemente, PhD

Vaginal Seeding Partially Modifies Infant Microbiome in ACTIVATE, With Jose Clemente, PhD