JAMA Editors' Summary Updates in GLP-1 Therapy, Lung-Protective Ventilation During Open Abdominal Surgery, ARNI for Chagas Cardiomyopathy, and More
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Dec 5, 2025 The hosts dive into WHO guidelines advocating for GLP-1 use in obesity management. They explore the implications of GLP-1 exposure during early pregnancy and its weight gain association. A trial assessing lung-protective ventilation during abdominal surgery finds no reduction in complications. They also discuss the impact of ARNI therapy on Chagas cardiomyopathy outcomes. Additionally, trends show rising methamphetamine use and its health consequences, alongside discussions on healthcare costs and innovative clinical updates.
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Prescribe GLP-1s Within A Multimodal Plan
- Use GLP-1 therapies as a long-term treatment for adults with obesity when clinically appropriate.
- Provide intensive behavioral therapy alongside GLP-1s as part of a multimodal approach when possible.
GLP-1s Raise Questions In Pregnancy Care
- GLP-1 exposure before or during early pregnancy was associated with about 3.3 kg greater gestational weight gain in a retrospective cohort.
- Reproductive safety of GLP-1 receptor agonists remains unresolved and must guide obstetric decisions.
Don't Adopt Levosimendan For ECMO Weaning
- Do not rely on early levosimendan to shorten time to successful VA ECMO weaning based on current randomized trial data.
- Use well-designed, blinded trials with hard outcomes before adopting agents suggested by biologic plausibility.