Linda Stein Gold, MD, is a dermatologist at Henry Ford Health. 

Overview of the ADVANCE trials showing ICO’s superior efficacy to deucravacitinib and consistent safety across 24 weeks.

The Psychosocial Impact of Psoriasis in Pediatric Patients: Why Treating Aggressively Early Matters 

, despite the expanding therapeutic landscape. Linda Stein Gold, MD, and her colleagues analyze patient- and provider-reported data from the 

 surveys, revealing that many patients remain dissatisfied with current therapies and that oral agents are overwhelmingly preferred over injectables. The experts discuss how patient lifestyle, comorbidities, and psychosocial burden influence shared decision-making and treatment adherence. They also interpret the 

International Psoriasis Council’s (IPC)

 and explore its implications for reducing “topical churn” and advancing systemic therapy earlier in the disease course.

 and its potential to close current gaps in care. The panel provides an in-depth review of the 

 clinical development program, summarizing the 

 trials, which demonstrated superior efficacy versus deucravacitinib at both 16 and 24 weeks, with favorable safety and tolerability. They also discuss new 

 showing sustained clearance and no new safety signals in adults and adolescents. The faculty reflect on ICO’s implications for adolescent psoriasis and how early, aggressive oral intervention may help prevent progression to psoriatic arthritis, marking a significant milestone in the evolution of oral IL-23–targeted therapy.

The final portion of the series shifts focus to 

managing active psoriatic arthritis (PsA)

. The experts discuss new findings from the 

 demonstrated the first clear evidence of IL-23–mediated inhibition of structural joint damage, reinforcing the rationale for early biologic use in high-risk patients. They compare APEX to prior IL-23 studies, discuss implications for therapy sequencing, and highlight other emerging data from 

 studies. In closing, Stein Gold and colleagues emphasize a forward-looking approach that integrates personalized therapy selection, early detection of PsA, and cross-specialty collaboration to elevate standards of psoriasis care

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Remibrutinib Onset of Action and Safety Profile

New data on remibrutinib demonstrates the agent’s rapid onset of action in patients with chronic spontaneous urticaria (CSU). Shyam Joshi, MD, assistant professor of medicine in the Section of Allergy and Clinical Immunology at Oregon Health & Science University (OHSU) School of Medicine, discussesdiscusses data from phase 3 REMIX trials revealed that significant improvements in symptom control were observed as early as one to two weeks following initiation of therapy. This early efficacy distinguishes remibrutinib from established biologic therapies, such as omalizumab and dupilumab, which typically require longer durations to achieve comparable clinical endpoints.

The rapid mitigation of pruritus and hive activity provides clinically meaningful relief for patients who often experience prolonged morbidity prior to effective management. Early symptom resolution can improve sleep quality, daily functioning, and overall quality of life for individuals with CSU. For clinicians, the potential to offer immediate improvement is a significant advancement, particularly for those patients suffering with delayed diagnosis and limited success on previous therapies.

The most notable side effect in clinical trials was the occurrence of mild petechiae, which generally resolved without intervention and did not necessitate discontinuation of therapy. Importantly, incidence rates for infection, changes in immunoglobulin levels, and alterations in B cell function were comparable between remibrutinib and placebo groups. These data provide clinicians with confidence in prescribing remibrutinib as a safe and efficacious option within the CSU treatment landscape.

Shyam Joshi, MD, discusses the rapid onset of action and favorable safety profile of remibrutinib, distinguishing it among therapies for CSU.

 Remibrutinib Onset of Action and Safety Profile

Jennifer Soung, MD, outlines ICO’s mechanism as an IL-23 receptor antagonist and its significance in oral systemic therapy.

A Novel Treatment in Psoriasis: Expert Perspectives on the ICONIC-LEAD Trial

Matthew Dapas, PhD, research assistant professor at Northwestern University Feinberg School of Medicine

Polygenic Risk Scores Linked to Specific SLE Manifestations, With Matthew Dapas, PhD

, Matthew Dapas, PhD, of Northwestern University, discussed recent findings on polygenic risk scores for 

American College of Rheumatology Convergence (ACR) 2025

. The study evaluated associations between genetic risk and clinical features derived from electronic health records across more than 32,000 participants in the Electronic Medical Records and Genomics Network.

One advantage of this study was the large database. The polygenic risk score was derived using summary statistics from a genome-wide association study of 6748 lupus cases and 11,516 controls of European ancestry.

“The reality of the genetics of these diseases is that it's not one gene that causes a disease, but it's actually a constellation of very small effects that just are enough to tip the scales in one direction or the other,” Dapas told 

. “So, to identify those really small effects, you need really large databases. There's a number of large efforts, and [in] the United States… where we're trying to generate whole genome sequencing for millions of individuals to derive new discoveries and genetics because the more the more people you have in a database, the more accurate model you can build, more effective the implementation of that model will be in a clinical setting, and the better outcomes that leads.”

In the Northwestern cohort (n = 1061), the polygenic risk score predicted SLE with an area under the receiver operating characteristic curve of 0.724 and was significantly associated with both localized and systemic lupus (

= 1.6×10^-9) and systemic lupus erythematosus (

 = 3.0×10^-9). Additional nominal associations were observed for cardiac complications (

 = 2.8×10^-3) and impaired renal function (

 = 4.6×10^-3), with enrichment for circulatory system (

 = 9.7×10^-5) and hematopoietic traits (

Genetic risk was further associated with several individual Systemic Lupus International Collaborating Clinics criteria, including acute cutaneous lupus, thrombocytopenia, leukopenia, and low complement levels. Low complement was observed in 55% of patients in the highest polygenic risk score decile, compared with 30% in the lowest decile, suggesting that greater genetic risk may be linked to specific immunological features.

Dapas emphasized that although polygenic risk scores are not yet part of routine clinical practice, they have the potential to support risk assessment. Dapas noted that high-quality clinical data and patient evaluation, combined with expanding genomic databases, can help train risk models.

“I anticipate that's something that will become routine in the not-too-distant future,” he said. “One important thing to keep in mind, as a medical geneticist, [is that] we rely so much on that fundamental interaction between clinician and patient.”

He said this helps us train genetic risk models, which rely on accurate phenotyping and accurate classification

“Logging of data into a database that is then used for research is so essential, because without accurate workups of patients, it all kind of falls apart,” Dapas said. “In all my work, I work closely with a team of clinicians, and it really is kind of a symbiotic relationship. It's a whole network of individuals with different sets of expertise, working together to try and improve outcomes for patients with the disease. I appreciate what the clinicians do, and I hope, through this work and other geneticists, that we can collectively move the needle on some of these diseases.”

Dapas has no relevant reported disclosures.

Forrest N, Tuteja S, Pacheco J, Mitrovic V, Ramsey-Goldman R, Walunas T, Dapas M. Polygenic risk of lupus is differentially associated with individual EHR-derived classification criteria [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). 

https://acrabstracts.org/abstract/polygenic-risk-of-lupus-is-differentially-associated-with-individual-ehr-derived-classification-criteria/

Dapas M. Polygenic Risk Scores Reveal Genetic Drivers of Lupus Heterogeneity, With Matthew Dapas, PhD. HCPLive. November 24, 2025. https://www.hcplive.com/view/polygenic-risk-scores-reveal-genetic-drivers-lupus-heterogeneity-matthew-dapas-phd. Accessed December 3, 2025. 

ACR 2025 research shows polygenic risk scores correlate with specific SLE phenotypes, highlighting potential applications for clinical risk assessment.

News

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Conference

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

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.

Ryan Livingston joined the MJH Life Sciences team in March of 2025, shortly after graduating from TCNJ with a bachelor’s degree in English. He enjoys creative writing, reading, and scuba diving. He can be reached at rlivingston@mjhlifesciences.com.

Jennifer Snaith, MBBS | Image Credit: Garvan Institute of Medical Research

Metformin failed to present improvements in liver, muscle, or adipose tissue insulin resistance after treatment for 26 weeks in patients with 

, based on data from the Insulin in Type 1 Diabetes Managed with Metformin (INTIMET) study.

Metformin is an inexpensive and safe oral medication used as a first-line treatment for 

. Previous studies have demonstrated metformin’s capacity to alter glucose metabolism in the muscle and liver in patients with type 2 diabetes based on hyperinsulinemic-euglycemic clamp data. Additionally, existing reviews of randomized controlled trials have demonstrated metformin’s capacity to reduce total daily insulin dose, which has been interpreted as an improvement in insulin resistance.

“However, studies in type 1 diabetes using the gold-standard clamp technique to directly measure insulin resistance have only been performed in adolescents,” Jennifer Snaith, MBBS, B. Med. Sci, an endocrinologist and research fellow at the Garvan Institute of Medical Research, and colleagues wrote. “No study has employed the clamp technique to assess the effect of metformin on insulin resistance in adults with type 1 diabetes.”

INTIMET began as a cross-sectional study in adults with and without T1D, aiming to quantify insulin resistance at muscle, liver, and adipose tissue and identify biochemical and clinical features associated with muscle and liver insulin resistance. Subsequently, Snaith and colleagues conducted a 6-month randomized controlled clinical trial to test the hypothesis that, among adults with T1D, relative to placebo, the addition of metformin to insulin would decrease hepatic insulin resistance and improve other cardiometabolic measures without increasing adverse effects.

Male and female patients with T1D for ≥10 years were eligible for the trial, so long as they were between ages 20 and 55 with fasting c-peptide <0.3 nmol/L and HbA1c <9.5% (80 mmol/mol). Patients who were taking medications or who had conditions known to impact insulin sensitivity were excluded. During the trial, the team assessed insulin resistance via the 3-stage hyperinsulinemic-euglycemic clamp technique with isotope-labelled glucose. The primary outcome was the change in endogenous glucose production (EGP) during the low-dose phase of the clamp.

A total of 40 patients were enrolled in the trial; of these, 20 had T1D and 20 did not. All patients underwent basic phenotyping assessment between November 2019 and December 2021. In the T1D cohort, the mean age was 37.4 +/- 8.8 years (mean +/- standard deviation [SD]), with a T1D duration of 22.9 +/- 8.9 years. The T1D cohort also had a mean BMI of 26.3 +/- 3.8 kg/m2, a mean total daily insulin dose of 0.6 units/kg/day, and a mean HbA1c of 7.5 +/- 0.9%. Of the 20 adults without T1D, mean age was 37 +/- 8.4 years, mean BMI was 26.2 +/- 4.3 kg/m2, and mean HbA1c 5.1 +/- 0.3%.

The T1D group exhibited greater liver, adipose, and muscle insulin resistance compared to control, and participants with T1D had higher endogenous glucose production than controls (EGP; 5.9 +/- 2.2 µmol/kg fat free mass [FFM]/min and 3.6 +/- 1.7 µmol/kgFFM/min respectively; 

 = .0002) and higher non-esterified fatty acids (NEFA) in the low-dose phase (0.08 +/- 0.01 mmol/L and 0.02 +/- 0.02 mmol/L respectively; 

 = .001), which indicated impaired insulin-mediated suppression of hepatic glucose release and lipolysis, respectively.

Ultimately, 37 of 40 enrolled participants completed the study. At 26 weeks, no significant difference was found in the change in EGP between the metformin and placebo groups (mean difference 0.2 µmol/kg FFM/min; 95% CI, -0.4 to 0.8; 

 = .53). There was also no increase in hypoglycemia or episodes of ketoacidosis in either group.

“These results do not support prescribing metformin to reduce insulin resistance in adults with type 1 diabetes but suggest that metformin may reduce insulin dose via mechanisms independent of insulin resistance,” Snaith and colleagues wrote. “The potential cardiovascular benefits of insulin sparing and reducing peripheral hyperinsulinemia warrant further study.”

Snaith JR, Olsen N, Evans J, et al. Effect of metformin on insulin resistance in adults with type 1 diabetes: a 26-week randomized double-blind clinical trial. Nat Commun. 2025;16(1):9884. Published 2025 Nov 24. 

Liu YS, Chen CN, Chen ZG, Peng Y, Lin XP, Xu LL. Vascular and metabolic effects of metformin added to insulin therapy in patients with type 1 diabetes: A systematic review and meta-analysis. Diabetes Metab Res Rev. 2020;36(6):e3334. 

Articles

Metformin did not improve insulin resistance in liver, muscle, or adipose tissue in adults with type 1 diabetes (T1D) after 26 weeks, according to the INTIMET study. The study used the hyperinsulinemic-euglycemic clamp technique to measure insulin resistance, a method previously applied only in adolescents with T1D. Despite no significant changes in endogenous glucose production, metformin may reduce insulin doses through mechanisms unrelated to insulin resistance. The study suggests further investigation into metformin's potential cardiovascular benefits and its role in reducing peripheral hyperinsulinemia.

Results from the INTIMET study have shown no significant differences between metformin and placebo in liver, muscle, or adipose tissue insulin resistance.

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.

Type 1 Diabetes

Metformin Fails to Improve Insulin Resistance in Type 1 Diabetes

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

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.

Lingdolinurad Demonstrates Dose-Dependent Serum Uric Acid Reductions

University of Colorado Health Sciences Center

Recent advancements in HAE treatments offer hope, but experts stress the need for more pediatric options and diverse therapies.

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.

This Year In Medicine

Rare Disease, Rapid Progress: FDA's HAE Approvals in 2025 Signal Changing Course

November 2025 saw new data on asthma therapies and new insights from experts on continuing trends in the field.

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.

Asthma

The HCPLive asthma page is a comprehensive resource for clinical news and insights on asthmatic disease. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for allergic and severe asthma, and more.

5 Pulmonology Headlines You Missed in November 2025

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.

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

Ophthalmology

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Deep Capillary Plexus Microaneurysms A Sign of CKD in Diabetic Retinopathy

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.

This month in review highlights November’s biggest psychiatry stories, including FDA moves, phase 4 findings, and new data on digital mental health tools.

Psychiatry

Psychiatry condition center page is a comprehensive resource for clinical news and insights on mental illnesses. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for depression, schizophrenia, bipolar disorder, anxiety, and more.

Major Depressive Disorder

Major Depressive Disorder condition center page, resources on the topics of medical news and expert insight into depression can be found. Content includes articles, interviews, videos, podcasts, and breaking news on MDD research, treatment, and drug development.

4 Psychiatry Headlines You Missed in November 2025

Ozlem Bilen, MD, is an associate professor of medicine in the cardiology division and chief of cardiology at Emory University Hospital.

Bilen discusses the COLLIGO-HCM trial, investigating the real-world efficacy of mavacamten monotherapy for patients with obstructive HCM.

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...

Cardiomyopathy

Mavacamten Monotherapy Improves Cardiac Function in oHCM, With Ozlem Bilen, MD

Tim Smith joined the MJH Life Sciences team as an assistant editor for HCPLive in August 2022. He graduated from UC Berkeley with a degree in political science, working in multimedia journalism as a staff writer prior to joining MJH. In his spare time, he enjoys reading, watching TV, listening to podcasts, and rock climbing. You can contact him at 

This review of November 2025 highlights several notable news stories covered in the dermatology space.

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.

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.

8 Dermatology Headlines You Missed in November 2025

A multicenter study outlines stage-specific risk factors, protective traits for sarcopenia in older adults on maintenance hemodialysis, supporting earlier screening.


Risk Factors for Sarcopenia in Older Adults on MHD Include Physical Activity, Nutrition

Jason Hawkes, MD, MS details the clinical advantages and patient populations best suited for oral BTK inhibitor therapy, such as remibrutinib, in CSU.


Benefits of Oral BTKi Administration in CSU

Amanda Armstrong, MD, MPH, predicts a move toward mechanism-based therapy selection and highlights biomarkers that could guide personalized treatment.

Latest News

The Psychosocial Impact of Psoriasis in Pediatric Patients: Why Treating Aggressively Early Matters

Remibrutinib Onset of Action and Safety Profile

A Novel Treatment in Psoriasis: Expert Perspectives on the ICONIC-LEAD Trial

Polygenic Risk Scores Linked to Specific SLE Manifestations, With Matthew Dapas, PhD

Metformin Fails to Improve Insulin Resistance in Type 1 Diabetes