Sophia Schneider, MD, MS, is an internal medicine resident at Brigham and Women’s Hospital.

Sleep Apnea Associated With Worsening HF Outcomes, With Sophia Schneider, MD, MS

 is associated with a higher risk of cardiovascular mortality and 

 events, according to an analysis of the FINEARTS-HF trial.

American College of Cardiology (ACC) Scientific Sessions 2026

 in New Orleans, Louisiana, by Sophia Schneider, MD, MS, an internal medicine resident at Brigham and Women’s Hospital.

“I think that the immediate impact is related to heightened recognition,” Schneider told 

 in an exclusive interview. “When we see patients with HFpEF and HFmrEF who have recurrent decompensations, difficult-to-control hypertension, or disproportionately high symptom burden, that should raise red flags for clinicians to be thinking about screening for sleep apnea to potentially get patients started on treatment.”

FINEARTS-HF was an international, double-blind trial enrolling patients with HF and a left ventricular ejection fraction (LVEF) ≥40%, who were assigned in a 1:1 ratio to either finerenone or placebo on top of standard therapy. Finerenone was administered at a maximum dose of either 20 or 40 mg once daily; placebo doses were matched. The primary outcome was a composite of total worsening HF events – defined as a first or recurrent unplanned hospitalization or urgent visit for HF – and cardiovascular death.

A total of 6001 patients were included in the trial, with 3003 assigned to receive finerenone and 2998 assigned to placebo. Over the course of the 32-month program, investigators recorded 1083 primary-outcome events in 624 patients in the finerenone arm compared to 1283 events among 719 patients in the placebo group (rate ratio [RR], 0.84; 95% CI, 0.74-0.95; 

 = .007). The total number of worsening HF events was 842 in the finerenone arm and 1024 in the placebo arm (RR, 0.82; 95% CI, 0.71-0.94; 

 = .006). The percentage of cardiovascular mortalities was 8.1% and 8.7%, respectively (HR, 0.93; 95% CI, 0.78-1.11).

In the present analysis, Schneider and colleagues created a primary composite endpoint of cardiovascular death and total HF events. Secondary outcomes included total HF events, cardiovascular death, KCCQ change, and all-cause mortality. Among the 6001 patients enrolled in the original trial, the presence or history of sleep apnea was investigator-reported.

Of the original patients, 400 (6.7%) had sleep apnea. These patients were more often men (64% vs 54%), had a higher body mass index (BMI) (34 vs 29 kg/m2), and had a higher prevalence of diabetes (57% vs 40%). Over a follow-up period of 2.6 years, the team noted that sleep apnea was associated with a higher risk of the primary outcome (RR, 1.57; 95% CI, 1.38-1.79; 

 <.001). This correlation was consistent regardless of adjustment for age, sex, region, BMI, and diabetes history.

Ultimately, the apparent solidity of these data belies the small proportion of patients in the study with confirmed sleep apnea. Schneider acknowledges this limitation, noting that sleep apnea was not confirmed with polysomnography, and details on the severity of the condition and its treatment status were not collected. This naturally limits the study’s broad applicability and, in Schneider’s opinion, calls for further research with a more structured definition of sleep apnea.

“I think that this overlap between these conditions suggests that there is a potential mechanism of intervention,” Schneider said. “Finerenone is likely one of these, especially given the outcomes that we saw in our study showing improved clinical outcomes in both patients with and without sleep apnea.”

Editors’ Note: Schneider reports no relevant disclosures.

Schneider S, Pabon M, Lu H, et al. Sleep Apnea in Heart Failure With Mildly Reduced or Preserved Ejection Fraction: the FINEARTS-HF Trial. Abstract presented at the American College of Cardiology Scientific Sessions 2026, New Orleans, LA. March 28-30, 2026.

Solomon SD, McMurray JJV, Vaduganathan M, et al. Finerenone in heart failure with mildly reduced or preserved ejection fraction. 

Videos

Schneider discusses her analysis of the FINEARTS-HF trial, noting the apparent efficacy of finerenone regardless of sleep apnea presence.

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Credit: Skin and Cancer Associates and The Center for Cosmetic Enhancement

Advances in topical dermatologic medications are quickly reshaping how clinicians manage chronic inflammatory skin diseases, providing them with new options designed to extend beyond the long-standing reliance on corticosteroids.

In a new interview, Brad Glick, DO, MPH, a board-certified dermatologist and the director of the dermatology residency training program at the Larkin Health System Palm Springs campus in Florida, reflected on this topic in light of data he presented in his recent presentation at the 

American Academy of Dermatology (AAD) Annual Meeting

In this session and in his subsequent Q&A interview with 

’s editorial team, Glick highlighted emerging nonsteroidal therapies and their growing role in clinical practice:

What were some of the topical therapies you elected to discuss in this talk, titled ‘What’s New in Dermatology’?

First of all, it's such an honor to be able to be at the podium at the Academy, and I've had that opportunity the last few years to do so. But one of my favorite sessions at virtually the end of the meeting is this. When my colleague, Dr. Mark Lebwohl, invited me last year to be at the podium to do this very same topic. One of the things he told me was to make sure everything is pretty brand spanking new. So I tried to do that. What did I talk about?...I spoke on steroidal topical therapies, which are really in Vogue now. We still need our topical corticosteroids, but we can use them more effectively, even more now than we did before.

Now we have three topical non steroidal therapies, roflumilast, ruxolitinib, and tapinarof, which was the first one to be approved down to the age of 2 for treating our kiddos with atopic dermatitis. Roflumilast has multiple indications: psoriasis, seborrheic dermatitis, atopic dermatitis. And we have things in our toolbox now that we can use for our recommendations for our patients once or twice a day where they don't have what I like to call that ‘saw-tooth’ pattern that we get with corticosteroids. Someone has a bad rash, we still prescribe topical corticosteroids, but for something that is chronic, what is the solution for them?

When we tell them, ‘Okay, use it for 2 or 3 weeks and then take a break,’ we have to have some substantive substitute for that particular product so that they can continue with their therapy. Otherwise, we run into what I talked about in my lecture, which was not only the common side effects that we're concerned about with the chronic use of topical corticosteroids…and not just atrophy of the skin and broken blood vessels, telangiectasias, and maybe steroid acne and steroid rosacea, particularly when topical steroids are used in the face, but what has become a topic of significant discussion. There've been multiple articles published in this last year…steroid withdrawal syndrome. We have hundreds of thousands of patients that have been using topical steroids for many years, some of them for reasonably moderate periods of time, but many of them have this phenomenon over longer periods of time because that's what they were given, or that's what they found successful, transiently.

But [for some] it then seems to backfire, where they get this rebound type of change, worsening of their rash and profound involvement of their face. It may not always be where the corticosteroid is being utilized. So all that told we've had this need for topical, non-steroidals and I talked a lot about newer ones like delgocitinib, which was recently approved for chronic hand eczema. It will have some other uses. I talk a lot about off-label uses of all of these new non-steroidals, so whether it's tapinarof for things like seborrheic dermatitis, there is some data around that for vitiligo that's in progress.

JAK inhibitors [too] are becoming like the Windex of dermatology. We can use them for almost anything right now, although there are obviously FDA-approved indications, such as those for ruxolitinib 1.5% cream for atopic dermatitis down to the age of two, and also for adolescents and adults for non-segmental vitiligo. But there are off-label uses for these therapeutics as well. Palmoplantar postulosis is being studied with a number of these topical non-steroidals.

The punchline is, for our cutaneous, inflammatory, immune-mediated diseases, we now can shift our therapy to more long-term solutions, because patients can use these therapies for longer periods of time compared to, for instance, higher potency corticosteroids. Hopefully, that was an exciting part of my talk. But there are new things that are coming as well, that are exciting for disease states that have been very difficult to treat. Let's talk about one of them, frontal fibrosing alopecia. We've largely used hydroxychloroquine orally and intralesional corticosteroids, but now we may be able to use some of these topical, for instance, Janus kinase inhibitors, to treat that condition. We also have some therapies that may be coming for treatment.

In certain conditions, like cutaneous T-cell lymphoma, and from a topical perspective, we have a certain topical like hypericin gel, which may be beneficial in combination with photodynamic therapy, meaning we use a light source to allow this particular substance, which appears to work just about as well as one of our topical nitrogen mustards. And then this is a fairly uncommon condition, CTCL, cutaneous T cell lymphoma. Nevertheless, the toolbox is not there and is very full. We'll mostly use phototherapy and topical corticosteroids. And of course, for advanced disease, we've had to either use topical retinoids in combination with phototherapy or even systemic retinoids. And so this is a unique and novel agent that's still under study.

Its mechanism of action is to downregulate a lot of these inflammatory changes that are leading to the chronic inflammatory change that we see in CTCL, which leads to the development of these atypical lymphocytes that we see in this particular condition. So stay tuned on that. But hyperson gel, in combination with photodynamic therapy, a light source used with this agent, may have some benefit in the treatment of CTCL, so that's particularly exciting. And actually, there's some thought that maybe even some of the topical Janice kinase inhibitors that I talked about may play some role in the treatment of CTCL, albeit a little bit controversial, and we have to stay tuned there.

Would you go a bit more in depth about JAK inhibitors covered in your talk? Do you feel clinicians are more open to their use now that some of the JAK safety data has been cleared up?

Let's answer question number one first. There's really three reasonable, reasonably accessible topical Janus kinase inhibitors. So let's start with topicals first, and then I'll answer part, part two of the question second, because your question involves the orals and the topicals, which is pertinent. There are 3 topical therapies. Two of them are FDA approved, one that we can get from compounding pharmacies that are primarily used. There are others that are on the horizon. I gave a talk about some of them, providing a list. I mentioned the pan-JAK inhibitor in delgocitinib. It's a pan-JAK inhibitor that's approved for chronic hand eczema first and only, currently approved for adults only. But I can tell you, there was the DELTA-TEEN study that was done. I did talk about it in one slide in my talk…We saw treatment success versus vehicle in the clinical trials for chronic hand eczema, and hopefully it will be approved soon down to the age of 12. That's one to highlight.

The second one, which is the originator topical JAK that was first approved for atopic dermatitis, now approved down to the age of 2, is ruxolitinib 1.5% cream. Use it twice daily. That's also one to highlight, highly effective in the treatment of atopic dermatitis in that age spectrum of 2 years and above. And then finally, for topical tofacitinib…[It] has been evaluated topically for the treatment of various forms of alopecia, including alopecia area and frontal fibrosine alopecia. Our audience will know that the initial discovery for the benefits of JAK inhibitor started with oral tofacitinib, and so many of us have used it for many years in a variety of different settings.

…Question two was that you asked about the risk adverse nature of some of our colleagues where JAK inhibitors are concerned, because the systemic agents of which there are now 3 that are approved for alopecia areata in baricitinib, ritlecitinib, and now deuruxolitinib, and then also our originator products in baricitinib for alopecia areata, but also upadacitinib for atopic dermatitis down to the age of 12, of getting those approvals correctly. Abrocitinib is also approved for adolescents. These are unique therapies, but all of them, and including one of the topical therapies, which is ruxolitinib cream…The point is that I think with more use, yes, we're starting to see a steady uptake of the use of the orals and certainly the topicals. I think that our expert dermatology colleagues feel quite comfortable that these topical therapies, unless someone is swimming in it and using all over their body, 100%.

The quotes used in this Q&A interview summary were edited for clarity.

Glick has served as an adviser, consultant, speaker, or investigator for Amgen, AbbVie, AstraZeneca, Almirall, Arcutis, Bausch Health/Valeant, Ortho Dermatologics, Boehringer Ingelheim, Bristol-Myers Squibb, Brickell Biotech, Cara, ChemoCentryx, Dermavant, Dermira, Eli Lilly, EPI/Novan, Incyte, Janssen Pharmaceuticals, LEO Pharma, Galderma, Nimbus Lakshmi, Inc, Novartis, Sun Pharma, Pfizer, Sanofi, Regeneron, UCB and the CorEvitas AD, CorEvitas PSO, and PROSE Registries and is a shareholder of Top MD

Glick B, et al. S065 What's New in Dermatology. Session presented at: 2026 American Academy of Dermatology Annual Meeting; March 27–31, 2026; Denver, CO.


Articles

Topical dermatologic management is shifting toward steroid-sparing, longer-horizon strategies for chronic inflammatory disease control. Newer nonsteroidals—roflumilast, ruxolitinib cream, tapinarof, and emerging agents like delgocitinib—aim to reduce reliance on intermittent corticosteroid cycles and mitigate risks such as atrophy, telangiectasias, acne/rosacea, and topical steroid withdrawal. Topical JAK inhibition is expanding across approved indications and off-label exploration, with increasing clinician comfort as safety understanding matures. Pipeline approaches also include novel topical options for difficult diseases, including CTCL.

This Q&A interview from AAD 2026 covers a number of notable tips for clinicians in dermatology regarding topical therapies.

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.

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.

What's New in Topical Dermatology Drugs, With Brad Glick, DO, MPH

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.

Spyre Therapeutics has announced positive 12-week induction data from Part A of the phase 2 SKYLINE trial of SPY001, a potential best-in-class anti-α4β7 being investigated for the treatment of moderate-to-severely active ulcerative colitis (UC).

In the April 13, 2026, press release, the Company additionally announced that recruitment for Part A of SKYLINE is now closed and enrollment is open for Part B, which includes 3 monotherapy cohorts (SPY001, SPY002, and SPY003) and 3 combination cohorts (SPY120, SPY130, and SPY230) into which participants may be randomized versus a shared placebo. Proof-of-concept induction data for the remaining cohorts of Part A are now expected mid-2026 (SPY002) and Q3 2026 (SPY003), while Part B induction data for all cohorts remain on track for 2027.

“SPY001 was designed to improve upon vedolizumab’s proven activity in IBD by matching its epitope and potency while increasing target coverage through an extended half-life and greater induction dosing. Our data today support the hypothesis that this approach could lead to a best-in-class anti-α4β7 product across safety, efficacy, and convenience,” said Deanna Nguyen, MD, SVP of Clinical Development and SKYLINE study lead.

 “Beyond SPY001’s potential as a monotherapy, we continue to believe that its gut-selective mechanism makes it an ideal backbone for combination therapy alongside our cytokine-targeting investigational antibodies SPY002 (anti-TL1A) or SPY003 (anti-IL23). We have begun enrolling these combinations globally and look forward to unveiling proof-of-concept data next year.”

SPY001 is an investigational, novel, extended half-life monoclonal antibody targeting α4β7 for the treatment of inflammatory bowel disease (IBD). It targets the same epitope as vedolizumab, which was approved by the US Food and Drug Administration for the treatment of both UC and Crohn’s disease in 2014, and has demonstrated equivalent potency and selectivity as vedolizumab in head-to-head preclinical studies.

Interim data from a previous phase 1 trial demonstrated that SPY001 was well tolerated and exhibited a human half-life of ~80 days, approximately 3-fold greater than vedolizumab and supporting potential quarterly or biannual SC maintenance dosing in a single autoinjector compared to vedolizumab's Q2W SC profile.

SKYLINE is a 2-part induction and maintenance platform trial of SPY001, SPY002, SPY003, as well as pairwise combinations thereof, totalling 6 investigational agents, in patients with moderately to severely active UC. Part A is an open-label assessment of the safety and efficacy of a single dose level of each investigational monotherapy, and Part B is a randomized and placebo-controlled assessment of the safety and efficacy of investigational monotherapies (2 dose levels) and combinations.

Results showed SPY001 achieved the primary endpoint, demonstrating a statistically significant reduction in the Robart’s Histopathology Index score of 9.2 points (P <.0001). Rates of key secondary endpoints of clinical remission and endoscopic improvement were clinically meaningful and support SPY001’s potential best-in-class profile.

SPY001 was well tolerated with a safety profile consistent with the α4β7 class. There were 6 subjects with treatment-emergent adverse events (TEAEs) during the induction treatment period, with one serious adverse event (SAE) deemed not drug-related. The most common AE (occurring in ≥ 2 patients) was back pain (n = 2).

“On behalf of the Spyre team, I’d like to thank the patients and investigators whose partnership has made this progress possible as we advance the study with the goal of delivering paradigm-changing combinations for IBD patients,” Sheldon Sloan, MD, MBE, Chief Medical Officer of Spyre Therapeutics, said in a statement.

 “Thanks to our team’s outstanding execution, we enrolled Part A with exceptional speed and now transition to Part B. We expect heightened investigator enthusiasm given these promising results for SPY001, a low placebo allocation for the remainder of the trial, and a unique opportunity to evaluate perhaps the three most promising combinations in development.”

Spyre Therapeutics. Spyre Announces Potential Best-in-Class SPY001 Part A Induction Results from SKYLINE Trial in Moderate-to-Severe Ulcerative Colitis Patients. April 13, 2026. Accessed April 13, 2026. 

https://ir.spyre.com/news-releases/news-release-details/spyre-announces-potential-best-class-spy001-part-induction

Spyre Therapeutics. Spyre Therapeutics Announces Poster Presentations at Digestive Disease Week (DDW) 2025 Including Up to Eight months of Follow-up from an Ongoing Phase 1 Trial of SPY001. May 5, 2025. Accessed April 13, 2026. 

https://ir.spyre.com/news-releases/news-release-details/spyre-therapeutics-announces-poster-presentations-digestive

Drugs.com. FDA Approves Entyvio (vedolizumab) to treat Ulcerative Colitis and Crohn's Disease. May 20, 2014. Accessed April 13, 2026. 

https://www.drugs.com/newdrugs/fda-approves-entyvio-vedolizumab-ulcerative-colitis-crohn-s-4040.html

Spyre Therapeutics reported positive 12-week induction results from Part A of the phase 2 SKYLINE trial evaluating SPY001, an extended half-life anti-α4β7 monoclonal antibody for moderate-to-severe ulcerative colitis. Part A enrollment is complete, and Part B has opened with randomized monotherapy and combination cohorts versus shared placebo. SPY001 met the primary endpoint with a statistically significant Robarts Histopathology Index reduction and showed clinically meaningful remission and endoscopic improvement. Safety was consistent with the α4β7 class, with limited TEAEs and one non–drug-related SAE.

Positive 12-week induction data from Part A of the phase 2 trial highlight the potential best-in-class safety and efficacy of SPY001, a novel anti-α4β7 therapy.

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SPY001, An Anti-α4β7, Shows Promise in Phase 2 SKYLINE Trial for Ulcerative Colitis

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.

Image Credit: US Food and Drug Administration

 announced its tentative approval of an Abbreviated New Drug Application (ANDA) for a generic semaglutide injection submitted by Apotex Corp.

The decision marks a regulatory step toward potential generic competition in the GLP-1 RA class. However, the approval does not permit immediate marketing but indicates that the application meets FDA standards for quality, safety, and efficacy, pending resolution of patent or exclusivity barriers.

“Achieving technical equivalence for complex peptide products requires deep scientific rigor, advanced analytical precision, and a highly disciplined development approach,” M. S. Mohan, PhD, managing director of Orbicular Pharmaceutical Technologies, said in a statement. “We are proud to have supported Apotex in this important program. Their regulatory leadership, coupled with Orbicular’s development and execution excellence, was central to securing FDA Tentative Approval.”

Semaglutide, a long-acting GLP-1 receptor agonist marketed under brand names including Ozempic and Wegovy, is widely used for 

 and chronic weight management. The tentative approval is clinically relevant given ongoing concerns about drug affordability and intermittent supply constraints affecting GLP-1 therapies in the United States.

Tentative approval is granted when a generic product satisfies all scientific and regulatory requirements but cannot yet receive final approval due to existing intellectual property protections or regulatory exclusivities. The FDA’s decision suggests that Apotex’s semaglutide formulation has demonstrated pharmaceutical equivalence and bioequivalence to the reference listed drug, though details of the submitted data have not been publicly disclosed.

Semaglutide is a GLP-1 receptor agonist that enhances glucose-dependent insulin secretion, suppresses glucagon release, delays gastric emptying, and promotes satiety. Its extended half-life allows for once-weekly dosing, contributing to improved adherence relative to earlier agents in the class.

The drug has also demonstrated cardiovascular benefit. In the SUSTAIN-6 trial, semaglutide reduced the risk of major adverse cardiovascular events compared with placebo in patients with T2D at high cardiovascular risk. These findings have supported guideline recommendations from organizations such as the American Diabetes Association for the use of GLP-1 receptor agonists in patients with established atherosclerotic cardiovascular disease.

T2D affects >40 million individuals in the United States, with substantial associated morbidity and mortality. GLP-1 receptor agonists have become a cornerstone of therapy due to their glycemic efficacy, weight reduction benefits, and demonstrated cardiovascular risk reduction in high-risk populations.

Semaglutide specifically has shown robust clinical effects across multiple phase 3 trials. In the SUSTAIN program, once-weekly semaglutide significantly reduced glycated hemoglobin (HbA1c) levels and body weight compared with placebo and active comparators. In the STEP trials, semaglutide 2.4 mg demonstrated substantial weight loss in patients with 

 or overweight, leading to its approval for chronic weight management.

Despite these benefits, access remains uneven due to high costs and insurance coverage limitations. The introduction of lower-cost generic alternatives could potentially expand access, although timing will depend on patent expirations and regulatory developments.

While the tentative approval represents a meaningful regulatory milestone, its immediate clinical impact is limited. Generic semaglutide will not be available until exclusivity barriers are resolved, and the timeline for market entry remains uncertain. Additionally, manufacturing complexity for peptide-based injectables may influence pricing dynamics and supply scalability even after approval.

Moreover, clinicians should recognize that not all generic entries result in substantial cost reductions, particularly in highly specialized biologic-like or peptide categories. Real-world affordability gains will depend on market competition, payer policies, and supply chain factors.

“This is a clear demonstration of what true partnership can achieve,” Barry Fishman, chief corporate development officer at Apotex, said in a statement. “As a Force for Health, this milestone reflects Apotex’s leadership in bringing together complementary strengths, a shared purpose, and an unwavering commitment to execution excellence.”

Apotex Corp. Apotex Receives First US FDA Tentative Approval for a Generic Version of Ozempic (Semaglutide Injection) in Partnership With Orbicular. 

. April 10, 2026. Accessed April 13, 2026. 

https://www.prnewswire.com/news-releases/apotex-receives-first-us-fda-tentative-approval-for-a-generic-version-of-ozempic-semaglutide-injection-in-partnership-with-orbicular-302739348.html

Marso SP, Bain SC, Consoli A, et al. SEMAGLUTIDE and cardiovascular outcomes in patients with type 2 diabetes. New England Journal of Medicine. 2016;375(19):1834-1844. 

Wilding JPH, Batterham RL, Calanna S, et al. Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine. 2021;384(11):989-1002. 

Marso SP, Daniels GH, Brown-Frandsen K, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. New England Journal of Medicine. 2016;375(4):311-322. 

The FDA granted tentative approval to Apotex’s ANDA for a generic semaglutide injection, signaling that quality, safety, and bioequivalence expectations have been met but that marketing remains blocked by patent/exclusivity constraints. Semaglutide’s established roles in type 2 diabetes and chronic weight management—along with cardiovascular risk reduction in high-risk patients—underscore the potential clinical significance of eventual generic entry amid affordability and supply pressures. Nonetheless, peptide-injectable manufacturing complexity and market dynamics may temper price erosion and delay meaningful access improvements.

Although the approval does not permit entrance into the market, this decision marks an important step to more universally accessible GLP-1 RAs.

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Type 2 Diabetes

FDA Gives Tentative Approval of ANDA for Generic Semaglutide Injection

Ali Rezaie, MD, is medical director of the GI Motility Program at Cedars-Sinai.

How IBS Treatment Has Evolved: From Symptom Relief to Precision Care

 remains one of the most common but complex disorders in gastroenterology, historically characterized by a symptom-based diagnosis and broad treatment strategies. However, growing insight into its diverse underlying mechanisms has prompted a shift in how clinicians approach management.

, Ali Rezaie, MD, highlighted how instead of relying solely on empiric, symptom-driven care, today’s paradigm increasingly emphasizes careful evaluation, patient-specific factors, and targeted therapies that reflect a deeper understanding of IBS as a heterogeneous condition rather than a single disease entity.

Check out part 1 of the interview with Rezaie 

Historically, he said clinicians focused on dominant symptoms rather than root causes. Patients presenting with diarrhea were typically prescribed antidiarrheals, while those with constipation received laxatives. While this approach offered some degree of symptom relief, it often failed to address the heterogeneity of the disorder.

As Rezaie explained, IBS is not a single disease entity but rather a collection of conditions grouped under a broad diagnostic umbrella defined by abdominal pain and altered bowel habits.

Today, management begins with a thorough clinical evaluation, including detailed history-taking and physical examination to exclude alarm features and rule out alternative diagnoses such as malignancy, inflammatory bowel disease, or structural abnormalities. This step remains critical to ensuring appropriate treatment and avoiding missed diagnoses with more serious prognoses.

Lifestyle and dietary assessment also play a central role in modern IBS care. Clinicians increasingly emphasize the importance of dietary modification and “cleaner” eating patterns, which can provide meaningful symptom improvement for some patients. However, Rezaie noted that lifestyle interventions alone are often insufficient for many patients.

“The reality is that the majority of the patients, just by dietary modification and lifestyle changes, won't see that much improvement to a point where they're considered tolerable,” he explained. “So as the next step, we reach for pharmacotherapy.”

Multiple US Food and Drug Administration-approved therapies are now available for IBS with constipation (IBS-C) and IBS with diarrhea (IBS-D), addressing mechanisms such as gut motility, fluid secretion, and, in some cases, the gut microbiome.

Beyond approved therapies, clinicians continue to use a range of guideline-supported agents, including antidepressants, antispasmodics, bile acid sequestrants, and μ-opioid receptor agonists, though Rezaie noted many of these primarily target symptoms rather than underlying disease drivers. Increasingly, the field is moving toward identifying distinct IBS subtypes and matching therapies accordingly, informed by both clinical presentation and, when available, diagnostic testing.

According to Rezaie, this shift represents a marked departure from the “one-size-fits-all” strategies of the past.

“This is a dramatic shift from 20, 30, years ago, when we would empirically treat patients and mostly just target symptoms,” he explained. “So if you have diarrhea, this is your constipating agent. Or if you have constipation, here's your laxative. That has changed.”

By recognizing IBS as a spectrum of disorders with diverse pathophysiologic mechanisms, Rezaie says clinicians are better positioned to deliver more precise, effective, and individualized care.

Editors’ note: Rezaie reports relevant disclosures with Bausch Health, Ardelyx, and others.

 Association of pharmacotherapy with all-cause mortality among patients with irritable bowel syndrome. 

https://doi.org/10.1038/s43856-026-01498-6

Cedars-Sinai Medical Center. Some common IBS treatments linked to higher risk of death. EurekAlert! April 8, 2026. Accessed April 13, 2026. 

https://www.eurekalert.org/news-releases/1122913

Rezaie explains how IBS care has shifted from symptom-based treatment to targeted, mechanism-driven strategies.

Irritable Bowel Syndrome

On the HCPLive irritable bowel syndrome page, resources on the topics of medical news and expert insight into IBS can be found. Content includes articles, interviews, videos, podcasts, and breaking news on IBS, IBD, and more.

Rethinking IBS Management: The Shift Toward Precision Care, With Ali Rezaie, MD

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

This episode, titled "Exploring Network Meta-Analyses (NMA) in Psoriasis," features panelists discussing the value and limitations of network meta-analyses as a tool for comparing multiple psoriasis therapies across different clinical trials simultaneously.

Video Series

Exploring Network Meta-Analyses (NMA) in Psoriasis

In "Evaluating Psoriasis Therapies using MAICs," our panel delves into several recent and clinically meaningful MAIC analyses comparing biologic therapies for plaque psoriasis, examining what the data reveals about relative efficacy across treatment classes and how these analyses have been validated over time.

Evaluating Psoriasis Therapies using MAICs

Melissa Engel, PhD, a postdoctoral fellow at Feinberg School of Medicine at Northwestern Medicine.

Engel discusses ADAA 2026 findings identifying fear of social judgment as a distinct component of food allergy–related anxiety in adolescents.

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.

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.

Food Allergy

Social Anxiety May Influence Safety Behaviors in Teens With Food Allergy, With Melissa Engel, PhD

Stay updated with the latest healthcare breakthroughs, including FDA actions, in this week’s essential news roundup.

Ophthalmology

Ophthalmology page, resources on the topics of medical news and expert insight into ophthalmic disease can be found. Content includes articles, interviews, videos, podcasts, and breaking news on eye disease research, treatment, and drug development.

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.

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.

The HCPFive: Top News for Healthcare Providers from the Week of 04/05

This Q&A interview at AAD 2026 highlights a number of notable tips for clinicians in dermatology from the ‘Pearls: Diagnostic and Therapeutic’ talk.

Key Diagnostic and Therapeutic Pearls in Dermatology, With Brad P. Glick, DO, MPH

Chelsea Christensen, PA-C, is a cardiology physician assistant at Sentara Virginia Beach General Hospital.

Christensen discusses the mechanics and practical applications of the HFMS, emphasizing its success in predicting HF events based on pulmonary fluid levels.

ZOLL Heart Failure Management System Predicts Events Before Hospitalization, With Chelsea Christensen, PA-C

Nissen discusses his post-hoc analysis of the SURPASS-CVOT trial, comparing the 2 drugs for a 6-component composite endpoint of cardiorenal outcomes.

Atherosclerotic Cardiovascular Disease

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.

Tirzepatide Outperforms Dulaglutide in Cardiorenal Outcomes, With Steven Nissen, MD

Michael H. Gold, MD, is the founder and medical director of Gold Skin Care Center, Advanced Aesthetics Medical Spa, The Laser & Rejuvenation Center.

During this video interview at AAD 2026, Gold touches on key points made in his session titled ‘Complications of Cosmetic Procedures.’

How to Deal With Cosmetic Complications in Dermatology, With Michael H. Gold, MD

Treprostinil significantly slowed FVC decline and reduced clinical worsening events over 52 weeks in patients with IPF.


Pulmonary Fibrosis

TETON-2 Supports Antifibrotic Benefit of Inhaled Treprostinil in IPF, With Steven Nathan, MD

Eingun James Song, MD, is the director of clinical research for Frontier Dermatology. 

In this episode, ‘Redefining Treatment Success in Psoriasis,’ the expert dermatologists explore the remarkable evolution of treatment expectations in psoriasis, moving from modest improvements to ambitious goals of complete skin clearance and sustained remission. The faculty reflect that in earlier treatment paradigms even a 50% improvement in disease severity was considered a meaningful success. 

Latest News

Sleep Apnea Associated With Worsening HF Outcomes, With Sophia Schneider, MD, MS

What's New in Topical Dermatology Drugs, With Brad Glick, DO, MPH

SPY001, An Anti-α4β7, Shows Promise in Phase 2 SKYLINE Trial for Ulcerative Colitis

FDA Gives Tentative Approval of ANDA for Generic Semaglutide Injection

Rethinking IBS Management: The Shift Toward Precision Care, With Ali Rezaie, MD