Lancet Regional Health-Europe最新文献

{"title":"Brand-specific influenza vaccine effectiveness in three Nordic countries during the 2024–2025 season: a target trial emulation study based on registry data","authors":"Kristyna Faksova ,&nbsp;Emilia Myrup Thiesson ,&nbsp;Nicklas Pihlström ,&nbsp;Ulrike Baum ,&nbsp;Tor Biering-Sørensen ,&nbsp;Eero Poukka ,&nbsp;Tuija Leino ,&nbsp;Rickard Ljung ,&nbsp;Anders Hviid","doi":"10.1016/j.lanepe.2025.101518","DOIUrl":"10.1016/j.lanepe.2025.101518","url":null,"abstract":"<div><h3>Background</h3><div>Seasonal influenza causes substantial morbidity and mortality in older adults. While vaccination is recommended in Nordic countries for individuals aged ≥65 years, brand-specific effectiveness estimates are scarce but essential for regulatory decision-making. We evaluated brand-specific effectiveness of seasonal influenza vaccines against laboratory-confirmed influenza-related outcomes in Denmark, Finland, and one Swedish region during the 2024/2025 season.</div></div><div><h3>Methods</h3><div>We conducted a nationwide cohort study using target trial emulation and linked health registries. Individuals aged ≥65 years were matched 1:1, comparing seasonal influenza vaccine recipients to non-recipients. Cumulative incidences of laboratory-confirmed influenza A and B, influenza-related hospitalisation, and death were assessed at 18 weeks post-immunisation. Vaccine effectiveness (VE) was calculated as 1 minus the risk ratio.</div></div><div><h3>Findings</h3><div>A total of 1,164,686 matched pairs were included (mean age 75.4 years, standard deviation 7.3). Overall VE against influenza-related hospitalisation was 46.8% (95% CI 40.8–52.9), with risk differences of −21.3 (−28.9 to −13.8) and −99.3 (−119.6 to −79.1) in Finland and Denmark, respectively, per 100,000 vaccinated individuals. Brand-specific VE was 63.4% (38.1–88.7) for Efluelda Tetra (split virion-high dose), 48.2% (40.8–55.6) for Fluad Tetra (subunit standard-dose adjuvanted), 43.6% (23.7–63.6) for Vaxigrip Tetra (split virion standard-dose), and 30.6% (−7.8 to 69.1) for Influvac Tetra (subunit standard-dose). VE waned by −6.5 percentage points (−10.5 to −2.5) every 3 weeks.</div></div><div><h3>Interpretation</h3><div>Seasonal influenza vaccines moderately reduced the risk of severe outcomes in older adults. Efluelda Tetra and Fluad Tetra appeared to offer favourable protection in their respective target groups, supporting their use in the 2025/2026 season. Annual monitoring using Nordic registries is crucial for informing evidence-based vaccination strategies and regulatory decisions.</div></div><div><h3>Funding</h3><div><span>European Medicines Agency</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"60 ","pages":"Article 101518"},"PeriodicalIF":13.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145468471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of cigarette prices and age-of-sale policies on smoking prevalence among youth in 26 European Member States (2012–2023): a longitudinal ecological study using repeated cross-sectional data","authors":"Ayaka Teshima ,&nbsp;Ariadna Feliu ,&nbsp;Silvano Gallus ,&nbsp;Cristina Martinez ,&nbsp;Esteve Fernandez","doi":"10.1016/j.lanepe.2025.101511","DOIUrl":"10.1016/j.lanepe.2025.101511","url":null,"abstract":"<div><h3>Background</h3><div>Reducing tobacco and nicotine use and preventing smoking initiation among youth are key public health priorities. We evaluated the impact of cigarette prices and age-of-sale laws on youth smoking prevalence in the European Union (EU).</div></div><div><h3>Methods</h3><div>In this ecological study with 26 EU Member States as the unit of analysis, we estimated smoking prevalence among individuals aged 15–24, using five Eurobarometer waves (2012–2023, n = 12,087). We used fixed-effects panel regression models to assess the association between cigarette prices, the introduction of 18+ age-of-sale laws for tobacco products and changes in youth smoking prevalence, controlling for time and tobacco control policy implementation.</div></div><div><h3>Findings</h3><div>Weighted youth smoking prevalence decreased from 28.4% (841/2818) in 2012 to 22.2% (490/2222) in 2023, although the trend was not consistently downward. A €1 increase in inflation-adjusted cigarette prices per pack was associated with a 3.4 percentage point reduction in male youth prevalence (95% CI: −6.40 to −0.45), while there was no significant association for females or at the EU level. Regional variation was observed, with price increases associated with substantial reductions in youth smoking among both sexes in Southern Europe and among males in Northern Europe. In contrast, no such associations were found in Western or Eastern Europe. Age-of-sale laws were not significantly associated with youth smoking prevalence at the EU level.</div></div><div><h3>Interpretation</h3><div>Current taxation and age-of-sale policies remain insufficient, with impacts varying by sex and region. Achieving the tobacco endgame requires harmonised EU-level measures and stronger enforcement, particularly of these two policies, to prevent the ongoing influx of new youth smoking initiates. This study suggests that their potential impact has been constrained by inadequate enforcement to date rather than by policy ineffectiveness.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"60 ","pages":"Article 101511"},"PeriodicalIF":13.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145420438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicide after involuntary psychiatric care: a nationwide cohort study in Sweden","authors":"Leoni Grossmann ,&nbsp;Fred Johansson ,&nbsp;Seena Fazel ,&nbsp;Ralf Kuja-Halkola ,&nbsp;Björn Bråstad ,&nbsp;David Mataix-Cols ,&nbsp;Lorena Fernández de la Cruz ,&nbsp;Bo Runeson ,&nbsp;Paul Lichtenstein ,&nbsp;Zheng Chang ,&nbsp;Henrik Larsson ,&nbsp;Isabell Brikell ,&nbsp;Brian D'Onofrio ,&nbsp;Ronnie Pingel ,&nbsp;Christian Rück ,&nbsp;John Wallert","doi":"10.1016/j.lanepe.2025.101504","DOIUrl":"10.1016/j.lanepe.2025.101504","url":null,"abstract":"<div><h3>Background</h3><div>Little is known about the risk of suicide in individuals treated against their will in involuntary psychiatric care (IPC). This population-based study provides a first comprehensive description of suicide among individuals who experienced IPC.</div></div><div><h3>Methods</h3><div>We studied all individuals discharged from IPC in Sweden from 2010 through 2020. Clinical and sociodemographic characteristics are reported followed by suicide risk for the complete IPC population and stratified by sex, age, IPC history, and diagnostic category. Crude and adjusted relative risks compared to all individuals discharged from psychiatric in- and outpatient care and the general population were estimated using Poisson regression. Suicide methods, seasonal trends, and geographical variance are also reported.</div></div><div><h3>Findings</h3><div>We identified 72 275 patients treated in IPC with a total of 134 514 inpatient care episodes (mean age = 44·8 years, 37 462 [51·8%] males). Of these, 2104 (2·9%) died by suicide over a median follow-up time of 4·4 years (IQR: 1⋅8–7⋅5). Suicide decedents were younger, more often male, single, diagnosed with personality and substance use disorders, and had a history of self-harm and IPC, compared to those who did not die by suicide. The absolute risk (crude incidence rate (IR) per 100 000 person-years) for all IPC patients was highest closest to discharge (IR_1month = 2941 [2538, 3408]) and decreased thereafter (IR_5years = 738 [705, 773]). Suicide risk in IPC patients was elevated relative to psychiatric inpatients (crude IR ratio (IRR)_5years = 1·57 [1·48, 1·65]), psychiatric outpatients (IRR_5years = 3·77 [3·58, 3·97]), and the general population (IRR_5years = 55·52 [52·65, 58·54]).</div></div><div><h3>Interpretation</h3><div>We found substantial risk differences in distinct subgroups of IPC patients and an excess suicide risk among IPC patients compared to other clinical populations. These findings warrant further investigation as they could inform clinicians and policy makers regarding potential risk stratification, monitoring, and care. Preventing suicides after IPC should be a priority.</div></div><div><h3>Funding</h3><div><span>VR</span>, <span>ALF</span> Medicine, <span>CIMED</span>, <span>FORTE,</span> and <span>Söderström König Foundation</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"60 ","pages":"Article 101504"},"PeriodicalIF":13.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145468505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer diagnoses, referrals, and survival in people with a learning disability in the UK: a population-based, matched cohort study","authors":"Oliver John Kennedy ,&nbsp;Umesh Chauhan ,&nbsp;Louise Gorman ,&nbsp;Paul Lorigan ,&nbsp;Samuel Merriel ,&nbsp;Tjeerd Van Staa ,&nbsp;Alison Wright ,&nbsp;Darren Mark Ashcroft","doi":"10.1016/j.lanepe.2025.101519","DOIUrl":"10.1016/j.lanepe.2025.101519","url":null,"abstract":"<div><h3>Background</h3><div>People with a learning disability (LD, also known as intellectual disability) face poorer health outcomes, yet the burden of cancer in this population is poorly understood. This study investigated cancer-related outcomes in people with a LD compared to the general population.</div></div><div><h3>Methods</h3><div>A matched cohort study was conducted using linked primary care, hospital, mortality, and cancer registry data from Clinical Practice Research Datalink (CPRD) Aurum. In total, 180,911 individuals with a LD were matched with 3,405,467 controls. Outcomes included urgent suspected cancer (USC) referrals, cancer diagnoses, treatment within six months, and overall survival (OS) post-diagnosis.</div></div><div><h3>Findings</h3><div>Individuals with a LD had fewer USC referrals within 28 days of possible cancer symptoms (adjusted risk ratio [aRR] 0.52, 95% confidence interval [CI] 0.49–0.55). LD was associated with several cancers, including sarcoma (adjusted hazard ratio [aHR] 1.98, 1.65–2.39), central nervous system (aHR 3.42, 2.99–3.90), testicular (aHR 2.06, 1.61–2.62), and uterine cancers (aHR 1.69, 1.40–2.05) as well as cancer before age 50 years (aHR 1.74, 1.63–1.86). Absolute incidence was lower in individuals with a LD compared to without (3396 [1.9%] vs 67,506 [2.0%]) due to increased all-cause mortality (aHR 3.19, 3.12–3.27). LD was associated with fewer diagnoses via USC referrals (aRR 0.81, 0.76–0.86), fewer treatments within six months (aRR 0.83, 0.80–0.85) and shorter OS (median 4.4 years, 95% CI 3.9–5.1 vs 9.1 years, 8.8–9.5; aHR 1.73, 1.65–1.83). Melanoma, breast, and prostate cancers were less common but had up to a fourfold increased risk of death after diagnosis in individuals with a LD.</div></div><div><h3>Interpretation</h3><div>Individuals with a LD have higher cancer risk, more diagnoses outside USC pathways, fewer treatments, and poorer prognosis. Fewer diagnoses of some cancers, alongside worse outcomes, may indicate under-investigation. As premature all-cause mortality improves, cancer burden in this population may rise disproportionately.</div></div><div><h3>Funding</h3><div><span>NIHR</span> Greater Manchester Patient Safety Research Collaboration (NIHR204295).</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"60 ","pages":"Article 101519"},"PeriodicalIF":13.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"5 years of the Lancet Regional Health – Europe: science, equity, and why Europe must lead","authors":"The Lancet Regional Health – Europe","doi":"10.1016/j.lanepe.2025.101588","DOIUrl":"10.1016/j.lanepe.2025.101588","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"60 ","pages":"Article 101588"},"PeriodicalIF":13.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examination of self-harm clustering in adolescent peer networks: a nationwide registry cohort study in Finland","authors":"Jussi Alho ,&nbsp;Roger T. Webb ,&nbsp;Mai Gutvilig ,&nbsp;Ripsa Niemi ,&nbsp;Kaisla Komulainen ,&nbsp;Kimmo Suokas ,&nbsp;Petri Böckerman ,&nbsp;Marko Elovainio ,&nbsp;Nav Kapur ,&nbsp;Christian Hakulinen","doi":"10.1016/j.lanepe.2025.101517","DOIUrl":"10.1016/j.lanepe.2025.101517","url":null,"abstract":"<div><h3>Background</h3><div>Clusters of self-harming behaviour among adolescents have been observed, yet population-based epidemiological evidence is lacking. This study aims to address this lack by examining the clustering of self-harming behaviour within adolescent peer networks at the population level.</div></div><div><h3>Methods</h3><div>We used nationwide registry data on Finnish people born between January 1, 1985, and December 31, 2000, to examine whether having same-grade schoolmates who had self-harmed was associated with greater subsequent self-harm risk. Cohort members were followed up until first recorded self-harm episode, emigration, death, or December 31, 2020, whichever came first. Hazard ratios (HRs) were estimated using mixed-effects Cox proportional hazards models adjusted for a comprehensive set of individual-, parental-, school-, and area-level covariates.</div></div><div><h3>Findings</h3><div>The cohort comprised 913,149 Finnish residents. Having same-grade schoolmates who had self-harmed between school-starting age and finishing ninth grade was associated with a higher, albeit small in magnitude, HR of subsequent self-harm over a median of 11.6 years of follow-up (HR 1.05, [95% CI 1.01–1.09]). HR was not consistently higher over follow-up time but was highest in the beginning of follow-up when the cohort members were around age 16 (1.45 [1.25–1.69]). Limiting exposure to schoolmates’ self-harm episodes to 1 year consistently showed the highest risk around age 16, regardless of whether the exposure occurred in ninth grade (1.49 [1.21–1.82]) or eighth grade (1.36 [1.07–1.74]), with follow-up commencing after the respective grade.</div></div><div><h3>Interpretation</h3><div>While we cannot rule out residual confounding, our findings suggest that self-harm may socially transmit within adolescent peer networks. The observed highest risk around age 16 suggests that external stressors associated with transitioning to new life stages at this age may moderate the impact of peer self-harm exposure. Prevention and intervention measures that consider possible peer influences on adolescents’ self-harming behaviour may help reduce the public health burden of self-harm.</div></div><div><h3>Funding</h3><div><span>European Research Council</span> and <span>Research Council of Finland</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"60 ","pages":"Article 101517"},"PeriodicalIF":13.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145468472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The NITAG debate in Italy: an opportunity for prevention","authors":"Massimo Agosti","doi":"10.1016/j.lanepe.2025.101487","DOIUrl":"10.1016/j.lanepe.2025.101487","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"59 ","pages":"Article 101487"},"PeriodicalIF":13.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paediatric invasive group A streptococcal infections and associations with viral infections in 15 European countries after lifting non-pharmaceutical interventions against SARS-CoV-2: an interrupted time-series analysis","authors":"Léa Lenglart ,&nbsp;Izel Özmen ,&nbsp;David Aguilera-Alonso ,&nbsp;Daniel Blazquez-Gamero ,&nbsp;Navin P. Boeddha ,&nbsp;Emilie Pauline Buddingh ,&nbsp;Danilo Buonsenso ,&nbsp;Cristina Calvo ,&nbsp;Riccardo Castagnoli ,&nbsp;Marta Daina ,&nbsp;Maria-Myrto Dourdouna ,&nbsp;Marieke Emonts ,&nbsp;Carmen Ezinwoke ,&nbsp;Catarina Gouveia ,&nbsp;David Grandioso Vas ,&nbsp;Jeroen Hol ,&nbsp;Mette Holm ,&nbsp;Christian R. Kahlert ,&nbsp;Benno Kohlmaier ,&nbsp;Kamila Ludwikowska ,&nbsp;Ana Friães","doi":"10.1016/j.lanepe.2025.101497","DOIUrl":"10.1016/j.lanepe.2025.101497","url":null,"abstract":"<div><h3>Background</h3><div>After lifting non-pharmaceutical interventions (NPIs) against the transmission of SARS-CoV-2, various countries experienced an increase in invasive Group A Streptococcal (iGAS) infections. We aimed to characterise the paediatric outbreak across Europe and to analyse the influence of viral infections.</div></div><div><h3>Methods</h3><div>We conducted an interrupted time-series analysis based on data from 15 European countries from the PEGASUS consortium. We assessed the evolution of the number of iGAS cases aged 1 month to 18 years between 01/01/2018 and 03/31/2024, comparing the post-NPIs period (01-04-2022 until 31-03-2024) to the baseline period (01-01-2018 until 31-03-2020). Further analyses were performed by country, clinical phenotype, age and severity, including sensitivity analyses. We then explored whether certain iGAS phenotypes correlated with trends in RSV, influenza and VZV across countries over time using Google Trends data.</div></div><div><h3>Findings</h3><div>We included 2091 iGAS cases over the study period; 79 children (3.6%) died and 580 (27.7%) required PICU admission. We estimated an overall increase of +229.8% (95% CI (141.9–341.6)) among iGAS cases from October 2022 to March 2024, compared to the baseline period. The observed increases varied across clinical phenotypes, ranging from +62.7% (95% CI (8.3–157.9)) for osteo-articular infections to +238.7% (95% CI 75.8–464.8) for pneumonia. We observed a strong correlation between the incidence of iGAS pneumonia and RSV (Rho: 0.57, 95% CI [0.11–0.79]) and influenza (Rho 0.69, 95% CI 0.35–0.87); and between skin and soft tissue infections and VZV (Rho: 0.73, 95% CI [0.42–0.89]).</div></div><div><h3>Interpretation</h3><div>The patterns observed across Europe during this outbreak demonstrate an association between respiratory viruses as well as VZV, and iGAS.</div></div><div><h3>Funding</h3><div>This study has received funding from <span>ESPID</span>, INOPSU and the Northwest Clinics. The COPP study group was supported by grants of the Dutch <span>National Health Council</span> (ZonMW) project number 10430072110007 and the Christine Bader Foundation.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"59 ","pages":"Article 101497"},"PeriodicalIF":13.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145333709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PD-L1 inhibitors combined with chemotherapy for extensive-stage small cell lung cancer: a French nationwide cohort study","authors":"Hugo Jourdain ,&nbsp;Nicolas Albin ,&nbsp;Adrien Monard ,&nbsp;David Desplas ,&nbsp;Mahmoud Zureik ,&nbsp;Nadia Haddy","doi":"10.1016/j.lanepe.2025.101484","DOIUrl":"10.1016/j.lanepe.2025.101484","url":null,"abstract":"<div><h3>Background</h3><div>Immunotherapy with atezolizumab and durvalumab has significantly advanced the treatment of extended-stage small cell lung cancer (esSCLC). We aimed at studying the real-world use and comparative effectiveness and safety of these treatments.</div></div><div><h3>Methods</h3><div>We utilised the French National Health Data System (SNDS) to include all patients treated with atezolizumab or durvalumab for esSCLC from May 1, 2019 to December 31, 2023, with follow-up until June 30, 2024. Baseline characteristics were described. Effectiveness (time to treatment discontinuation and overall survival) and safety (all-cause and cause-specific overnight hospitalisations) were assessed using Cox proportional hazards models.</div></div><div><h3>Findings</h3><div>A total of 8612 patients were included, with 5188 initiating atezolizumab and 3424 initiating durvalumab. The mean age at inclusion was 66·2 years (standard deviation 8·7), and most patients were men (63·8%, n = 5493). The median time to treatment discontinuation was 5·4 months (95% CI, 5·3–5·5) for atezolizumab and 5·5 months (95% CI, 5·4–5·6) for durvalumab, with an adjusted hazard ratio (aHR) of 0·97 (95% CI, 0·92–1·02) for durvalumab vs. atezolizumab. The median overall survival was 11·1 months (95% CI, 10·6–11·4) for atezolizumab and 11·4 months (95% CI, 10·9–11·9) for durvalumab, with an aHR of 0·93 (95% CI, 0·88–0·98) for durvalumab vs. atezolizumab.</div><div>While 61·8% (n = 5323) of patients received systemic steroids, testifying of immune-mediated side effects, no significant safety differences were observed between the groups.</div></div><div><h3>Interpretation</h3><div>Our study found no clinically relevant differences in effectiveness or safety between atezolizumab and durvalumab for first-line esSCLC. Both treatments appearing interchangeable, treatment decision could be based on drug availability, local institutional protocols, administrative organisation, or cost considerations.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"59 ","pages":"Article 101484"},"PeriodicalIF":13.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COP30: still failing to meet the challenge","authors":"The Lancet Regional Health – Europe","doi":"10.1016/j.lanepe.2025.101559","DOIUrl":"10.1016/j.lanepe.2025.101559","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"59 ","pages":"Article 101559"},"PeriodicalIF":13.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}