NEJM This Week NEJM This Week — May 8, 2025
May 7, 2025
This discussion highlights innovative strategies for managing high-risk smoldering multiple myeloma and new insights on tuberculosis prevention. It covers the promising results of automated insulin delivery for type 2 diabetes and a potential treatment for uncontrolled hypertension. Groundbreaking CAR T-cell therapies for lymphoma are also explored, alongside a case study illustrating the impact of nutrition on chronic disease. Finally, the conversation addresses the challenges faced by healthcare providers in today's political landscape and the emotional complexities in patient care.
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Daratumumab Benefits Early Myeloma
- Subcutaneous daratumumab monotherapy reduces progression risk to active multiple myeloma and improves overall survival in high-risk smoldering myeloma.
- This benefit is notable since daratumumab alone shows limited efficacy in active multiple myeloma.
BCG Revaccination Ineffective for TB
- BCG revaccination does not prevent sustained M. tuberculosis infection in HIV-negative adolescents.
- Effective tuberculosis vaccines require identifying better antigens than those present in BCG.
Automated Insulin Delivery Efficacy
- Automated insulin delivery (AID) systems significantly improve glycemic control in insulin-treated type 2 diabetes.
- Widespread use will require addressing cost, clinic burdens, and patient education challenges.