Pub Date : 2025-10-07DOI: 10.1016/s2213-8587(25)00292-x
David Beran, Amanda Adler, Carol Abidha, Naomi Levitt, Nikhil Tandon, Janeth Tenorio Mucha, John S Yudkin, Stephen Colagiuri
No Abstract
没有抽象的
{"title":"Has the WHO Model Essential Medicines List lost its way?","authors":"David Beran, Amanda Adler, Carol Abidha, Naomi Levitt, Nikhil Tandon, Janeth Tenorio Mucha, John S Yudkin, Stephen Colagiuri","doi":"10.1016/s2213-8587(25)00292-x","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00292-x","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"5 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145241423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/S2213-8587(25)00223-2
Kiran Jobanputra, Sigiriya Aebischer Perone, Éimhín Ansbro, Saeed Baraiah, David Beran, Sadhana Bhagwat, Philippa Boulle, Hicham El-Berri, Ibtihal Fadhil, Sylvia Kehlenbrink, Lilian Kiapi, Lars Bruun Larsen, Adelheid Marschang, Anna Nakayama, Iryna Vlasenko, Michael Woodman
People with non-communicable diseases (NCDs) are particularly vulnerable to health service disruptions resulting from conflicts, natural disasters, and major disease outbreaks. The 2018 Political Declaration of the 3rd UN High-Level Meeting of the General Assembly on the Prevention and Control of NCDs called for the strengthening of health system resilience to withstand emergencies due to all hazards. Since this declaration, substantial progress has been made by countries and implementing organisations in the development of policies that reduce risk to people with NCDs, as well as the integration of NCDs in emergency preparedness and response measures. However, the increasing frequency of conflicts and natural disasters and the financing shortfall for NCDs have slowed progress. This Personal View describes key developments and lessons learned since the 2018 UN Political Declaration with regard to NCDs across the emergency management cycle, and highlights the current operational and policy challenges. We propose three areas of focus for further development, together with detailed actions for improving NCD care in emergencies.
{"title":"Strengthening non-communicable disease care in all-hazards emergencies.","authors":"Kiran Jobanputra, Sigiriya Aebischer Perone, Éimhín Ansbro, Saeed Baraiah, David Beran, Sadhana Bhagwat, Philippa Boulle, Hicham El-Berri, Ibtihal Fadhil, Sylvia Kehlenbrink, Lilian Kiapi, Lars Bruun Larsen, Adelheid Marschang, Anna Nakayama, Iryna Vlasenko, Michael Woodman","doi":"10.1016/S2213-8587(25)00223-2","DOIUrl":"10.1016/S2213-8587(25)00223-2","url":null,"abstract":"<p><p>People with non-communicable diseases (NCDs) are particularly vulnerable to health service disruptions resulting from conflicts, natural disasters, and major disease outbreaks. The 2018 Political Declaration of the 3rd UN High-Level Meeting of the General Assembly on the Prevention and Control of NCDs called for the strengthening of health system resilience to withstand emergencies due to all hazards. Since this declaration, substantial progress has been made by countries and implementing organisations in the development of policies that reduce risk to people with NCDs, as well as the integration of NCDs in emergency preparedness and response measures. However, the increasing frequency of conflicts and natural disasters and the financing shortfall for NCDs have slowed progress. This Personal View describes key developments and lessons learned since the 2018 UN Political Declaration with regard to NCDs across the emergency management cycle, and highlights the current operational and policy challenges. We propose three areas of focus for further development, together with detailed actions for improving NCD care in emergencies.</p>","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"13 10","pages":"891-896"},"PeriodicalIF":41.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-29DOI: 10.1016/s2213-8587(25)00216-5
Filip K Knop, George Kunos, Dror Dicker, Jean-Sebastien Paquette, Louis Aronne, Ofir Frenkel, Thomas Holst-Hansen, Karine Lalonde, Jisoo Lee, Glenn Crater
Background
Monlunabant, a novel cannabinoid receptor 1 (CB1R) inverse agonist, has shown encouraging weight loss efficacy and tolerability. We aimed to evaluate the efficacy and safety of monlunabant in individuals with obesity and metabolic syndrome.
Methods
This 16-week, randomised, double-blind, placebo-controlled, dose-ranging phase 2a trial, conducted at 25 outpatient research centres in Canada, enrolled adults with obesity and metabolic syndrome. Participants were randomly assigned (1:1:1:1) by means of an interactive response system to once-daily oral tablets of monlunabant 10 mg, 20 mg, 50 mg, or placebo. The participants, site staff, sponsor, and contract research organisation were masked to treatment allocation. The primary endpoint was mean bodyweight (kg) change from baseline at week 16 versus placebo, assessed in all eligible randomised participants, whereas the safety analysis was done in all randomised participants who received at least one dose of trial product. The estimator for the primary estimand was analysed using a mixed model for repeated measures, assuming missing data are missing at random. This trial is registered with ClinicalTrials.gov (NCT05891834) and is complete.
Findings
From Sept 8, 2023, to Jan 26, 2024, 409 individuals were screened for eligibility. In total, 243 individuals were randomly assigned to monlunabant 10 mg (n=61), monlunabant 20 mg (n=61), monlunabant 50 mg (n=60), and placebo (n=61); 242 participants received treatment, including 167 (69%) females and 75 (31%) males. 183 (76%) of 242 participants completed the trial: 50 (82%) of 61 received monlunabant 10 mg, 42 (70%) of 60 received monlunabant 20 mg, 34 (57%) of 60 received monlunabant 50 mg, and 57 (93%) of 61 received placebo. At week 16, participants receiving monlunabant showed statistically significant weight loss compared with those receiving placebo (least squares mean difference vs placebo of –6·4 kg [95% CI –8·0 to –4·9] for monlunabant 10 mg, –6·9 kg [–8·5 to –5·3] for monlunabant 20 mg, and –8·0 kg [–9·7 to –6·4] for monlunabant 50 mg). Adverse events were mostly mild to moderate gastrointestinal and psychiatric disorders and were seen in 42 (69%) of 61 participants in the monlunabant 10 mg group, 47 (78%) of 60 participants in the monlunabant 20 mg group, 55 (92%) of 60 participants in the monlunabant 50 mg group, and 42 (69%) of 61 participants in the placebo group. Withdrawals due to adverse events appeared dose-dependent, occurring in eight (13%) participants who
{"title":"Efficacy and safety of monlunabant in adults with obesity and metabolic syndrome: a double-blind, randomised, placebo-controlled, phase 2a trial","authors":"Filip K Knop, George Kunos, Dror Dicker, Jean-Sebastien Paquette, Louis Aronne, Ofir Frenkel, Thomas Holst-Hansen, Karine Lalonde, Jisoo Lee, Glenn Crater","doi":"10.1016/s2213-8587(25)00216-5","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00216-5","url":null,"abstract":"<h3>Background</h3>Monlunabant, a novel cannabinoid receptor 1 (CB1R) inverse agonist, has shown encouraging weight loss efficacy and tolerability. We aimed to evaluate the efficacy and safety of monlunabant in individuals with obesity and metabolic syndrome.<h3>Methods</h3>This 16-week, randomised, double-blind, placebo-controlled, dose-ranging phase 2a trial, conducted at 25 outpatient research centres in Canada, enrolled adults with obesity and metabolic syndrome. Participants were randomly assigned (1:1:1:1) by means of an interactive response system to once-daily oral tablets of monlunabant 10 mg, 20 mg, 50 mg, or placebo. The participants, site staff, sponsor, and contract research organisation were masked to treatment allocation. The primary endpoint was mean bodyweight (kg) change from baseline at week 16 versus placebo, assessed in all eligible randomised participants, whereas the safety analysis was done in all randomised participants who received at least one dose of trial product. The estimator for the primary estimand was analysed using a mixed model for repeated measures, assuming missing data are missing at random. This trial is registered with <span><span>ClinicalTrials.gov</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span> (<span><span>NCT05891834</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>) and is complete.<h3>Findings</h3>From Sept 8, 2023, to Jan 26, 2024, 409 individuals were screened for eligibility. In total, 243 individuals were randomly assigned to monlunabant 10 mg (n=61), monlunabant 20 mg (n=61), monlunabant 50 mg (n=60), and placebo (n=61); 242 participants received treatment, including 167 (69%) females and 75 (31%) males. 183 (76%) of 242 participants completed the trial: 50 (82%) of 61 received monlunabant 10 mg, 42 (70%) of 60 received monlunabant 20 mg, 34 (57%) of 60 received monlunabant 50 mg, and 57 (93%) of 61 received placebo. At week 16, participants receiving monlunabant showed statistically significant weight loss compared with those receiving placebo (least squares mean difference <em>vs</em> placebo of –6·4 kg [95% CI –8·0 to –4·9] for monlunabant 10 mg, –6·9 kg [–8·5 to –5·3] for monlunabant 20 mg, and –8·0 kg [–9·7 to –6·4] for monlunabant 50 mg). Adverse events were mostly mild to moderate gastrointestinal and psychiatric disorders and were seen in 42 (69%) of 61 participants in the monlunabant 10 mg group, 47 (78%) of 60 participants in the monlunabant 20 mg group, 55 (92%) of 60 participants in the monlunabant 50 mg group, and 42 (69%) of 61 participants in the placebo group. Withdrawals due to adverse events appeared dose-dependent, occurring in eight (13%) participants who ","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"19 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-26DOI: 10.1016/s2213-8587(25)00251-7
Lorenz C Hofbauer, Juliet E Compston, Kenneth G Saag, Martina Rauner, Elena Tsourdi
Despite advances in targeted therapies, treatment with glucocorticoids remains a mainstay in the management of various immune-mediated diseases. High cumulative doses of exogenous glucocorticoids lead to a spectrum of side-effects, in particular increased fracture risk. Fragility fractures might result in immobility, frequent admission to hospitals, and loss of quality of life. Glucocorticoid excess impairs bone microarchitecture and bone strength and can cause multiple vertebral fractures. Fracture risk at other skeletal sites is also enhanced and triggered by an increased risk for falls. Glucocorticoid-induced osteoporosis results from direct suppression of osteoblast and osteocyte function, a transient stimulation of osteoclast formation and activity, catabolic effects on bone matrix and muscle protein, and metabolic alterations. Assessment of fracture risk using the Fracture Risk Assessment Tool (FRAX) with dual-energy X-ray absorptiometry represents the first diagnostic step; its predictive value can be improved by applying specific adjustments such as the trabecular bone score. This Review highlights how the bone microenvironment responds to supraphysiological glucocorticoid concentrations, and discusses the basis for skeletal fragility and fractures. We review the use and limitations of current and emerging imaging technologies and prediction tools, and discuss bone-forming and antiresorptive treatment strategies and their use to prevent and treat glucocorticoid-induced osteoporosis.
{"title":"Glucocorticoid-induced osteoporosis: novel concepts and clinical implications","authors":"Lorenz C Hofbauer, Juliet E Compston, Kenneth G Saag, Martina Rauner, Elena Tsourdi","doi":"10.1016/s2213-8587(25)00251-7","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00251-7","url":null,"abstract":"Despite advances in targeted therapies, treatment with glucocorticoids remains a mainstay in the management of various immune-mediated diseases. High cumulative doses of exogenous glucocorticoids lead to a spectrum of side-effects, in particular increased fracture risk. Fragility fractures might result in immobility, frequent admission to hospitals, and loss of quality of life. Glucocorticoid excess impairs bone microarchitecture and bone strength and can cause multiple vertebral fractures. Fracture risk at other skeletal sites is also enhanced and triggered by an increased risk for falls. Glucocorticoid-induced osteoporosis results from direct suppression of osteoblast and osteocyte function, a transient stimulation of osteoclast formation and activity, catabolic effects on bone matrix and muscle protein, and metabolic alterations. Assessment of fracture risk using the Fracture Risk Assessment Tool (FRAX) with dual-energy X-ray absorptiometry represents the first diagnostic step; its predictive value can be improved by applying specific adjustments such as the trabecular bone score. This Review highlights how the bone microenvironment responds to supraphysiological glucocorticoid concentrations, and discusses the basis for skeletal fragility and fractures. We review the use and limitations of current and emerging imaging technologies and prediction tools, and discuss bone-forming and antiresorptive treatment strategies and their use to prevent and treat glucocorticoid-induced osteoporosis.","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"154 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145153620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-18DOI: 10.1016/s2213-8587(25)00293-1
Brandi ML, Pieterman CRC, English KA, et al. Multiple endocrine neoplasia type 1 (MEN1): recommendations and guidelines for best practice. Lancet Diabetes Endocrinol 2025; 13: 699–721—In this Review, the spelling of Camilla Schalin-Jäntti's name was incorrect in the appendix. This correction has been made to the online version as of Sept 18, 2025.
Brandi ML, Pieterman CRC, English KA，等。1型多发性内分泌瘤（MEN1）：最佳实践的建议和指南。柳叶刀糖尿病内分泌2025；[03:699 - 721]在这篇评论中，附录中Camilla Schalin-Jäntti的名字拼写不正确。此更正已于2025年9月18日对在线版本进行了修改。
{"title":"Correction to Lancet Diabetes Endocrinol 2025; 13: 699–721","authors":"","doi":"10.1016/s2213-8587(25)00293-1","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00293-1","url":null,"abstract":"<em>Brandi ML, Pieterman CRC, English KA, et al. Multiple endocrine neoplasia type 1 (MEN1): recommendations and guidelines for best practice.</em> Lancet Diabetes Endocrinol <em>2025;</em> 13: <em>699–721</em>—In this Review, the spelling of Camilla Schalin-Jäntti's name was incorrect in the appendix. This correction has been made to the online version as of Sept 18, 2025.","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"79 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-16DOI: 10.1016/s2213-8587(25)00253-0
Brynn E Marks, Jaisree R Iyer, Steven James, Valla Tantayotai, Carine de Beaufort
No Abstract
没有抽象的
{"title":"Improving type 1 diabetes care globally: the importance of medical education","authors":"Brynn E Marks, Jaisree R Iyer, Steven James, Valla Tantayotai, Carine de Beaufort","doi":"10.1016/s2213-8587(25)00253-0","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00253-0","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"70 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145072420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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