Table of Contents

Canagliflozin is a sodium–glucose cotransporter-2 inhibitor approved for the treatment of type 2 diabetes mellitus (T2DM) in adults and shown to be highly effective. However, data in children are limited. This phase 3 randomized trial assessed the safety and efficacy of canagliflozin in children and adolescents with T2DM.

Clinical trial evidence suggests that weight loss combined with exercise improves knee pain due to osteoarthritis, but whether weight loss improves hip pain is uncertain. This randomized clinical trial examines the effectiveness of a very-low-calorie weight loss diet combined with exercise compared with exercise alone on hip pain among patients with osteoarthritis of the hip.

Medial opening wedge high tibial osteotomy is a limb realignment surgery that aims to preserve joint structure and improve clinical outcomes among patients with knee osteoarthritis, but evidence is limited on its effectiveness. This randomized clinical trial examines the procedure’s effectiveness in preserving knee cartilage and improving pain and function in patients with knee osteoarthritis.

Eosinophilic granulomatosis with polyangiitis (EGPA), formerly known as Churg–Strauss syndrome, is an eosinophilic antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis. Prognosis has improved with the use of glucocorticoids and immunosuppressants, such as cyclophosphamide, but these therapies carry significant toxicities. Although rituximab has been shown to be noninferior to cyclophosphamide in other forms of ANCA-associated vasculitis, it has not been specifically studied in EGPA. To address this gap, this phase 3, multicenter, randomized, double-blind, controlled superiority trial compared glucocorticoids plus rituximab with the conventional induction strategy.

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have been shown to decrease blood glucose levels, promote weight loss, and prevent cardiovascular events, but evidence is limited regarding their effect on dementia. This target trial emulation compared the effect of GLP-1RAs versus dipeptidyl peptidase-4 inhibitors as second-line therapy for type 2 diabetes on risk for dementia among older adults.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), which are used to treat type 2 diabetes and obesity, are associated with delayed gastric emptying, which is a risk factor for gastroesophageal reflux disease (GERD). However, evidence linking these drugs to GERD is limited. This cohort study estimated the effect of GLP-1 RAs versus sodium–glucose cotransporter-2 inhibitors on risk for GERD and its complications among patients with type 2 diabetes.

Patients with diabetes have alterations in glucose metabolism due to insulin dysregulation. This analysis of the National Health Interview Study examines the association of different patterns of physical activity with all-cause, cardiovascular, and cancer mortality in persons with diabetes.

Social determinants of health contribute to disparities in SARS-CoV-2 infection, but their associations with long COVID are unknown. This prospective observational cohort study, which enrolled adults from 33 states plus Washington, DC, and Puerto Rico, sought to determine associations between social determinants of health at the time of SARS-CoV-2 infection and risk for long COVID.

Observational evidence suggests that obesity is associated with worse in vitro fertilization outcomes. Some guidelines recommend that women with obesity lose weight before in vitro fertilization. This systematic review examines trials on the effect of weight loss interventions on reproductive outcomes in women with obesity.

Engineering infection controls include a wide range of interventions that are used indoors to reduce occupants’ exposure to respiratory pathogens. This scoping review sought to identify and describe primary studies evaluating the effects of engineering infection control interventions designed to reduce the spread of respiratory infections transmitted via indoor air.

Clinicians increasingly rely on prediction models to guide treatment choices. Most prediction models, however, are developed using observational data that include some patients who have already received the treatment the prediction model is meant to inform. The authors discuss why special attention to the causal role of those earlier treatments is required when interpreting the resulting predictions. They identify problems with 3 common approaches to addressing this issue and propose alternative approaches.

In the context of potential U.S. government actions that would reduce Medicaid funding, the authors identified 6 of the potential cuts that are each estimated to reduce the federal government’s Medicaid outlays by at least $100 billion over 10 years. They then estimated the effects of these actions on the ranks of the uninsured, the annual number of persons forgoing needed medical care, and the resulting annual medically preventable deaths.

Pneumococcal disease continues to cause a significant burden among U.S. adults.  On 23 October 2024, for the first time, the Advisory Committee on Immunization Practices recommended pneumococcal conjugate vaccination (PCV) for all PCV-naive adults aged 50 years and older. The authors discuss the rationale for and implications of this change from previous recommendations that included all adults aged 65 years and older and adults aged 19 to 64 years with a specific risk condition or conditions for pneumococcal disease.

In their article, Nadgir and colleagues reported the results of a trial of canagliflozin versus placebo as adjunct therapy in youth with type 2 diabetes. The editorialists discuss the findings and outline issues that warrant further study.

In their article, Hall and colleagues reported the results of a randomized controlled trial of a very-low-calorie weight loss diet plus exercise compared with exercise alone on osteoarthritis-related hip pain in persons with overweight or obesity. The editorialists discuss the findings and outline gaps in our understanding of the net benefit of weight loss in persons with osteoarthritis.

Inoue and colleagues explored glucagon-like peptide-1 receptor agonists (GLP-1RAs) and dipeptidyl peptidase-4 inhibitors as potential therapeutic agents for reducing dementia incidence in elderly adults with type 2 diabetes. The editorialists discuss drugs under study for prevention or treatment of Alzheimer dementia and the need to further explore the potential effects of GLP-1RAs, especially the newer and more powerful agents, in preventing Alzheimer dementia and other types of dementia.

Wu and colleagues' study examined the benefits of exercise patterns that differ from the recommended physical activity for patients with diabetes. The editorialists discuss the findings, which while not definitive, provide encouraging evidence that benefits of physical activity could be achieved through 1 or 2 weekly physical activity sessions

Michalopoulou and colleagues conducted a systematic review and meta-analysis to summarize the available evidence on the effect of weight loss before in vitro fertilization on reproductive outcomes in women with obesity. The editorialist discusses the findings, their contribution to our understanding of what affects reproductive outcomes, and additional outcomes that future studies might aim to evaluate.

As an introvert, I have my own unique capabilities.

The Annals Consult Guys provide advice on the preoperative care of patients with type 2 diabetes and hypertension before nonurgent orthopedic surgery.

Annals Graphic Medicine brings together original graphic narratives, comics, animation/video, and other creative forms by those who provide or receive health care. They address medically relevant topics—whether they be poignant, thought-provoking, or just plain entertaining.

In this episode of Annals On Call, Dr. Centor discusses the role of ablation in the management of patients with atrial fibrillation with Dr. Peter Zimetbaum.

In this episode of Annals On Call, Dr. Centor revisits information included in the Annals of Internal Medicine supplement “What You May Have Missed in 2024.”

This Annals Video Summary discusses the following article: “The Effect of Weight Loss Before In Vitro Fertilization on Reproductive Outcomes in Women With Obesity: A Systematic Review and Meta-analysis.”

This Annals Video Summary discusses the following article: “Engineering Infection Controls to Reduce Indoor Transmission of Respiratory Infections: A Scoping Review.”