Weight Loss May Be Key to Resolving OHS, Says Atul Malhotra, MD 

, the 39th annual meeting of the Associated Professional Sleep Societies in Seattle, Atul Malhotra, PhD, a sleep medicine specialist at UC San Diego Health, presented “Obesity Hypoventilation Syndrome - Updates in Diagnosis, PAP, and Weight Management” on June 10th in Seattle. HCPLive sat down with Malhotra at the meeting to discuss updates in weight management for 

In the first half of the interview, Malhotra shared OHS updates regarding diagnosis and positive airway pressure (PAP), which can be viewed

. He discussed how, despite OHS being a common issue, arterial blood gases are not checked as often as they used to be.

However, examining serum bicarbonate is helpful for identifying OHS, a disorder that often worsens the prognosis of obstructive sleep apnea (OSA). OHS and OSA tend to occur at the same time with a raised bicarbonate level.

Many patients with OHS do not find relief with PAP. Even though Malhotra offered suggestions to improve PAP adherence—patient education, intensive support, maintaining nasal pain—he said weight management is the most helpful.

“Data suggest you need to lose about 25 or 30% [of] your body weight to resolve obesity hypoventilation syndrome,” Malhotra said.

Malhotra conducted a big clinical trial recently that showed appetite therapy was helpful in improving OSA and cardiovascular symptoms, such as systolic blood pressure, reactive protein sleep apnea, and hypoxic burden. In that study, weight loss of 18 to 20% was substantial.

“So, if I started 200 pounds, 20% weight loss would be 40 pounds, or bring me 260 pounds, quite a game changer for those patients,” Malhotra said. “But given the need [of] 25% - 30% weight loss to resolve obesity hypoventilation syndrome... current data suggests that your tirzepatide may not be enough to get you to resolution of that subset of patients.”

Malhotra highlighted another drug in the pipeline—retatrutide (Triple G), a GLP-1 with a glucagon agonist. He said that retatrutide looks promising in preliminary studies, providing up to 25% of weight loss.

“That might be what we need to see [for] resolution of obesity hypervalent syndrome, but bottom line is, we need more data,” he said.

Relevant disclosures for Malhotra include Eli Lilly and Company, LivaNova, Itamar, ZOLL Respicardia, Impulse Dynamics, Jazz Pharmaceuticals, and Eisai Inc.

Nowalk N, Malhotra A, Mokhlesi B, et al. Obesity Hypoventilation Syndrome - Updates in Diagnosis, PAP, and Weight Management. Presented at SLEEP 2025, the 39th annual meeting of the Associated Professional Sleep Societies, on Tuesday, June 10 in Seattle.

At SLEEP 2025, Malhotra emphasized the need for weight loss to resolve obesity hypoventilation syndrome and highlighted limitations of current therapies.


 Atul Malhotra, MD

At the Southern California Psychiatry (So Cal Psych) Conference in Huntington, CA, from July 11 – 12, Alejandro Alva, MD, chief medical officer and CEO for Pacific Neuropsychiatric Specialists, presented 2 sessions: “Evaluating Patients with TD” and “Treatment-Resistant and Difficult-to-Treat Depression: Definitions and Illness Burden.” During an on-site interview, Alva shared how to identify tardive dyskinesia, the importance of “pushing the dose” to get maximum benefit, and exciting medications in the pipeline for 

 Can you tell us a little bit about your session on tardive dyskinesia?

 We're going to be talking about how to identify tardive dyskinesia. As you know, targeted kinetic movements have become an interesting topic in psychiatry. The reason why I say that is because prior to recent times, we did not have any type of treatment for that type of movement disorder…We kind of hung our hat on the risk-benefit analysis, saying, Well, you need this medication so that you don't have psychosis, and you want to have quality of life, but then this kinetic problem could also cause social isolation. It could cause disfiguration.

It was not until recently, with the advent of the BM2 inhibitors, that we became not only more adept at treating it but effective at treating it.

The first order of business is to realize that a) with the use of any dopaminergic blocking medication, we run the risk of [tardive] dyskinesia. Number two, we need to be able to identify these patients, because historically, we haven't been able to, or we haven't really looked for it, which is even worse, right?

What we do now is use different tools, for example, the aim scale and plain look at your patient. Okay, stick your tongue out at me. Open your mouth. Let me look at your toes…Do I see any truncal movements that shouldn't be there? Those types of things.

 How do you approach choosing between the 2 available medications for tardive dyskinesia?

It is a personal preference, really, and it also hinges on insurance constraints.

Sometimes, we have to kind of go with the formulary. When we look at efficacy rates, they're very similar, especially with the extended-release formulations… Sometimes you try a medication, and the patient doesn't do as well as we would expect, and that's when you switch…So do I have a particular preference? Not really. I will go with whatever I can get my hands on quicker so that the patient can actually benefit quicker.

The other thing that is important is to push the dose to what I consider to be the maximum efficacious dose. A lot of clinicians tend to underdose… The challenge that I would throw out there for any clinician is [to] push the dose, see what happens, because I can guarantee you that you will be surprised.

 Is it fair to say that giving a therapeutic dose a full trial is essential before switching?

Absolutely. I say, look, at least four weeks. At the very least, add a therapeutic dose. And if you get to that point and it's not working, then, yeah, it's fair game [to] switch. Don't just say…there’s nothing else I can do, because we do have options.

 You’re also covering treatment-resistant depression. How do you define and differentiate it from difficult-to-treat depression?

That's an interesting topic because there is a differentiation between treatment-resistant depression and difficult-to-treat depression.

We now know that they are treated similarly, but there are differences. What we want to put out to the general public and to our colleagues is the fact that there are multiple treatment modalities that can be used. We usually stick to medication management…We start with the simple things like an SSRI or an SNRI… and then we augment, but then what happens after we augment with multiple medications? The STAR*D trial actually showed us a very valuable lesson, and that is, we want to hit it hard from the very beginning.

So now we are looking at other modalities. Interventional psychiatry is coming into its own. We started with ECT, and it became kind of nasty because of 

. But, no, we don't do that. Then we have the advent of…transcranial magnetic stimulation, which is now one of the mainstays of interventional psychiatry.

We are also going to be talking about vagal nerve stimulation, which is now becoming a mainstay treatment, albeit…expensive, but incredibly effective, and we use things like ketamine, s-ketamine, and things of that nature. So again, we're not confined to only one modality.

I always tell my patients, all right, you have 2 types of situations here. You have a biological nature or genesis of your depression. You have a psychosocial genesis of your depression. And guess what? We need to address what's happening in your life because all the medication or all the interventions in the world are not going to help you unless you figure out that you need to grieve.

 Are there any new or emerging medications you’re particularly excited about?

There’s so many different things that are happening. We went from the monoamine theory, which was the mainstay of treatment for many years. Now we are looking at GABA receptors. We're looking at GABA modulators…glutamate modulators…muscarinic receptor agonists or antagonist as well.

There are a number of different medications [in] the pipeline. It’s an exciting time because now we have 2 options. We can go with the monoamines, or we can go with either muscarinic or…different modulators. We are making inroads into different modalities.

 With so many innovations in psychiatry today, how can clinicians stay current and involved in advancing care?

A very easy way to stay up to date is conferences like this. It's fun because you meet new colleagues…If you do it in person, I would highly recommend it, because you run into incredible, amazing people that are very willing to compart their knowledge. The most important thing is that you have a free, open exchange of ideas.

The second thing is, stay current. There's so many publications, both written and online, so just look at what you have available. Keep up on the current theories and the current medications, and, more importantly, talk to your peers.

Alejandro Alva, MD, presented sessions on tardive dyskinesia (TD) and treatment-resistant depression at the So Cal Psych Conference. He emphasized the importance of identifying TD, using tools like the AIM scale, and maximizing medication doses. Alva discussed the differentiation between treatment-resistant and difficult-to-treat depression, highlighting the role of interventional psychiatry and emerging treatments like transcranial magnetic stimulation and vagal nerve stimulation. He expressed excitement about new medications targeting GABA and glutamate receptors. Alva encouraged clinicians to stay informed through conferences and peer discussions.

In this Q&A, Alva discusses how to identify tardive dyskinesia, approaches for treatment-resistant depression, and emerging therapies.

Strategies for Managing Tardive Dyskinesia, With Alejandro Alva, MD

Alejandro Alva, MD

Before we sign off, I’d love to hear from everyone any advice or practice pearls for other APPs [advanced practice providers] that are either new or established in the management of plaque psoriasis. Darren, let’s start with you.

Try your best to get your office to get you a good biologic coordinator, because no matter how much we know and can prescribe these medications, having a team effort in the access of these medications is very important. I know recently they had a biologic coordinator day. We’re getting more and more recognition in this, but you have to have somebody you can work with. Advanced practice providers seem to be the default providers who see psoriasis anyway, so we really want to make it streamlined as much as possible. Our patients deserve the best. We take the most time with them, it seems. I’m always spending as much time as I can with them until I’m forced out of the room. I love these medications. These are incredible.

Our toolbox is definitely full, and to Doug’s point, the quiver is full. There are so many different weapons we can use now. It is incredible. We just have to feel safe and comfortable with a lot of these. We’ve had a lot of years of using biologics and small molecules now. And there are different medications and newer creams are coming out, and you just have to use them. That’s going to be the biggest thing we can do—have a whole team that works with this. I know the companies are helping us a little with some of this access to medications, but we want to make sure everyone has access to it. And being a team player with someone in your office, like a biologic coordinator, is my biggest help. Otherwise, it’s daunting. It’s just too much work.

What’s kind of amazing is pharmaceutical companies are now sponsoring biologic coordinators to be speakers for their company to help other biologic coordinators get medication approved. I love that so much. Because there’s only so much that we know and so much we can help our biologic coordinators with and vice versa. It’s just like us talking with our peers and colleagues. It’s the same thing, and I love that that community is blowing up.

Absolutely, and they deal with all the patients. They’re the ones talking. They’re making the phones calls. They’re behind the scenes. We know the medications, we prescribe them, and it’s great, but they really do a lot of the background work and all the hard work in some cases.

There’s a biologic coordinator council and society now. They have a journal and a publication. Last month, I received the first publication of biologic coordinator council, so it’s really neat to see all that happen.

For APPs who potentially want to expand their knowledge of psoriasis and the toolbox and things we use—I know sometimes I hear that it’s a little daunting just because we have so many tools now. When you look at clinical data, I would encourage to look at not only your primary end points but also a little further out. Look out to week 52 or week 60. It kind of gives an understanding or a general feel of the trajectory of medication. Then also looking at data out a couple years down the road that maybe some companies will have. Some companies publish that as that comes out for you to understand what you may see in your clinical practice, and each medication is going to work a little differently. So its not just primary end point but some of these longer end points, too.

There are certain nuances, like with deucravacitinib. Just because they monitor for certain things doesn’t necessarily mean there’s a high incidence of safety events. Clinical monitoring is not always 100% correlated with clinical incidence. That’s something that is the other nuance, too, with medications. With some medications, clinical incidence is more frequent, which is why we justify monitoring for certain safety signals. It’s kind of just teasing out those nuances. It does get overwhelming sometimes. And like what Darren was saying with bio coordinators and them understanding the insurance part and helping us through that guidance, that is a super useful tool for us as clinicians, for the paperwork and getting medications to our patients.

The labor of love for us as clinicians is understanding the products we’re using. At least now the products and medications we’re using have delivery of really high outcomes in a tolerable vehicle for our patients. It’s kind of just grouping your medications and trying to decipher which way you go and almost having a playbook for your psoriasis treatment on how you stratify your topicals, how you stratify your systemics, and then templating it. A lot of times, having a system may help you through this process, too. It’s kind of our own flavor of what system works best for us as individual clinicians.

Awesome. Jayme, what pearls do you have, whether they’re educational or clinical? Is there anything you would give advice on for other practitioners?

I think we have a responsibility. We need to be that beacon of hope for these patients. They have such a physical and emotional burden for their disease. It’s very hard. We also have a responsibility to support one another. I feel very lucky to say I know the panelists here today, and I have a great deal of respect for them. It’s really nice to be able to reach out to somebody. Even if somebody I don’t even know were to reach out, I would be more than willing to help them just like I help the other colleagues in my office.

We always need to make sure our patients get what they need. Sometimes it’s just making sure we know all our resources. Like Darren said, it is just an invaluable resource to have a biologic coordinator. It’s very difficult. We need to know all these programs. We need to know how we can get access for our patients. To do that, we need to continue reaching out to one another. We need to continue to support one another, we need to educate one another, and we need to educate our patients. We need to always let patients know that when they leave, they are supported, we do care, and we are going to help them. That’s our commitment to dermatology, and that’s why we have been entrusted as PAs [physician assistant] and NPs [nurse practitioner] to go ahead and take on this dynamic role to help patients with psoriasis.

Douglas, do you have any advice or any practice pearls for other APPs, whether new or established, in managing plaque psoriasis?

I can only echo what my great colleagues have already said. There’s obviously a theme here: get to know the medications, take the time to understand these medications, and practice presenting them to patients. Maybe you practice by pulling your nursing assistants together and say, “Let’s talk about these medications.” Maybe you meet with colleagues that are in your office. Maybe you reach out to someone you met at a conference, or reach out to any of us. I know we’re all willing to talk to people. There’s a great supportive network in the NP and PA community, as well as with our physician supervisors.

We want to do what’s best for our patients, so the takeaway pearl is to realize the power you have at your disposal. This is not power that’s meant to lift you up. It’s power to be transferred to your patients to change their lives. What an awesome opportunity it is to do that. My pearl is to take a little bit of time. If you got into medicine and you don’t consider yourself a lifetime learner, then you may be in the wrong place. Because if you’re not a person who’s willing to get up sometimes on a Saturday morning or stay up a little bit later—I’m just a believer that what you do from 9 am to 5 pm is not as important as what you do between 5 pm and 9 am. It takes a little bit of some buy-in to be someone [who’s] going to be on the cutting edge, that’s going to be evidence based, and that’s going to be empathetic. That empathy is shown by giving patients the best options we have. Your patients deserve it, they love it, and we’re all capable of doing that. It makes it fun. That’s my encouragement to you—be a prescriber of hope. Tell patients we’ve got great things- there are great things available to them. Speak that positivity into their life when you first see them, because that begins to change things right off the bat that I’ve seen at least in my practice.

Darren, I think I cut you off before. Was there anything else you wanted to add?

We have an obligation to treat our patients, and I think we do a disservice to our patients when they walk through the door, take the time to come in and see us, and we just give them a cream and turn them loose. We need to understand these medications. We need to understand how well they work. We need to give our patients hope. I think that’s why they come and see us. I think the advantage of us being in this industry today is that we have so many tools to work with. We have the advantage on our side, and we can change lives forever. It’s incredible. I’m glad we’re a part of it these days. The companies that have put a lot of effort and work into getting these drugs to market, and the research and development we see today, is incredible. We need to all work together. We don’t have all these amazing drugs just to sit on the shelf. We need to be bold enough to try them out. We need to be not fearful in prescribing these and just jump off that ledge and do it and see how it works.

I’m not saying this, but I’ve heard others say this—others that are much more influential and are in this space. They feel like we’re getting to a point, very close in time, that not offering a patient who has severe disease a systemic agent—I’ll keep it in the category of severe—may be considered malpractice in the near future. Because we know, with severe disease, the chance of them creating a destructive joint, having a heart disease, and all the other problems we’ve mentioned—not addressing that is something that is such a disservice. I’ve heard others who are far more influential than me make those bold statements from the podium. I’m not sure I’m willing to make that bold of a statement from a podium yet, but I sit there and shake my head and agree. We’ve got these tools and we’ve got to put them to work.

Think about deciding to not treat an uncontrolled diabetic. We have to get into that mindset of the systemic condition, and I think that is changing. Psoriasis is no longer a skin condition. We just talked about all the comorbidities, all these things that come along with it, and we have to continue to relay that message to each other and our patients. I think we can always continue to learn, like Douglas said.

Thanks to all of you for this rich and informative discussion. Thank you for watching this 

 discussion. If you enjoyed the content, please subscribe to our e-newsletters to receive upcoming peer exchanges and other great content right in your inbox.

Experts in dermatology share practice pearls to advanced practice providers and community dermatologists for the management of plaque psoriasis.

Clinical Pearls and Educational Needs in Plaque Psoriasis

Alexa Hetzel, MS, PA-C

Connor Iapoce is the assistant managing editor for 

joining the MJH Life Sciences team in April 2021. He graduated from The College of New Jersey with a degree in Journalism and Professional Writing. He enjoys listening to records, going to the movies, and playing with his cat, Squish. You can reach him at 

Welcome to The HCPFive, your go-to roundup for the latest healthcare news and breakthroughs, curated specifically for busy healthcare professionals.

Each week, we highlight 5 key developments or headlines from healthcare that you need to know—whether it's a cutting-edge treatment, regulatory updates, or innovations shaping the future of medicine. This week's top stories include the 

 approval of a new dry eye disease (DED) drug, a first-of-its-kind oral hydrocortisone solution for adrenal insufficiency, the failure of a Phase 3 trial for AL amyloidosis, a Priority Review granted for IgA nephropathy (IgAN), and new surgical guidelines for treating chronic rhinosinusitis.

With The HCPFive, you'll get the essential takeaways to stay informed and ahead of the curve. Here’s your quick dive into the top stories for the week of May 18, 2025—let’s jump in!

FDA Approves Acoltremon Ophthalmic Solution (TRYPTYR) for Dry Eye Disease

The FDA approved acoltremon ophthalmic solution .003% (TRYPTYR), formerly AR-15512, a first-in-class transient receptor potential melastatin 8 channel (TRPM8) receptor agonist that stimulates corneal sensory nerves, to treat signs and symptoms of DED. Approval was awarded to Alcon based on positive data from two Phase 3 clinical trials, COMET-2 and COMET-3, analyzing more than 930 patients with DED.

FDA Approves Hydrocortisone Oral Solution for Adrenal Insufficiency

The FDA approved hydrocortisone (KHINDIVI) oral solution as a replacement therapy in pediatric patients aged 5 years and older with adrenocortical insufficiency. Awarded to Eton Pharmaceuticals, this approval marked the first FDA-approved oral solution formulation of hydrocortisone, designed to address administration and dosing accuracy in patients who may have special requirements.

Birtamimab Misses Primary Phase 3 Endpoint for AL Amyloidosis

Birtamimab missed the primary endpoint in the Phase 3 AFFIRM-AL clinical trial for the treatment of AL amyloidosis, resulting in the discontinuation of development and the halt of the open-label extension. As a result, Prothena Corporation announced plans to cut operating costs and significantly shrink its workforce, with further details on the matter expected in June.

FDA Accepts, Grants Priority Review to Sibeprenlimab BLA for IgA Nephropathy

The FDA accepted and granted Priority Review to the Biologics License Application (BLA) for sibeprenlimab for the treatment of IgAN. Supported by positive data from the Phase 3 VISIONARY trial, the BLA was assigned a Prescription Drug User Fee Act (PDUFA) target action date of November 28, 2025.

New Guidelines Outline When to Consider Sinus Surgery for Chronic Rhinosinusitis

The American Academy of Otolaryngology-Head and Neck Surgery Foundation released new clinical practice guidelines for the surgical management of 

 The guidelines, targeted for otolaryngologist-head and neck surgeons who manage adults with chronic rhinosinusitis, provided 11 evidence-based key action statements to inform the main surgery options for chronic sinus problems and additional treatments or follow-up procedures.

The latest healthcare updates include the FDA's approval of acoltremon ophthalmic solution for dry eye disease and a new oral hydrocortisone solution for adrenal insufficiency. Birtamimab failed to meet the primary endpoint in a Phase 3 trial for AL amyloidosis, leading to halted development. The FDA granted Priority Review to sibeprenlimab for IgA nephropathy, with a target action date set. New guidelines for chronic rhinosinusitis surgery were released, providing evidence-based recommendations for otolaryngologists managing adult patients with this condition.

Stay updated with the latest healthcare breakthroughs, including FDA approvals and new treatment guidelines, in this week's essential news roundup.

The HCPFive: Top News for Healthcare Providers from the Week of 05/25

Connor Iapoce

Dominic Sisti, PhD, is an associate professor in the Department of Medical Ethics & Health Policy and the director of the Scattergood Program for the Applied Ethics of Behavioral Health Care. Sisti is also the host of 

, our monthly multimedia series on medical ethics in modern healthcare. 

This episode of Medical Ethics Unpacked focuses on the changing climate surrounding vaccine hesitancy and public policy.

Medical Ethics Unpacked: Shifting Vaccine Regulation and Policy, with Jason Schwartz, PhD

, hosts Dominic Sisti and Steve Levine welcome Jason Schwartz, PhD, associate professor at the Yale School of Public Health, for a discussion on vaccine ethics, public health infrastructure, and the challenges of maintaining trust in immunization programs.

Together, they explore how the COVID-19 pandemic reshaped public attitudes toward vaccines, while also underscoring long-standing tensions between individual autonomy and collective responsibility. Schwartz, whose work focuses on vaccine policy and history, offers perspective on the systems and institutions, such as the CDC's Advisory Committee on Immunization Practices (ACIP), helping to translate scientific evidence into public health recommendations.

This episode comes at a time when ACIP is once again in the headlines as HHS Secretary Robert F. Kennedy Jr. recently 

replaced all 17 members with a new slate of individuals

, citing concerns about groupthink and conflicts of interest. The move has generated widespread commentary about the role and value of such expert advisory bodies in shaping public health decisions, especially in the face of growing skepticism and political scrutiny.

Ethical questions about equity, communication, and responsibility are threaded throughout the discussion. The hosts and Schwartz reflect on what it means to make fair vaccine recommendations in the context of incomplete data, and how institutions can maintain public trust amid scientific uncertainty. They also discuss how the infrastructure behind public health decisions—committees, advisory boards, and interagency coordination—can either strengthen or undermine confidence depending on how they function and how well they are understood.



This podcast explores complex and sensitive topics. The views and opinions expressed by the hosts and guests are their own and do not necessarily reflect those of HCPLive or MJH Life Sciences. This content is intended to encourage thoughtful discussion and does not constitute medical advice or endorsement of any particular position. Listeners are encouraged to approach these subjects with care and consult appropriate resources for further information.


Stone W. RFK Jr. names new slate of vaccine advisers after purging CDC panel. NPR. Published June 11, 2025. Accessed June 17, 2025. 

https://www.npr.org/sections/shots-health-news/2025/06/11/nx-s1-5430870/cdc-vaccine-experts-rfk-jr

Asturias EJ, Brewer NT, Brooks O, et al. Advisory Committee on Immunization Practices at a Crossroads. 

Explore the ethical dilemmas of vaccine policy and public trust in health systems as experts discuss the impact of COVID-19 on immunization attitudes.

Dominic Sisti, PhD

Artificial Intelligence in Cataract Surgery and Optometry at Large with Harvey Richman, OD, and Rebecca Wartman, OD

2025 American Optometric Association Conference

 in Minneapolis, MN, Harvey Richman, OD, Shore Family Eyecare, and Rebecca Wartman, OD, optometrist chair of AOA Coding and Reimbursement Committee, presented their lecture on the implementation of artificial intelligence (AI) devices in cataract surgery and 

AI has been implemented in a variety of ophthalmology fields already, from analyzing and interpreting ocular imaging to determining the presence of diseases or disorders of the retina or macula. Recent studies have tested AI algorithms in analyzing fundus fluorescein angiography, finding the programs extremely effective at enhancing clinical efficiency.

However, there are concerns as to the efficacy and reliability of AI programs, given their propensity for hallucination and misinterpretation. To that end, Drs. Richman and Wartman presented a study highlighting the present and future possibilities of AI in cataract surgery, extrapolating its usability to optometry as a whole.

Richman spoke to the importance of research in navigating the learning curve of AI technology. With the rapid advancements and breakneck pace of implementation, Richman points out the relative ease with which an individual can fall behind on the latest developments and technologies available to them.

“The problem is that the technology is advancing much quicker than the people are able to adapt to it,” Richman told 

. “There’s been research done on AI for years and years; unfortunately, the implementation just hasn’t been as effective.”

Wartman warned against the potential for AI to take too much control in a clinical setting. She cautioned that clinicians should be wary of letting algorithms make all of the treatment decisions, as well as having a method of undoing those decisions.

“I think they need to be very well aware of what algorithms the AI is using to get to its interpretations and be a little cautious when the AI does all of the decision making,” Wartman said. “Make sure you know how to override that decision making.”

Richman went on to discuss the 3 major levels of AI: assistive technology, augmented technology, and autonomous intelligence.

“Some of those are just bringing out data, some of them bring data and make recommendations for treatment protocol, and the third one can actually make the diagnosis and treatment protocol and implement it without a physician even involved,” Richman said. “In fact, the first artificial intelligence code that was approved by CPT had to do with diabetic retina screening, and it is autonomous. There is no physician work involved in that.”

 that a significant amount of surgical technology is already using artificial intelligence, mainly in the form of pattern recognition software and predictive devices.

“A lot of our equipment is already using some form of artificial intelligence, or at least algorithms to give you patterns and tell you whether it’s inside or outside the norm,” Wartman said.

Richman H, Wartman R. A.I. in Cataract Surgery. Presented at the 2025 American Optometric Association in Minneapolis, MN, June 25-28, 2025.

Shao A, Liu X, Shen W, et al. Generative artificial intelligence for fundus fluorescein angiography interpretation and human expert evaluation. NPJ Digit Med. 2025;8(1):396. Published 2025 Jul 2. doi:10.1038/s41746-025-01759-z

Drs. Richman and Wartman discuss the benefits of using predictive and diagnostic AI, while cautioning about the implicit risks of overreliance on early, imperfect technology.

Harvey Richman, OD

What types of resources are available to our vitiligo patients?

 Until recently, we didn’t have great resources. If you just Google Vitiligo Foundation, you will find resources like the Global Vitiligo Foundation, the vitiligo support group, the National Vitiligo Foundation. Ruxolitinib has really come out with some good educational material on their website. The American Academy and Dermatology for Patients has great information on vitiligo as well as many other dermatologic conditions.

Social media can sometimes be helpful. You can find other people with vitiligo to connect with. You have to be careful because there is a lot of misinformation out there, but if you are feeling alone, it is a way to find other people who are living with vitiligo, too.

This was such a wonderful evening. I’m so happy I got to meet you, Tarasha, and spend the evening talking about your journey with vitiligo. Thank you for your bravery and for being so open and honest about how vitiligo affected your life and your journey. We are very grateful for you participating in this evening. And thank you, Dr Lain, for all of your insightful, brilliant advice and information about vitiligo. There is so much to learn. I am really excited about the research that is coming up soon.

. If you enjoyed the program, please subscribe to our e-newsletters to receive upcoming programs and other great content right in your inbox.

Ted Lain, MD, reviews available support groups, vitiligo education, and other resources for patients with the disease.

Resources for Patients With Vitiligo

Heather Woolery-Lloyd, MD

Natalie Golub is a current University of Denver graduate student in the first year of the Sport and Performance Psychology masters program. During her first year in Denver, Golub has been involved in traumatic brain injury and concussion research, in the partners in pedagogy teaching program, in sports psychology consulting with youth athletes, and with COVID-19 graduate health and wellness ambassadors. She aspires to be a sport psychologist..

Natalie Golub, MA

Approaches to and Advancements in Rare Inherited Genetic Diseases with Roya Attar, OD

 in Minneapolis, MN, Roya Attar, OD, associate professor and director of optometric services at the University of Mississippi Medical Center, presented her lecture on 

Inherited retinal disease is the leading cause of blindness in several countries. Patients generally develop some form of visual impairment at a young age, which eventually expands to have a significant impact on quality of life.

Attar spoke to the value of genetic testing in the field of rare diseases, pointing out its ability to not only accurately diagnose rare genetic diseases, but also to discount potential misdiagnoses.

“Genetic testing is not only a way to confirm a diagnosis, but it’s also a great way to rule out a diagnosis,” Attar told 

. “There’s other things that can certainly masquerade as the possible inherited retinal disease. A patient could have presentations that may be the result of some type of past inflammatory incident in their eye, or as a result of a medication use.”

Attar also discussed her expectations and anticipations for future advancements in gene therapy, from upcoming treatments to the integration of artificial intelligence (AI) programs. She called for companies to make their data accessible to clinicians and patients alike. Additionally, Attar suggested that pharmaceutical companies broaden their treatment scopes to include less potentially profitable treatments to account for patients suffering from rare diseases.

“I implore all pharmaceutical companies to make their data available, and there is an initiative for that already,” Attar told 

. “Obviously, it’s easy for a pharmaceutical company to pick a disease, one that they’ll have a lot of customers for. However, the rare ones sort of get forgotten, but they are individuals that should also have that benefit.”

Attar endorsed the idea of recommending patients sign up for clinical trials, citing the variety of methods by which companies have attempted to make the process easier. Not only do clinical trials allow patients access to medications that may be better suited to their individual needs, but they also receive topline therapy and monitoring.

“One universal thing I have learned is that a lot of providers are not making patients aware that there are clinical trials and studies that they can participate in,” Attar said. “When patients get involved in clinical trials, they essentially receive the best care there is. They are checked, they are given certainly the most comprehensive examination of their eyes, as well as multiple forms of imaging, but also monitored for any type of systemic side effects.”

Ultimately, Attar suggested that both patients and clinicians alike make themselves more aware of clinical trials, both to provide patients with the best possible treatment and to facilitate the research, development, and eventual implementation of improved drugs and medications.

“Whether it’s for an inherited retinal disease, or even if it’s something like diabetic retinopathy, there’s a clinical trial for almost everything,” Attar said. “So please be aware of clinical trials, and make sure that you tell your patients about it. We would be doing our patients a disservice if we did not make them aware of this forum.”

Attar reports the following disclosures: Apellis Pharmaceuticals, Heidelberg Engineering, Glaukos, Tarsus, and Dompe.

1: Attar R, Rafieetary M. Inherited Retinal Diseases: Genetic Testing and Emerging Gene Therapies. Presented at the 2025 American Optometric Association in Minneapolis, MN, June 25-28, 2025.

2: Lin S, Vermeirsch S, Pontikos N, et al. Spectrum of Genetic Variants in the Most Common Genes Causing Inherited Retinal Disease in a Large Molecularly Characterized United Kingdom Cohort. Ophthalmol Retina. 2024;8(7):699-709. doi:10.1016/j.oret.2024.01.012

Attar discusses the medication pipeline, possible AI implementation, and the importance of making patients aware of clinical trials for rare genetic diseases.

Roya Attar, OD

Counting down the most impactful news at major medical meetings, it’s the HCPLive Five! This episode focuses on 5 key internal medicine updates from the 2025 American College of Physicians (ACP) IM meeting.

HCPLive Five - Internal Medicine Updates at ACP 2025

Thousands of internal medicine specialists gathered in New Orleans for the 

2025 American College of Physicians (ACP) Internal Medicine Meeting

 to share clinical insights, examine emerging data, and attend hundreds of sessions.

 on-site coverage, the Internal Medicine Team conducted expert interviews and reported on timely topics across hospital medicine, artificial intelligence, health policy, and more. In this edition of the HCPLive Five, the team highlights key conversations on opioid-sparing regimens in hospitalized patients, the clinical risks and benefits of AI tools, bias mitigation in AI modeling, AI's diagnostic performance in urgent care, and the ACP’s call to action on national health policy issues.

Validating Opioid-Sparing Pain Management Regimens, with Angel Goenawan, MD

Angel Goenawan, MD, a hospitalist at Bayhealth in Delaware, discussed a meta-analysis of eight randomized clinical trials comparing opioid-sparing regimens to traditional opioid-based pain management in hospitalized patients. 

The analysis showed that patients on non-opioid regimens had better pain control and used significantly lower total doses of opioids across both surgical and nonsurgical groups.

Balancing Benefits and Risks of AI Mitigation of Clinician Burden, with Ellen Gelles, MD

Ellen Gelles, MD, from the American College of Physicians, discussed how AI tools can reduce clinician workload by handling tasks like ambient documentation and message triage. 

She noted pilot studies showing improved efficiency but emphasized the need for data transparency and monitoring to avoid unintended consequences like bias or safety lapses.

Reducing Racial Bias in AI Models, with Nawsabah Noor, MBBS

Nawsabah Noor, MBBS, presented on an AI-driven tool that modifies image saturation to improve dermatologic diagnosis accuracy in patients with darker skin tones. 

Early results suggest that this intervention enhances visual clarity of skin conditions and could reduce diagnostic disparities across racial groups.

AI Bests Clinicians in Urgent Care Treatment Recommendations, with Zehavi Kugler, MD, and Ran Shaul

Zehavi Kugler, MD, and Ran Shaul discussed a study showing that AI-generated recommendations for virtual urgent care visits were rated as optimal 72% of the time, compared to 61% for clinician recommendations. 

The AI system also produced fewer suboptimal recommendations, suggesting a role for decision support tools in improving care quality.

ACP Urges Concern for Health Policy Issues, with Shari Erickson, MPH

Shari Erickson, MPH, from the American College of Physicians, highlighted key health policy threats including prior authorization burdens, data privacy concerns, and clinician burnout. 

She referenced ACP survey data indicating high levels of frustration among internists and warned of potential legal action to protect access to evidence-based care.

Kugler and Shaul's disclosures include K Health. Goenawan, Gelles, Noor, and Erickson had no relevant disclosures to report.

Counting down the most impactful news at major medical meetings, it’s the HCPLive Five! This episode focuses on 5 key internal medicine updates from the 2025 American College of Physicians (ACP) IM meeting.



Authors