Ahmad Anouti, MD, is a pediatric resident at the University of Texas Southwestern in the Physician Scientist Training Program.

Simplifying, Expediting Biliary Atresia Diagnosis, with Ahmad Anouti, MD

Recent guidance from the American Academy of Pediatrics (AAP) is helping facilitate the early identification of 

 in infants, providing pediatric primary care providers with a novel strategy to simplify and expedite the process.

Intended to be used between 2 and 4 weeks of life at the “By 1 month” well-child visit in the Bright Futures/AAP “Recommendations for Preventive Pediatric Health Care,” the strategy involves examining infants’ eye color, stool color, and prior laboratory results to determine whether measurement of a direct or conjugated bilirubin level is warranted.

Biliary atresia is estimated to impact 1 in 8,000 to 1 in 18,000 live births worldwide, with symptoms typically appearing between 2 and 6 weeks after birth. The trapped bile can quickly cause liver damage and cirrhosis, eventually leading to liver failure, but outcomes can be improved with early diagnosis and surgery.

“The key here is to catch it early and catch it fast,” Ahmad Anouti, MD, a pediatric resident at the University of Texas Southwestern in the Physician Scientist Training Program, explained to 

. “If we do, the success and the outcomes have been proven time and time again to be better."

Anouti emphasized the importance of the strategy provided by the recent AAP guidance, citing frequent overcomplication in medicine as a whole when it comes to diagnoses and testing. For biliary atresia, he noted the step-by-step guide provided by AAP can simplify the diagnostic process for any primary pediatrician, ideally expediting linkage to a hepatologist.

In addition to being a medical doctor, Anouti is also a patient advocate. Having been diagnosed with biliary atresia as a child and eventually requiring a liver transplant after receiving a late Kasai procedure when he was about 77 days old, Anouti told 

 he wishes the AAP guideline had existed when he needed it as a child.

“With a guideline like this and with an approach like this, the answers come quicker and the treatment comes quicker,” he explained. “As a patient and as a resident in training, it's really eye-opening to see how much these minutes or days or months impact the patient's life, decrease the anxiety, make the answers come quicker, and really make the patient feel like this is being taken seriously and not dragging on.”

Anouti went on to describe how he considers himself to be a patient before a doctor, and the unique perspective this equips him with during his research and clinical work.

“It's very humbling and very exciting to see guidelines like this come out, because it shows me how the field is pushing forward,” he said.

Editors’ note: Anouti has no relevant disclosures.

Brooks A. New Biliary Atresia Guidance Released by American Academy of Pediatrics. 

. February 21, 2025. Accessed March 4, 2025. 

https://www.hcplive.com/view/new-biliary-atresia-guidance-released-american-academy-pediatrics

Anouti discusses the new AAP biliary atresia guidance and what it means to him as a patient-advocate who had biliary atresia as an infant.

Ahmad Anouti, MD

Risks, Benefits of Current Food Allergy Therapies, with Aikaterini Anagnostou, MD, PhD

 therapies—oral immunotherapy for peanut allergy and omalizumab for single or multiple food allergies—each come with their own risks and benefits.

Aikaterini Anagnostou, MD, MSc, PhD, the director of the Food Immunology Program at Texas Children’s Hospital, presented the session, “Navigating the Landscape of Food Allergies,” at the 

2025 American Academy of Allergy, Asthma, & Immunology (AAAAI)

 annual meeting in San Diego on Friday, February 28. 

 spoke with Anagnostou about evaluating the best treatment options for food allergies, weighing their risks and benefits.

“The main benefit from both of these therapies is raising the threshold of reactivity in patients with food allergies, meaning that patients can tolerate a larger amount of food while on the therapy compared to baseline,” Anagnostou said. “This has also the benefit of protecting patients from allergic reactions, accidental exposures, as well as severe reactions such as anaphylaxis.”

Anagnostou considers several factors in determining treatment, including the food allergy diagnosis, the likelihood of outgrowing it, frequency and severity of accidental exposures and their impact on the patient’s quality of life, the nutritional burden, history of anaphylaxis, and the patient’s treatment goals.

“Goals and preferences from patients and families are very important,” Anagnostou said.

For instance, a patient might be reluctant to use epinephrine—or simply do not want to carry it around.

For patients with comorbidities such as uncontrolled asthma or allergic rhinitis, Anagnostou noted that while these are not contraindications for starting food allergy therapy, managing them beforehand may be beneficial.

Oral immunotherapy and omalizumab, although sharing the same benefits, have different risks. Risks associated with oral immunotherapy include adverse allergic reactions during therapy. Moreover, the most common risk associated with omalizumab includes site injection-related reactions.

Recently, there has been more of an emphasis on shared decision-making in the management of food allergies. Anagnostou talks with her patients about the risks and benefits of each treatment and listens to their therapy preferences and goals. Some patients may prefer protection from accidental exposures, and others may want to reduce the anaphylaxis risk.

“I work with my families; I listen to what they are aiming to achieve through undertaking a food allergy therapy, and we make a decision together on the one that best fits their preferences and values,” Anagnostou said.

Relevant disclosures for Anagnostou include Genetech USA, Inc, Genetech Inc, and Novartis Pharmaceuticals Corporation.

Anagnostou A, Rachid R, Chinthrajah R, et al. Navigating the Landscape of Food Allergy Therapies. Presented at AAAAI 2025 in San Diego on February 28.

HCPLive spoke with Anagnostou at AAAAI on how to determine what food allergy treatment patients should undergo.

Aikaterini Anagnostou, MD, MSc, PhD

Ironing Out Deficiency: Anemia Management in Hematology and Oncology 

This presentation discusses the management of iron deficiency in a general hematology practice, covering causes, diagnosis, treatment options, and patient education, particularly regarding iron infusions.

Common Causes of Iron Deficiency in Hematology Practice:


Iron deficiency often results from conditions such as menorrhagia (heavy menstrual bleeding), gastric bypass surgery, chronic kidney disease, and certain cancer treatments, which may require iron supplementation to manage the deficiency.


Diagnosis relies on a combination of patient history and lab results. Clinicians must differentiate between iron deficiency and anemia. It’s important to understand the body’s need for iron and consider treatment options, such as oral or IV iron, with a trial period before retesting for improvements.


Oral iron is often the first treatment choice for many patients. However, not all patients are suitable candidates for oral iron, particularly if they have gastrointestinal issues or other complicating factors. IV iron may be necessary for those who do not respond to oral supplementation.


IV iron treatment involves dosing strategies that aim to minimize the number of infusions, reducing patient burden. Fewer doses are preferable when managing iron deficiency through IV iron therapy.


Adverse reactions to IV iron are rare but can occur. Common symptoms include nausea, typically the next day. Test doses may not predict the development of these reactions. It’s important to be prepared to manage these rare adverse events effectively.


Patient education is crucial to addressing concerns about the risks and benefits of IV iron infusions. For pregnant patients, it’s important to emphasize the benefits of iron supplementation for both the patient and the fetus. Follow-up after IV infusion may be necessary, and some patients will require regular check-ins.


If iron deficiency is suspected to be related to gastrointestinal issues, such as those related to colon cancer, referring patients to a gastroenterologist is key. Understanding the criteria for referral helps ensure appropriate management of underlying conditions.

Future Directions in Iron Deficiency Management:


Looking ahead, there is an increasing focus on early screening for iron deficiency, including more rigorous iron and ferritin testing, particularly in childhood. The goal is to reduce iron deficiency-related deaths globally and improve management practices.

In summary, the management of iron deficiency in hematology requires a comprehensive approach involving accurate diagnosis, appropriate treatment choices, patient education, and collaboration with specialists when necessary. Ongoing advancements in treatment and screening hold promise for improving outcomes and reducing the global burden of iron deficiency.

Panelists discuss how accurately diagnosing iron deficiency, selecting appropriate treatments like oral or intravenous iron, educating patients, and collaborating with specialists are essential for effective management and improving outcomes in hematology practice.

VIDEO: Ironing Out Deficiency: Anemia Management in Hematology and Oncology 

David Kahn, MD 

Welcome back to Diabetes Dialogue: Technology, Therapeutics, and Real-World Perspectives!

Diabetes Dialogue: BELIEVE, GLP-1/GIP Agonists, and CATALYST-2 Results at ADA 2025

In this episode of Diabetes Dialogue, cohosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and co-director of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, continue their recap of ADA’s 2025 Scientific Sessions, spotlighting 3 more of the top clinical trials focused on obesity and type 2 diabetes.

They begin with the BELIEVE study, which evaluated bimagrumab, a monoclonal antibody targeting activin type II receptors, in combination with semaglutide. The trial demonstrated that the combination significantly enhanced fat mass reduction while preserving lean mass, compared to either agent alone. Over 48 to 72 weeks, participants receiving combination therapy lost up to 53 pounds, with over 90% of that loss from fat mass. Safety signals were comparable across arms, with muscle spasms, GI symptoms, and acne among the most reported. The hosts underscore the potential of this dual therapy to mitigate the clinically relevant issue of lean mass loss during weight reduction.

Next, Isaacs and Bellini discuss full 52-week results from a phase 2 trial of maritide, a once-monthly GLP-1/GIP receptor agonist. The trial showed up to 20% weight loss despite no clear dose-response relationship, and a weight loss curve that had not yet plateaued. However, GI-related adverse events—particularly nausea and vomiting—were reported in over 75% of participants, with discontinuation rates as high as 29% in non–dose-escalation arms. The speakers suggest slower titration and tailored patient selection could improve tolerability, and they note the upcoming phase 3 trials and ongoing part 2 of the study will further define maritide’s clinical utility.

Isaacs and Bellini also revisit CATALYST-2, a follow-up to the initial study identifying a high prevalence of hypercortisolism in patients with difficult-to-control type 2 diabetes. CATALYST-2 evaluated mifepristone, a glucocorticoid receptor antagonist, in patients with confirmed hypercortisolism. At 24 weeks, participants on mifepristone saw a mean A1c reduction of 1.5%, substantial decreases in insulin and sulfonylurea use, and modest weight and waist circumference reductions. Adverse effects were more frequent and included hypokalemia and euglycemic ketoacidosis. The hosts highlight the importance of screening for hypercortisolism in patients with refractory diabetes and hypertension, noting that although the therapy presents tolerability challenges, it represents a paradigm shift in personalized diabetes care.

The episode concludes with a reflection on how emerging therapies—and better phenotyping—are reshaping the approach to obesity, glycemic control, and underlying endocrine drivers of metabolic disease.

Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others.

Isaacs and Bellini discuss 3 more of the most impactful trials presented at the 85th annual American Diabetes Association conference in part 2 of this 2-part recap.

Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES

Dhiren Patel, PharmD, CDCES, BC-ADM, BCACP:

 Jen, for you in terms of…obviously there’s the prescribing of it, but I think you’ve served an equally important role in educating other HCPs [health care professionals], especially pharmacists. And so how do you, A, address this with patients? But also more importantly, there is a ton of confusion. Because even within the prescription, like Dr Bhatt alluded, there’s ones that have had data and there’s the ones that don’t have data. And then you have maybe that pharmacist that doesn’t know where it’s not covered, and they say it’s an IL-6 [interleukin 6] on the left-hand side. Which you also don’t want. If you can maybe walk us through kind of the over the counters and even within the prescription ones, how do you sort it, how do you not only educate your patients but also pharmacists and other HCPs?

Jennifer Goldman, RPh, PharmD, CDCES, BC-ADM, FCCP:

 I’m glad you asked that because I was listening to the 3 other panelists and what they’re saying and what they’re talking about is evidence that when I think back to 30 years ago, and I’ve been practicing over 30 years and my colleagues have been practicing quite a long time as well, and we gave drugs based on biomarkers, we were giving the fabric acid derivatives to lower a biomarker, but based on clinical trial, specifically the REDUCE-IT trial, and Dr Bhatt, we now have evidence. We have actual evidence that if we use icosapent ethyl [Vascepa] we not just lower a biomarker, we actually decrease cardiovascular events and so forth. So we have evidence. You can't just use the evidence when you feel like it. If you know the evidence, you have to use that evidence. The other fish oils, the various prescription plus supplements that are over-the-counter have been studied. They have been studied. And yes, they may reduce a biomarker. The triglyceride number might go down, but that does not translate to an outcome that we care about. So it doesn’t end up translating to a decreased cardiovascular event. So I think that’s 1 first educational piece that needs to go out to health care providers, but also to patients and particularly to pharmacists who are in the community, who might be the kind of end stop or the last provider that somebody actually speaks to. I’ll have patients that will come in and they’re on over-the-counter fish oil, and I’ll say, “Why are you taking that?” And they’ll say, “I don’t know. My doctor told me to take it.” So having that conversation. The other conversation is to make sure that everyone is educated about that biomarker. The point you just asked me about, Dhiren, is pharmacists in general. Supplements, fish oil supplements have been studied. They are not regulated. You don’t know what is in them. There could, there are all kinds of impurities in these supplements. The supplements that have been studied have not been shown to improve anything. When I have patients on that and when I advise other pharmacists, no, they’re wasting their money. Don’t get it. They’re not helping themselves. And the same thing with the prescription availability. The ones…you have to follow the evidence. So Dr Bhatt has done that for us. And Dr Busch is participating. For pharmacists out there in the community and for primary care, it’s not OK to just say go to the wholesale store and buy a big 5000 pills of fish oil. It’s not the same. So you can’t use evidence when it’s convenient. It’s all the time.

Joyce Ross, MSN, RNC, CRNP, CS, FNLA, FPCNA:

 I just wanted to jump here and say that there’s 2 points that I wanted to add to what you’re saying, Jen, which is so true. The patients don’t realize what they’re getting when they’re getting something over the counter. So really going through that. But what is worrisome to me is that we understand that the oxidized element of the fish oil over the counter, we have oxidation of the LDL [low-density lipoprotein], which is part of the problem. But we also have an increase in the LDL cholesterol in many of those products. And that is critically important. Saying to a patient, I think we’re shooting ourself in the foot when we’re just taking something that we know may increase your LDL cholesterol when all this time we’ve been working to reduce it. So again, taking the terms, look in the name of the trial, REDUCE-IT tells us all those things that are useful for education, both for the health care provider and for the patient as well.

 Yeah, no, absolutely. And I think hopefully what you saw here is that triglycerides are pretty well-established body of evidence now associated with it, but there’s a little bit of navigation that Jen, you pointed out that we need to make sure they get on the right product. Because there’s been a fair number of trials that haven’t had the positive cardiovascular data. And I say at the end of the day, we want to do things [that] are moving the needle from a population health standpoint and not just treating numbers that numerically make us feel better and they look pretty in a chart. At the end of the day that’s what we’re all here to do. So that’s excellent.

What pharmacists and providers need to know to counsel patients on when discussing the use of prescription or over-the-counter fish oil supplement as treatment for dyslipidemia and hypertriglyceridemia.

Efficacy of Prescription Vs OTC Fish Oil Products  

Joyce Ross, MSN, RNC, CRNP, CS, FNLA, FPCNA

Three recently approved topical non-steroidal treatments for patients living with atopic dermatitis were highlighted by Leon H. Kircik, MD, medical director at Skin Sciences, PLLC, at the 

2025 Revolutionizing Atopic Dermatitis (RAD) Conference

 editorial team at RAD, Kircik highlighted these 3 additions to the 

 treatment armamentarium. He was first asked which drugs he highlighted in his conference talk.

Highlighting New FDA Approvals for Atopic Dermatitis, with Leon H. Kircik, MD

“As you know, the mainstream treatment is still topical steroids for atopic dermatitis,” Kircik said. “We all know that when you have a chronic disease, topical steroids are difficult to use continuously. Especially given that a big population of atopic dermatitis is pediatric or adolescent. We know the side effects, and we're learning more and more about topical steroid side effects, but one thing that we usually don't think about is the disruption of the epidermal barrier when it comes to atopic dermatitis.”

These patients, Kircik explained, already have a disrupted epidermal barrier. He expressed that topical steroids can inhibit lipid synthesis and, unfortunately, worsen epidermal barrier function.

“We're lucky now that we have recently 3 topical non-steroidals approved, including ruxolitinib…roflumilast, a PDE4 inhibitor, as well as tapinarof, an arylhydrocarbon modulator,” Kircik said. “So those 3 have recently become approved for atopic dermatitis, and I think they're going to become an important part of our treatment armamentarium in atopic dermatitis when avoiding topical steroid use.”

Kircik highlighted parental and patient concerns with regard to topical steroids, noting patients’ responses to the presence of non-steroidal options for atopic dermatitis.

“I think those non-steroidal topicals are being welcomed by patients and, more importantly, by parents of the kids with atopic dermatitis,” Kircik said. “Certainly, the efficacy is all there. When we look at the numbers, you see mostly the interruption of itch, so that's really important. Early onset of action [as well], and you see very good efficacy when it comes to IGA or EASI-75 scores. So I think overall, they have great efficacy and, most importantly, a safety profile.”

To learn more about Kircik’s interview, view the full video posted above. For more on subjects related to US Food and Drug Administration (FDA) approvals for atopic dermatitis, check out our 

The quotes used in this video summary were edited for clarity.

This interview highlights 3 new topical non-steroidal options for atopic dermatitis covered in Kircik’s RAD 2025 presentation on FDA approvals.

Leon Kircik, MD

Repositioning Ocular Lenses and Optimizing Vision Outcomes with Mark Breazzano, MD

2025 New York State Ophthalmological Society (NYSOS) Annual Meeting

, Mark P. Breazzano, MD, associate professor of ophthalmology at the Flaum Eye Institute at the University of Rochester Medical Center, presented a surgical video demonstrating the repositioning of a 

Repositioning intraocular lenses (IOLs) presents a technical challenge, as it requires precision, planning, and familiarity with lens-specific features. Breazzano’s video presentation specifically highlighted a flipped lens, the positioning of which was determined based on comparison to optimal haptic placement behind the iris for the Bausch & Lomb Akreos adaptive optic 60 (AO60) lens. The operation aimed to correct the lens’s positioning between the anterior chamber and the vitreous cavity.

“The Akreos lens is a pretty commonly performed surgery, primarily out of necessity,” Breazzano told 

. “There are other techniques that have been quite popular; however, due to production constraints and materials involved, issues with haptic integrity and extrusion of the haptics through conjunctiva make options like Akreos a much more attractive option.”

Still, however, the need for repositioning is uncommon. Breazzano notes that outright removal of the lens is a much larger and more extensive surgery, given the size of the lens in question and the opening required to remove it. Repositioning the lens instead reduces surgical trauma in select cases.

Breazzano also noted the complexity of the repositioning, advising clinicians facing similar operations to prepare as much as possible for the operation. Maintaining vision while also properly orienting the lens so that the patient’s eye generates healthy tissue and exhibits fresh conjunctiva. Additionally, Breazzano suggested postoperative confirmation of lens orientation via direct visualization to further ensure success.

“I usually inform my trainees, residents, and fellows, measure three times and cut once,” Breazzano told 

. “That was certainly the case here; normally, just out of convention, we usually have the lens oriented in the horizontal plane if the patient were to be sitting or standing up.”

Relevant disclosures for Breazzano include Eyepoint, Ophtea, Ocuterra, and others.

Breazzano, MP. Repositioning of flipped and backward scleral-sutured intraocular lens. Presented at the 2025 New York State Ophthalmological Society Annual Meeting, May 16, 2025. New York, NY.

Breazzano presented a video of a surgery repositioning an Akreos AO60 lens, highlighting the complicated nature of the procedure and its planning.

Repositioning Ocular Lenses and Optimizing Vision Outcomes, With Mark Breazzano, MD

Mark Breazzano, MD

Mitchell Shultz, MD, is the Medical Director of Shultz Chang Vision in Los Angeles, California, and Co-Founder and Chief Medical Officer of Alchemy Vision.

Lotilaner Boosts Meibomian Gland Function, With Mitchell Schultz, MD

Lotilaner ophthalmic solution 0.25% (Xdemvy) achieved statistically significant improvements in meibum quality, meibomian gland function, and patient-reported symptoms at 12 weeks, compared with vehicle control, in a new meta-analysis of the ERSA and RHEA trials.

2025 American Society of Cataract and Refractive Surgery (ASCRS) Annual Meeting

, the studies assessed the safety and efficacy of lotilaner ophthalmic solution, 0.25%, for the treatment of patients with 

Demodex blepharitis and meibomian gland dysfunction (MGD)

“Approximately 57% of patients with Demodex blepharitis do have MGD,” Mitchell Shultz, MD, medical director of Shultz Chang Vision, told 

. “Demodex mite infestation has a significant impact on meibomian gland function, and the reason is that the Demodex mites have bacteria that produce inflammatory mediators, which impact meibomian gland function in several different ways.”

The randomized, double-masked ERSA study (n = 39) and vehicle-controlled RHEA study (n = 40) assessed twice- and three-times-daily lotilaner ophthalmic solution dosing over 12 weeks. No difference was seen between dosing frequencies, but extending the treatment duration made a clear impact.

“At the 12-week timepoint, we could get 66% of patients to less than two collarettes per eyelid, which was a significant impact,” Shultz told 

. “In the clinical trials, we saw about 85% of patients getting to less than 10 collarettes. With this treatment going for 12 weeks, we were able to get 100% of patients to fewer than 10 collarettes, which means they had improvement in functional treatment of Demodex and quality of life.”

Meibomian gland secretion also improved significantly with lotilaner ophthalmic solution 0.25%. At baseline, approximately 7 of 15 lower lid glands were functioning, which rose to 12.7 by week 12 in the active group. There was no notable improvement in the vehicle group.

“By the end of 12 weeks, we saw an improvement in the oil gland function, where we had 5.8 glands functioning with clear solution in the active arm of the study, whereas we had absolutely no impact utilizing the vehicle,” Shultz told 

Significant improvements in patient-reported outcomes, including itching and redness, were also identified in the lotilaner ophthalmic solution, 0.25% group. Visual fluctuation dropped from 50% at baseline to approximately 13% after treatment, with itching falling from 45% to 14%, burning decreasing from 35% to 10%, and redness reduced from 45% to 12%.

Shultz emphasized that the utilization of lotilaner ophthalmic solution 0.25% solution to treat active Demodex blepharitis is impactful, not only in reducing Demodex blepharitis itself, but in increasing meibomian gland function, or protecting meibomian glands from getting damaged over time.

“If we manage this early, this has a significant impact on patients' quality of life, both by improving their quality of vision through reducing visual fluctuation, reducing their daily symptoms like itching as well as redness and burning,” Shultz told HCPLive.

Shultz reports relevant disclosures with Alchemy Vision, Alcon, Bausch + Lomb, Ocuphire, Tarsus Pharmaceuticals, and others.

Shultz MC, Gupta PK, Vollmer P, et al. Lotilaner Ophthalmic Solution, 0.25% for the Treatment of Demodex blepharitis Patients with Meibomian Gland Dysfunction. Paper presented at the 2025 American Society of Cataract and Refractive Surgery (ASCRS) Annual Meeting. April 25-28, 2025. Los Angeles, CA.

Shultz discusses the impact of lotilaner ophthalmic solution 0.25% to treat active Demodex blepharitis in patients with meibomian gland dysfunction. 

Lotilaner Boosts Meibomian Gland Function, With Mitchell Shultz, MD

Mitchell Shultz, MD

HCPLive Five – Allergy Updates at AAAAI 2025

 2025 Academy of Allergy, Asthma, & Immunology (AAAAI) 

annual meeting in San Diego to connect with colleagues, explore late-breaking data, and attend hundreds of sessions.

 Allergy Team reported live from San Diego, conducting dozens of interviews and covering late-breaking research. In this iteration of the HCPLive Five, the team highlighted standout video interviews, covering topics such as insect allergy testing, chronic rhinosinusitis, omalizumab for food allergies, oral immunotherapy with autoclaved peanuts, and the WAYPOINT phase 3 trial assessing tezepelumab for nasal polyp management.

When to Test for Insect Sting Allergies, with David Golden, MD

David Golden, MD, from Johns Hopkins University, discussed the pitfalls of over-testing for insect sting allergies. He emphasized that a positive test does not confirm an allergy, as many people with positive results experience no reaction to stings.

Testing should be reserved for patients with anaphylactic reactions, as unnecessary testing can lead to undue worry and even disqualify individuals from opportunities like military service. Unlike peanut allergies, insect allergy tests do not predict reaction severity, making it crucial for clinicians to avoid misinterpreting strong test results as indicators of severe allergy risk.

When an Allergist Should Refer Endoscopic Sinus Surgery for Chronic Rhinosinusitis, with Kent Lam, MD

Kent Lam, MD, from Eastern Virginia Medical School at Old Dominion University, discussed when allergists should refer patients with chronic rhinosinusitis for endoscopic sinus surgery; surgery is recommended when symptoms persist despite treatment with topical steroids, saline irrigation, or antibiotics.

The procedure aims to improve sinus drainage and ventilation rather than remove tissue. Lam emphasized setting patient expectations regarding risks such as bleeding, scarring, and symptom persistence.

Omalizumab Performs Better Than Oral Immunotherapy for Food Allergy, with Robert Wood, MD

Robert Wood, MD, from Johns Hopkins Medicine, discussed the OUtMATCH trial comparing omalizumab and oral immunotherapy (OIT) for food allergies. The study found omalizumab superior in the intent-to-treat analysis (36% vs 19%;

 = .031), but per-protocol analysis—excluding dropouts—showed similar effectiveness (

OIT had a high dropout rate due to side effects, while omalizumab was well tolerated. Wood emphasized the need for individualized treatment, as OIT may offer long-term immune changes, but omalizumab provides a safer alternative with fewer side effects.

Patients Tolerate Oral Immunotherapy Better with Autoclaved vs Blanched Peanuts, with Casey Cohen, PhD

A study found that peanut-allergic patients tolerated oral immunotherapy better with autoclaved peanuts than with blanched peanuts. Casey Cohen, PhD, from McGill University, explained that autoclaving—using high temperature and pressure—reduces peanut-specific immunoglobulin binding, resulting in fewer severe reactions.

In a double-blind trial of 10 participants, the median tolerated dose was significantly higher for autoclaved peanuts (300 mg vs. 9 mg). No participants required epinephrine for autoclaved peanuts, whereas all were for blanched peanuts.

Tezepelumab Lowers Nasal Polyp Severity in CRSwNP During Phase 3 WAYPOINT, with Joseph Han, MD

The phase 3 WAYPOINT trial demonstrated that tezepelumab significantly reduced nasal polyp severity in patients with severe chronic rhinosinusitis with nasal polyps (CRSwNP), lowering the need for surgery by 92%. Tezepelumab significantly improved nasal congestion, sense of smell, and overall symptom scores at 52 weeks.

Investigator Joseph Han, MD, from Eastern Virginia Medical School, highlighted the near elimination of surgery in the treatment group. These findings support tezepelumab as a promising treatment option for CRSwNP, reducing reliance on systemic steroids and surgical intervention.

GlaxoSmithKline, Regeneron Pharmaceuticals, and AstraZeneca Pharmaceuticals for Lam, Genentech USA for Wood, none for Cohen, and GlaxoSmithKline, Genzyme Corporation, Regeneron Healthcare Solutions, Medtronic, Merck Sharp & Dohme, Optinose, AstraZeneca Pharmaceuticals, Aerin Medical, and PFIZER for Han.

Counting down the most impactful news at major medical meetings, it’s the HCPLive Five! This episode focuses on 5 key allergy updates from the 2025 American Academy of Allergy, Asthma, and Immunology (AAAAI) annual meeting.


Robert Wood, MD

Timothy Garvey, MD, is a professor of medicine at the Univeristy of Alabama at Birmingham. 

Welcome back to Diabetes Dialogue at ADA 2025!

Diabetes Dialogue: REDEFINE 1 and REDEFINE 2, with Timothy Garvey, MD, and Melanie Davies, MD

85th Scientific Sessions of the American Diabetes Association (ADA 2025)

, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and co-director of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, take a deep dive into the REDEFINE 1 and REDEFINE 2 trials with trial investigators W. Timothy Garvey, MD, of University of Alabama at Birmingham, and Melanie Davies, MD, of the University of Leicester.

REDEFINE 1 was a 68-week, phase 3a trial enrolling over 3400 adults without diabetes but with obesity or overweight and at least one comorbidity. Participants received once-weekly CagriSema, semaglutide alone, cagrilintide alone, or placebo alongside lifestyle intervention.

Key outcome: CagriSema led to a mean weight loss of 20.4%, vs 3.0% with placebo.

Over 50% of participants on CagriSema reached a non-obese BMI.

Gastrointestinal side effects were common (80%), but mostly mild to moderate.

REDEFINE 2 enrolled 1206 adults with type 2 diabetes and overweight or obesity, randomized to CagriSema or placebo for 68 weeks.

Key outcome: CagriSema led to 13.7% mean weight loss, vs 3.4% with placebo.

73.5% achieved an HbA1c ≤6.5% vs 15.9% on placebo.

Significant improvements were seen across all weight loss and glycemic endpoints.

The speakers also highlight the agent’s favorable side effect profile, flexibility in real-world dosing, and benefits in body composition and physical function. Garvey emphasizes the shift toward complication-centric obesity care, underscoring the need for clinician-guided treatment beyond online prescription models.

The conversation closes with a look ahead to REDEFINE 3—a cardiovascular outcomes trial including patients with and without diabetes—and other ongoing studies in the REDEFINE and REIMAGINE trial programs.

Relevant disclosures for Garvey include Boehringer-Ingelheim, Novo Nordisk, Eli Lilly and Company, Merck & Co., Inc., Alnylam Pharmaceuticals, Inc., Fractyl Health, Inc., Inogen, Epitomee, Pfizer Inc., and Neurovalens. Relevant disclosures for Davies include Abbie, Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly and Company, GSK, Novo Nordisk, Pfizer, Regeneron, Roche, Sanofi, and Zealand Pharma.

Garvey WT, Blüher M, Osorto Contreras CK, et al. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity. 

Davies MJ, Bajaj HS, Broholm C. Cagrilintide–Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes. 

Explore groundbreaking findings from the REDEFINE trials on CagriSema's impact on weight loss and diabetes management at ADA 2025.

Authors