Barry A. Borlaug, MD is a cardiologist in Rochester, Minnesota, affiliated with the Mayo Clinic.

Barry A. Borlaug, MD: Impact of Tirzepatide on Cardiorenal End-Organ Damage in HFpEF 

Tirzepatide lowered circulatory pressure-volume overload and reduced end-organ damage in the kidney and heart in patients with 

heart failure with preserved ejection fraction (HFpEF)

, according to data from the SUMMIT trial.

American Heart Association (AHA) Scientific Sessions 2024

, these data build upon the known benefit of tirzepatide, a long-acting glucose-dependent insulinotropic polypeptide receptor and glucagon-like peptide-1 receptor agonist (GLP-1 RA), for the treatment of obesity-related HFpEF.

“I think it ties together a lot of the pathophysiologic components that we think are very important in obesity-related HFpEF, and tirzepatide seems to be working through many of these different pathways, some of them hemodynamic and volume-loading and [others] related to inflammation,” presenting investigator Barry A. Borlaug, MD, Mayo Clinic, told 

The double-blind SUMMIT trial randomized 731 individuals with NYHA Class II-IV heart failure, an EF of ≥50%, and body mass index (BMI) ≥30 kg/m2 to tirzepatide (n = 364) or placebo (n = 367). Tirzepatide was titrated to a maximum weekly tolerated dose of up to 15 mg subcutaneously.

For the analysis, Borlaug and colleagues collected data on blood pressure, anthropometrics, estimated plasma volume, and blood samples at baseline and 52 weeks, to determine biomarkers of cardiorenal function in all patients. Primary results from SUMMIT showed tirzepatide lowered the risk of cardiovascular death or worsening heart failure (hazard ratio [HR], 0.62; 95% CI, 0.41–0.95; 

Trial participants exhibited borderline hypertension (systolic blood pressure [SBP], ~128 mmHg), volume expansion (estimated plasma volume, ~3.3 L), chronic kidney disease (urine albumin/creatinine ratio [UACR], ~2.8 g/mol), and subclinical myocardial injury (troponin T, ~11 ng/L).

Compared with placebo, tirzepatide treatment reduced SBP by ~6 mmHg (95% CI, –8 to –4; 

<.001) at 24 weeks and by –5 mmHg (95% CI, –7 to –3; 

 <.001) at 52 weeks, respectively. Tirzepatide also decreased the estimated plasma volume by ~0.32 L (95% CI, –0.36 to –0.27; 

At the same time, tirzepatide achieved an increase in eGFR at 52 weeks (~1.85 ml/min/1.73 m2; 95% CI, 0.19–3.51; 

 = .029), decreases in microalbuminuria at 24 weeks (–25.0%; 95% CI, –36 to –13; 

 <.001) and 52 weeks (–15%; 95% CI, –28 to 0.1; 

 = .051), and a reduction in troponin T at 24 weeks (–9.8%; 95% CI, –16.0 to –3.3; 

 = .004) and 52 weeks (–10.4%; 95% CI, –16.7 to –3.6; 

“I think we need to be looking to use these drugs, these incretin-based drugs, more frequently, including tirzepatide, for the treatment of people with obesity-related HFpEF,” Borlaug told 

Disclosures: Borlaug reports relevant disclosures with Amgen, Boehringer Ingelheim, Eli Lilly, Novo Nordisk, and others.

Borlaug BA. Effects of Tirzepatide on Cardiorenal End-Organ Damage in Heart Failure and Preserved Ejection Fraction: Insights from the SUMMIT trial. Presented at the American Heart Association (AHA) Scientific Sessions 2024. Chicago, Illinois. November 16-18, 2024.

Tirzepatide, a GLP-1 RA, demonstrated significant benefits in reducing circulatory pressure-volume overload and end-organ damage in patients with HFpEF and obesity, as shown in the SUMMIT trial. The trial, presented at the AHA Scientific Sessions 2024, involved 731 participants and revealed that tirzepatide lowered cardiovascular death risk and improved cardiorenal biomarkers. Notable improvements included reductions in systolic blood pressure, plasma volume, microalbuminuria, and troponin T levels, alongside an increase in eGFR. These findings suggest tirzepatide's potential in managing obesity-related HFpEF.

Barry A. Borlaug, MD describes the beneficial effect of tirzepatide on circulatory pressure-volume overload and end-organ damage in patients with HFpEF and obesity.

Barry A. Borlaug, MD

Triglyceride Management and Pancreatitis Risk, With Christie M. Ballantyne, MD

New results from two Phase 2 trials—SHASTA-2 and MUIR—show that plozasiran, an investigational siRNA therapy targeting hepatic APOC3, delivers a substantial reduction in triglyceride-rich lipoprotein particles (TRL-P) and drives a favorable shift in lipoprotein composition and size in patients with 

American College of Cardiology (ACC) 2025 Annual Scientific Sessions

, patients with severe hypertriglyceridemia (HTG) or mixed dyslipidemia received plozasiran 10, 25, or 50 mg subcutaneously at baseline and again at week 12. At the 25 mg dose, plozasiran significantly reduced TRL-P by ~50% in both trials.

“When you see high triglycerides, sometimes the low-density lipoprotein cholesterol (LDL-C) goes up. With nuclear magnetic resonance (NMR) data, you’re changing the particle, so you have an increase in the large particles and a reduction in small, dense LDL particles,” Christie M. Ballantyne, MD, chief of cardiovascular research at Baylor College of Medicine, told 

. “Reduction in small, dense LDL particles may be particularly atherogenic, but these triglyceride particles per particle might be worse for the common person. They have more LDL particles, but people with high triglycerides have different types of particles.”

Importantly, while total LDL-P remained stable, there was a shift toward larger LDL particles, considered less atherogenic. Small LDL-P declined by 20–22%, while large LDL-P increased up to 103% in MUIR. HDL particle concentration also improved, driven by increases in large HDL-P.

Insulin resistance also improved in both studies, by 24% in SHASTA-2 and 9% in MUIR, further supporting the cardiometabolic potential of plozasiran. Ballantyne noted that high triglyceride levels, particularly over 1000 mg/dL, pose an acute pancreatitis risk and could signal conditions like familial chylomicronemia syndrome (FCS).

In a recent analysis of 1.2 million patients, Ballantyne found more than 90% experienced triglyceride reductions with standard treatment, but about 1 in 5,500 had persistent chylomicronemia. Among those individuals, 26% developed pancreatitis, underscoring the need for close monitoring and targeted therapy.

“The other alarm feature is, if they've had a history of pancreatitis, you better worry about that patient, because it's like secondary prevention,” Ballantyne told HCPLive. “To keep it simpler, when you see the 1000 mg/dL, you know you need to have some alarms going off in terms of needing special attention.”

Relevant disclosures for Ballantyne include Arrowhead, AstraZeneca, Eli Lilly and Company, Abbott Diagnostics, NewAmsterdam, and others.

Ballantyne CM, Gaudet D, Rosenson RS, et al. Effect Of Plozasiran Targeting APOC3 On Lipoprotein Particle Number And Size Measured By NMR In Patients With Hypertriglyceridemia (Htg). Presented at: American College of Cardiology (ACC.25) Annual Scientific Session. March 29 – 31, 2025. Chicago, Il.

Christie M. Ballantyne, MD, discusses the role of plozasiran in managing elevated triglycerides and reducing pancreatitis risk.

Christie Ballantyne, MD

This interview in the latest issue of The Respiratory Report features Divay Chandra, MD, MSc, discussing lithium's potential enhancement of alveolar repair after injury.

Exploring Lithium: A Potential Disease-Modifying Therapy for Emphysema

While chronic obstructive pulmonary disease (COPD) remains a leading cause of death worldwide, there is still no treatment that reverses or halts its progression.  Recent research is exploring the potential of lithium, a drug commonly used for bipolar disorder, as a candidate to repair lung damage by targeting a key regenerative signaling pathway in the lung.

This study is being led by Divay Chandra, MD, MSc, an associate professor in the Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, at University of Pittsburgh in Pennsylvania. Chandra spoke in the third issue of 

 that is powered by the American Lung Association Research Institute, on his team’s current research in this area.

Chandra and his team analyzed data from large population cohorts to assess whether individuals taking lithium for other conditions had less lung disease and then measured environmental lithium exposure in people not on the drug. They found that both therapeutic and naturally occurring lithium levels were associated with reduced COPD severity, supporting its potential as a disease-modifying agent. The next step in Chandra's research is scaling up their studies to look at longitudinal progression and is enabled by an American Lung Association grant.

"Despite decades of research and multiple clinical trials, as yet, we have not been able to identify a disease modifying agent in COPD. And that is really the frustrating part. We have drugs that can treat symptoms. You know, we have drugs which can treat eosinophilia, which can reduce exacerbations, but we have no drug that can get at the fundamental disease process that drives this lung disease. That is exactly where lithium could play a role," Chandra said.

To learn more about Chandra's research, view the interview above or read his contribution to the third issue of The Respiratory Report here:

Exploring Lithium as a Potential Disease-Modifying Therapy for Emphysema

This interview in the latest issue of The Respiratory Report features Divay Chandra, MD, MSc, discussing lithium's potential enhancement of alveolar repair after injury.



Divay Chandra, MD, MSc

This article was originally published in ContagionLive.

China has officially passed the 1 billion dose mark for 

 vaccinations administered, becoming 1 of the world’s fastest inoculation efforts.

Despite the high number of doses given out, the country is still remaining very strict with its elimination efforts.

The borders are still mostly closed off to international travel, and social distancing measures are still being strongly enforced in some areas.

China has also been offering millions of its vaccines to other countries, but many places, like Brazil, are refusing the shot in hopes of getting Pfizer or Moderna’s vaccine.

In Cuba, officials are reporting that their homegrown COVID-19 vaccine, Soberana 2, is showing promising results.

On Saturday, results from a late-phase trial were reported, showing the vaccine to be 62% effective with 2 out of its 3 recommended doses.

The country has shunned foreign-made vaccines, putting all of their hopes in their own. Cuba has partnered with Iran, which has also boycotted foreign made vaccines.

The Philippines has recently agreed to purchase 40 million doses of the Pfizer-BioNTech vaccine, which will provide a significant boost to the country which has been struggling with infections.

The order is set to be delivered through the third and fourth quarter of 2020.

Since the start of the pandemic, the Philippines has seen over 1.35 millions COVID-19 infections, with 23,500 deaths.

Data Table per Our World in Data (June 20, 2021, 12 AM EST)

In the United States, Rochelle Walensky, the director of the US Centers for Disease Control and Prevention, warned on Friday that the Delta variant is soon likely to become the dominant strain in the country. The more transmissible variant is likely to spread throughout the unvaccinated population.

Data Table per CDC COVID-19 Tracker (June 20, 2021, 6 AM EST)

For more information on COVID-19 vaccination research, distribution, and assessment, check out some of these recent Contagion stories:

Emergency Use Authorization vs. Full Approval: What are the Implications?

Update on CureVac COVID-19 Vaccine Phase 2b/3 Trial

What Role Will Novavax’s Vaccine Play in the Global COVID-19 Effort?

Africa sees third wave as only 1% of the population is fully vaccinated.

China Hits 1 Billion COVID-19 Vaccines Administered 

Killian Meara

Leandro Boer, MD, PhD, vice president of general medicines at Amgen

Preliminary results from the VESALIUS-REAL study highlight a significant burden of 

 in real-world settings, revealing gaps in lipid-lowering management among more than 277,000 individuals in the U.S. with elevated low-density lipoprotein cholesterol (LDL-C).

The analysis found that most high-risk patients aged ≥50 years with atherosclerotic cardiovascular disease (ASCVD)—including coronary artery disease (CAD), peripheral artery disease (PAD), cerebrovascular disease (CeVD), or high-risk diabetes—who had no prior history of myocardial infarction or stroke were neither adequately tested for LDL-C nor treated with lipid-lowering therapy (LLT).

Among 277,808 patients, only 37.6% received statin therapy, while more than half (62.4%) had no background LLT. One year after the index date, 87.6% of patients had an LDL-C level above 70 mg/dL, yet only 22.4% intensified their treatment, and fewer than 2% initiated a nonstatin LLT.

, Leandro Boer, MD, PhD, vice president of general medicines at Amgen, discussed the study’s findings, emphasizing the urgent need for improved LDL-C management strategies to reduce cardiovascular risk in high-risk patient populations.

This transcript has been edited for clarity.

: What do these results inform about the current state of cardiovascular disease risk management in US patients?

These results are part of a whole cohort of patients in the VESALIUS-REAL study, comprising 277,000 patients in the US, alongside 11 other countries. This just focuses on the presentation of the US data. Who are these patients? These patients are patients with a very high risk of cardiovascular events. They have CVD, but have never had a stroke or myocardial infarction before. We are focused on what happened with them once they are in that situation.

We found very startling findings in the US, which may not be different from the rest of the world, showing 70% of these patients are not starting any therapy for LDL reduction, which is the most modifiable risk factor. In 88% of patients, if they start on a medication, they don’t have their medication intensified to the next level so they can achieve their goals. The level of patients not achieving this goal is high and that’s what we show in this poster.

: When we consider this issue, do we see it more as a provider-driven issue, a patient adherence challenge, or a systemic health care obstacle?

It’s a systemic health care gap. I like to say there is no silver bullet for this problem, but we also should not be looking at the gap and say ‘it is what it is.’ Since I started practicing, I prescribed my first statin prescription more than 20 years ago. We haven’t seen much happening and have seen a lot of inertia. These results and outcomes in the US population are not acceptable.

I believe there is a problem that we need to tackle. We need to be together, hand in hand, with insurers; they need to do their part. The manufacturers need to do their part and the patient needs to do their part. And the HCP needs to do their part. I think it’s missing the element of empowerment of the patient and the HCP binary, we need to help them take control of their destiny and their treatments.

: Despite the need for more intensive therapy, these data indicate <2% of patients initiated a nonstatin lipid-lowering therapy (LLT). What are the barriers that might be impacting the greater adoption of those agents?

In the US, we have some statistics. For example, one-third of the population does not have any insurance or is poorly insured. The second thing, a lot of cardiologists often come from cities, but 50% of counties in the country do not have a single cardiologist. We have a compounding effect of many things happening culminating with a patient not being intensified or therapy not achieving their goals. So, we have systemic barriers.

Even the possibility of a patient talking about their disease with their doctor, given the short duration of time, it often feels like patients spend more time asking questions with ChatGPT than their doctors. Is this the ideal thing? Maybe it’s an indication of how to use technology in the future, but we need to put the trust back in the relationship. Approximately three out of four patients in the US trust their primary care, so I think it’s an untapped opportunity.

We should not only focus on cardiology, we need to go to primary care, so they can also achieve their goals. This is not rocket science. We talk about lipids, the most modifiable risk factor. It’s accessible and really for everyone. It’s not complicated, so I think all primary care should have these goals and help their patients achieve those goals.

: How can recent guideline recommendations from organizations like the ACC and the American Heart Association (AHA) help address this issue?

Every time they go with the guidelines in a simple way, they can make it clear that what they’re recommending can be translated into clinical practice. Even when the guideline is not clear, we have a gap of 17 years between what is published and actual clinical practice. That’s why we need implementation science that’s been around with the National Institutes of Health (NIH) for the last 20 years. They help, by not only being a beacon and source of knowledge, but also helping us be partners for implementation initiatives. What works best to have those patients achieve their goals?

HCPLive: Do you have any final thoughts on these treatment

I would say just the importance of testing. In the country right now, we’re seeing dramatically low levels of testing. People are not testing for LDL, and when they do test, they don’t initiate the treatment. Something is going on there that we need to crack the code of, particularly what’s going on between the testing not being performed and why testing is not generating the urgency to do something.

It’s accessible to everyone and affordable, so why is someone not doing it? Testing is very important, because that’s the best way to put someone on a patient care pathway, so they can achieve their goals. The second thing is to continue mass education of both patients and also HCPs so they know the goal, know your number, and understand getting there is not so complicated.

Disclosures: Boer is an employee of Amgen.

Sakhuja S, Chan Q, Ochs A et al. Lipid Lowering Therapy Use in High-Risk ASCVD Patients Without Prior MI or Stroke - Preliminary Data from VESALIUS-Real, US. Presented at: American College of Cardiology (ACC.25) Annual Scientific Session. March 29 – 31, 2025. Chicago, Il.

The VESALIUS-REAL study reveals significant gaps in lipid-lowering management among over 277,000 U.S. patients with elevated LDL-C, highlighting a systemic healthcare issue. Despite being at high risk for cardiovascular events, many patients with ASCVD are inadequately tested and treated for LDL-C. Only 37.6% received statin therapy, and a mere 22.4% intensified treatment after a year. Barriers include lack of insurance, limited access to cardiologists, and insufficient patient-provider communication. Recent guidelines and implementation science are crucial for improving LDL-C management and reducing cardiovascular risk.

At ACC.25, Boer highlights treatment gaps in the US for lipid control in a high-risk ASCVD population.

VESALIUS-REAL Reveals Lipid Control Gaps in US with Leandro Boer, MD, PhD

Leandro Boer, MD, PhD

Maria Hordinsky, MD, is an R.W. Goltz Professor of the Department of Dermatology at the University of Minnesota.

Trichoscopy’s Role in Differentiating Alopecia Types, with Maria Hordinsky, MD

A session titled ‘Spotting Scarring Alopecia Early: Clues, Challenges, and Clinical Pearls’ was presented during the 

2025 SDPA Annual Summer Dermatology Conference

The presenter, Maria Hordinsky, MD, was interviewed by 

’s editorial team on the major highlights described in her talk. Hordinsky is an R.W. Goltz Professor at the University of Minnesota Department of Dermatology. Hordinsky was asked in this segment of her interview about how dermoscopy—or more specifically, trichoscopy—helps differentiate early-stage scarring alopecias from mimickers like telogen effluvium or traction 

“The trichoscopy of the scalp is amazing,” Hordinsky said. “With that instrument called the dermatoscope, one can take a look at the skin of the scalp and see if there's inflammation present, whether it's diffuse and loose like you would see in dandruff. Is it kind of a loose scale, or is there hugging of the scale? Is the scale hugging the hair fiber as it exits out of the skin, which goes along more with the scarring alopecia? With trichoscopy, you can also see if scarring has already occurred.”

Hordinsky noted that particularly in more richly-pigmented skin types, the network of the skin can face injury and scarring due to such alopecia. Occurred. In terms of density, with dermoscopy or trichoscopy, Hordinsky noted that one can also note the quality of the hair fibers.

“So, a good picture of the scalp would show you that most of the hair fibers are very uniform,” Hordinsky explained. “They're of the same diameter. But if there's pattern hair loss occurring, or abnormal hairs are coming back, there's going to be a lot of variation in fiber diameter and also perhaps in the quality of the hair.”

Hordinsky was asked about any other clinical pearls worth mentioning that were featured in her presentation on scarring alopecias.

“I think it's really important to recognize that when you're working with a patient as a scarring alopecia, and you are doing all the right things that are in the algorithm for the treatment of a scarring alopecia, if your patient does not get better, then you have to think about allergic contact dermatitis,” Hordinsky said. “Because sometimes the treatments that we prescribe, or the injections that we do, have chemicals in them that your patient might be allergic to. It's very important to recognize if you're doing everything you can and the patient's not getting better. Then it's time to investigate with testing, to figure out if there's something the patient's coming in contact with that's driving this process.”

For any further information on scarring alopecia covered in Hordinsky’s presentation at SDPA 2025, view her full interview segment posted above. To find out more about alopecia and other dermatologic diseases highlighted at the meeting, view the 

The quotes used in this interview summary were edited for the purposes of clarity.

Maria Hordinsky, MD, spoke at SDPA regarding her talk highlighting a variety of clinical pearls for spotting scarring alopecia early.

Maria Hordinsky, MD

Predicting Cardiovascular Disease in Patients Without Risk Factors with Matthew Budoff, MD

 in Philadelphia, PA, Matthew Budoff, MD, professor of medicine and director of Cardiac CT at UCLA School of Medicine, presented the results of a recent study investigating 

 risk via serum lipoproteins in patients who present without conventional risk factors.

According to recent studies, conventional risk factors such as 

, family history, tobacco use, obesity, physical inactivity, elevated LDL cholesterol, low HDL cholesterol, and hypertension only explain roughly 66% of all cardiac events. A substantial number of atherosclerosis cases are experienced by patients with no prior indications of risk and are therefore missed by clinicians.

However, Budoff indicated that these cases are often identifiable by skewed serum lipoproteins. Lipoprotein (a), apolipoprotein B (ApoB), and non-HDL cholesterol are all indicators of plaque, which in turn exhibits increased chances of cardiac events. All these measures are increased during atherosclerosis; to that end, Budoff suggests diagnosing and treating atherosclerosis itself to find otherwise symptomless coronary artery disease (CAD) instead of relying on conventional factors.

“So overall, in the US, about 20% of patients who have heart attacks have no cardiovascular risk factors,” Budoff told 

. “I think we have to look more carefully at LP(a), at C-reactive protein, at coronary calcium, as adjunctive ways of identifying this population that do have heart attacks but are not picked up by our population-based risk factors.”

Budoff’s study examined a meta-analysis of all patients looked at in a set of population-based studies, including the Miami Heart Study and the Multi-Ethnic Study of Atherosclerosis. Among these, Budoff and colleagues noted that Lp(a) was the most consistent predictor of atherosclerosis.

“It just reinforces what we’re learning; this is Lp(a) being elevated in the setting of normal LDL, no diabetes, no hypertension, no smoking,” Budoff said.

Budoff also stated that traditional population-based risk factors may be insufficient for diagnosing heart disease altogether. He posited that such broad categories miss patients outside of the typical conditions.

“I’ve always been somewhat against just using the traditional population-based risk factors, because it’s very impersonalized and a lot of patients don’t fit into those algorithms of care, where they might not have the right age or diabetes background or LDL to qualify as high risk, y et they really do have significant underlying atherosclerosis.” Budoff said. “And again, 20% of all heart attacks that occur in the United States occur in patients who don’t have any of these known modifiable risk factors.”

Budoff advised clinicians interpreting these results to begin conducting larger studies with broader scopes to better understand seemingly asymptomatic CAD and to better help patients in need.

“I think we need to do larger studies on patients who appear healthy, maybe earlier in life, to identify these patients who, long term, are not going to be so healthy and may put a significant burden on healthcare, but also not survive to their normal life expectancy,” Budoff said. “We’re not focusing on these lower risk individuals, but hopefully there will be enough of the population in these trials to start forming some good evidence.”

Budoff reports the following disclosures: AstraZeneca, Amarin, Merck, Novo Nordisk, Regeneron, and others.

Budoff M. Serum Lipoproteins & Coronary Atherosclerosis in Asymptomatic U.S. Adults Without Traditional Risk Factors. Presented at the 9

 Annual Heart in Diabetes conference in Philadelphia, PA, June 6-8, 2025.

Khot UN, Khot MB, Bajzer CT, et al. Prevalence of conventional risk factors in patients with coronary heart disease. JAMA. 2003;290(7):898-904. doi:10.1001/jama.290.7.898

Budoff suggests monitoring serum lipoproteins like Lp(a) and ApoB to predict cardiovascular disease risk in patients with no conventional indicators.

Matthew J. Budoff, MD

This article was originally published on 


A new drug is here to make waves in the menopause symptom treatment landscape with the FDA approval of fezolinetant (Veozah; Astellas Pharma) for the treatment of moderate to severe vasomotor symptoms (VMS) associated with menopause.

This approval makes fezolinetant the first neurokinin 3 receptor antagonist approved by the agency to treat VMS in menopause, according to the FDA.

“Hot flashes as a result of menopause can be a serious physical burden on women and impact their quality of life,” said Janet Maynard, MD, MHS, director of the Office of Rare Diseases, Pediatrics, Urologic, and Reproductive Medicine, in the FDA’s Center for Drug Evaluation and Research.

 “The introduction of a new molecule to treat moderate to severe menopausal hot flashes will provide an additional safe and effective treatment option for women.”

The approval is backed by positive data from the BRIGHT SKY program. This clinical trial program consisted of 3 phase 3 studies that enrolled more than 3,000 individuals from the United States, Canada, and Europe. In 

 (NCT04003155) and SKYLIGHT 2 (NCT04003142), results emphasized the safety and efficacy of the nonhormonal treatment for VMS associated with menopause. Meanwhile, 

 (NCT04003389) demonstrated the long-term safety of fezolinetant.2

"[The] approval of fezolinetant is a significant and, I believe, long-awaited milestone for individuals in the [United States] who experience moderate to severe vasomotor symptoms during the menopausal transition," said Genevieve Neal-Perry, MD, PhD, chair, University of North Carolina School of Medicine Department of Obstetrics and Gynecology.

 "This therapy is based on our understanding of the biology behind hot flashes. I'm excited to know that patients will have the option to choose this nonhormonal treatment."

Patients taking fezolinetant are instructed to take 1, 45 mg pill orally, once per day, with or without food. Additionally, the medication should be taken at the same time every day.

According to the FDA and the prescribing information, the medication includes a warning for elevated hepatic transaminase (liver injury). Prior to using fezolinetant, patients should have blood work completed to test for liver damage. Additionally, while taking fezolinetant, patients should undergo routine bloodwork every 3 months for the first 9 months of usage. If patients experience symptoms such as nausea, vomiting, or yellowing of the skin and eyes, they should contact their physician.

The FDA also notes that fezolinetant cannot be used with CYP1A2 inhibitors, and individuals with cirrhosis, severe renal damage, or end-stage renal disease should avoid taking the medication.

Per the prescribing information, the most common side effects of fezolinetant include abdominal pain, insomnia, back pain, hot flush, diarrhea, and elevated hepatic transaminases.

FDA approves novel drug to treat moderate to severe hot flashes caused by menopause. FDA. May 12, 2023. Accessed May 12, 2023. https://www.fda.gov/news-events/press-announcements/fda-approves-novel-drug-treat-moderate-severe-hot-flashes-caused-menopause

Astellas’ Veozah (fezolinetant) approved by US FDA for treatment of vasomotor symptoms due to menopause. PR Newswire. May 12, 2023. Accessed May 12, 2023. https://www.prnewswire.com/news-releases/astellas-veozah-fezolinetant-approved-by-us-fda-for-treatment-of-vasomotor-symptoms-due-to-menopause-301823639.html

Announced on May 12, 2023, the FDA's approval of fezolinetant (Veozah) marks their first approval for an NK3 receptor antagonist for the treatment of vasomotor symptoms of menopause.

FDA Approves Fezolinetant for Moderate to Severe Hot Flashes in Menopause

Morgan Petronelli

Perseus Patel, MD, clinical assistant professor at Stanford Medicine Children’s Health Center for IBD.

Prioritizing personalized care for children and adolescents with inflammatory bowel diseases (IBD) is critical to achieve early disease control and alleviate the long-term risks of IBD. A promising tool, a point-of-care intestinal ultrasound (IUS), offers a transformative approach that allows real-time, non-invasive images of disease activity directly in the clinic.

Historically, IBD diagnosis and treatment have relied on symptoms, blood and stool testing, colonoscopies, and cross-sectional imaging such as MRIs—all of which have drawbacks.

Symptoms and blood tests often do not correlate with mucosal inflammation, while blood tests are invasive, and stool tests are challenging to collect. For conventional cross-sectional imaging, the patient must drink a significant amount of oral contrast before the procedure. Children may find it difficult and anxiety-provoking to lie still in a scanner for a prolonged period, and CT scans expose children to radiation.

While a colonoscopy remains the gold standard to monitor intestinal inflammation, frequent colonoscopies are infeasible in children, owing to their invasive nature, extensive bowel preparation, and anesthesia exposure.

All these tests take time to yield results, delaying the next steps in disease management.

Understanding point-of-care intestinal ultrasound

Contrary to the traditional approaches of monitoring IBD, IUS is a non-invasive abdominal exam that can be performed during routine clinic visits. The exam provides high-level and detailed cross-sectional images of the bowel, allowing clinicians to assess inflammation in the gastrointestinal tract in real time.

The ultrasound exam typically takes 15-20 minutes. A warm gel is applied to the patient’s abdomen, and the ultrasound transducer is gently moved to assess the bowel. This method requires no fasting, preparation, or anesthesia, and exposes the patient to no radiation.

IUS is currently the only real-time, objective tool available for assessing intestinal inflammation in routine clinical care, eliminating delays associated with laboratory tests, stool tests, and traditional cross-sectional imaging. Stanford Medicine Children’s Health is among the first in the nation to provide this service to children as part of its routine IBD care.

Benefits of point-of-care intestinal ultrasound in pediatric IBD

Incorporating IUS into routine care is transforming the management of pediatric IBD. Its real-time imaging allows clinicians to visualize bowel inflammation during a clinic visit, enabling immediate and tailored treatment decisions.

During these visits, patients and families can speak with their care team about managing their disease while viewing the same images and verifying ongoing inflammation on a shared screen. While it does not replace all colonoscopies or traditional imaging tests, it potentially reduces the need for repeat invasive procedures by offering regular, real-time transmural monitoring of treatment response.

 demonstrated that normal bowel wall thickness in pediatric patients with IBD likely differs from adults.

 To further the study of the unique features of pediatric-specific IUS, Stanford Medicine Children’s Health’s Center for IBD and Celiac Disease Intestinal Ultrasound Program instituted a prospective Intestinal Ultrasound Registry to further characterize unique pediatric ultrasound features.

Research from the Stanford Medicine Children’s Health’s Center for IBD and Celiac Disease Intestinal Ultrasound Registry shows that incorporating intestinal ultrasound into a patient’s IBD clinic visit is superior in detecting inflammation compared to routinely used clinical disease activity indices.

 A personalized approach that integrates IUS data with symptoms discussed during a clinic visit may lead to immediate actionable management decisions that ultimately decrease the time to remission.

Integrating IUS into national learning health systems as a routine part of care is essential to further research, improve access, and optimize outcomes for all IBD patients. As such, Stanford Medicine Children’s Health has partnered with other national leaders in pediatric IUS to spearhead efforts to standardize the use of IUS across pediatric IBD centers.

To address the large gap in how many (pediatric) gastroenterologists are currently trained in point-of-care intestinal ultrasound in the United States, Stanford Medicine Children’s Health was at the forefront in seeking accreditation to train both pediatric and adult gastroenterologists in ultrasound through the International Bowel UltraSound (IBUS) group.

A deeper understanding of the utility of IUS as a monitoring tool for transmural disease outcomes may also facilitate access to novel medications, as clinical trials for children still often require multiple colonoscopies. New evidence highlights IUS’s ability to predict disease progression, and early ultrasound changes can indicate a child’s response to therapy.

As symptoms sometimes fail to correlate with inflammation, intestinal ultrasound could offer a proactive approach, allowing clinicians to detect and treat inflammation before symptoms emerge. This powerful tool can help optimize treatment plans, reduce the need for invasive procedures, and improve patients’ quality of life through faster, more targeted care decisions.

Kellar A, Chavannes M, Huynh HQ, et al. Defining normal bowel wall thickness in children with inflammatory bowel disease in deep remission: A multicenter study on behalf of the pediatric committee of the International Bowel Ultrasound Group (IBUS). 

. Published online April 29, 2025. doi:10.1002/jpn3.70049

Patel PV, Zuniga DJ, Goyal A, Bensen R, Bass DM, Moses J, Rosen MJ, Colman RJ. Bowel Wall Thickness and Hyperemia on Routine Clinical Care Intestinal Ultrasounds Are Associated with Clinical and Biochemical Disease Activity in Children with Inflammatory Bowel Disease. Presented at Digestive Diseases Week 2025, San Diego, California

Personalized care for pediatric IBD is crucial for early disease control and reducing long-term risks. Point-of-care intestinal ultrasound (IUS) offers a non-invasive, real-time imaging solution, overcoming limitations of traditional methods like colonoscopies and MRIs. IUS facilitates immediate treatment decisions by providing detailed images during clinic visits, potentially reducing the need for invasive procedures. Stanford Medicine Children’s Health is pioneering IUS integration, enhancing pediatric IBD management. National efforts aim to standardize IUS use and training, improving access and outcomes for IBD patients through proactive, personalized care.

Point-of-care intestinal ultrasound offers real-time, noninvasive monitoring for pediatric IBD, enabling faster, personalized treatment decisions in routine care.

Faster, Targeted Pediatric IBD Care with Point-of-Care Ultrasound

Perseus Patel, MD

Future Directions in the Management Atopic Dermatitis in Adult Patients

Video content above in prompted by the following:

Please provide your final thoughts on the future of atopic dermatitis treatments.

Panelists discuss how the future of atopic dermatitis treatments is evolving with novel biologics, Janus kinase inhibitors, and precision medicine targeting immune pathways. Advances in gene therapy, microbiome modulation, and personalized treatments offer promising long-term management options.

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