Isaac S. KohaneFrom the Department of Biomedical Informatics, Harvard Medical School, and Boston Children’s Hospital — both in Boston.
Large numbers of patients are already using AI tools to obtain medical advice. Rigorous trials of these tools will be important. But what will they be measured against?
{"title":"Compared with What? Measuring AI against the Health Care We Have","authors":"Isaac S. KohaneFrom the Department of Biomedical Informatics, Harvard Medical School, and Boston Children’s Hospital — both in Boston.","doi":"10.1056/nejmp2404691","DOIUrl":"https://doi.org/10.1056/nejmp2404691","url":null,"abstract":"Large numbers of patients are already using AI tools to obtain medical advice. Rigorous trials of these tools will be important. But what will they be measured against?","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":158.5,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490741","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}
A 2-year-old boy was brought to the ED after he had had four generalized seizures in the previous week. Physical examination was notable for brisk tendon reflexes and Chvostek’s sign (shown in a vi...
{"title":"Chvostek’s Sign in Familial Hypoparathyroidism","authors":"Zhigang YangHenan Children’s Hospital, Zhengzhou, ChinaJie DengBeijing Children’s Hospital, Beijing, China","doi":"10.1056/nejmicm2406864","DOIUrl":"https://doi.org/10.1056/nejmicm2406864","url":null,"abstract":"A 2-year-old boy was brought to the ED after he had had four generalized seizures in the previous week. Physical examination was notable for brisk tendon reflexes and Chvostek’s sign (shown in a vi...","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":158.5,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490815","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}
Rasadokht Forati, and Deborah BartzFrom Harvard Medical School (R.F., D.B.) and the Department of Obstetrics and Gynecology, Brigham and Women’s Hospital (D.B.) — both in Boston.
Pronatalist policies like those being increasingly promoted in the United States threaten the health and well-being of women and marginalized people, as well as progress toward gender equity.
美国日益推行的产前主义政策威胁着妇女和边缘化人群的健康和福祉，也威胁着实现性别平等的进程。
{"title":"“Blessed Be the Fruit” — The Contemporary Rise of Pronatalism","authors":"Rasadokht Forati, and Deborah BartzFrom Harvard Medical School (R.F., D.B.) and the Department of Obstetrics and Gynecology, Brigham and Women’s Hospital (D.B.) — both in Boston.","doi":"10.1056/nejmp2410208","DOIUrl":"https://doi.org/10.1056/nejmp2410208","url":null,"abstract":"Pronatalist policies like those being increasingly promoted in the United States threaten the health and well-being of women and marginalized people, as well as progress toward gender equity.","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":158.5,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490742","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}
Rasheed A. Gbadegesin, Ifeoma Ulasi, Samuel Ajayi, Yemi Raji, Timothy Olanrewaju, Charlotte Osafo, Adebowale D. Ademola, Adanze Asinobi, Cheryl A. Winkler, David Burke, Fatiu Arogundade, Ivy Ekem, Jacob Plange-Rhule, Manmak Mamven, Michael Matekole, Olukemi Amodu, Richard Cooper, Sampson Antwi, Adebowale A. Adeyemo, Titilayo O. Ilori, Victoria Adabayeri, Alexander Nyarko, Anita Ghansah, Toyin Amira, Adaobi Solarin, Olugbenga Awobusuyi, Paul L. Kimmel, Frank Chip Brosius, Muhammad Makusidi, Uzoma Odenigbo, Matthias Kretzler, Jeffrey B. Hodgin, Martin R. Pollak, Vincent Boima, Barry I. Freedman, Nicholette D. Palmer, Bernard Collins, Milind Phadnis, Jill Smith, Celia I. Agwai, Ogochukwu Okoye, Aliyu Abdu, Jillian Wilson, Winfred Williams, Babatunde L. Salako, Rulan S. Parekh, Bamidele Tayo, Dwomoa Adu, and Akinlolu Ojothe H3Africa Kidney Disease Research Network*From the Department of Pediatrics, Duke University Medical Center, Durham (R.A.G.), and the Departments of Medicine (..
Apolipoprotein L1 gene (APOL1) variants are risk factors for chronic kidney disease (CKD) among Black Americans. Data are sparse on the genetic epidemiology of CKD and the clinical association of A...
{"title":"APOL1 Bi- and Monoallelic Variants and Chronic Kidney Disease in West Africans","authors":"Rasheed A. Gbadegesin, Ifeoma Ulasi, Samuel Ajayi, Yemi Raji, Timothy Olanrewaju, Charlotte Osafo, Adebowale D. Ademola, Adanze Asinobi, Cheryl A. Winkler, David Burke, Fatiu Arogundade, Ivy Ekem, Jacob Plange-Rhule, Manmak Mamven, Michael Matekole, Olukemi Amodu, Richard Cooper, Sampson Antwi, Adebowale A. Adeyemo, Titilayo O. Ilori, Victoria Adabayeri, Alexander Nyarko, Anita Ghansah, Toyin Amira, Adaobi Solarin, Olugbenga Awobusuyi, Paul L. Kimmel, Frank Chip Brosius, Muhammad Makusidi, Uzoma Odenigbo, Matthias Kretzler, Jeffrey B. Hodgin, Martin R. Pollak, Vincent Boima, Barry I. Freedman, Nicholette D. Palmer, Bernard Collins, Milind Phadnis, Jill Smith, Celia I. Agwai, Ogochukwu Okoye, Aliyu Abdu, Jillian Wilson, Winfred Williams, Babatunde L. Salako, Rulan S. Parekh, Bamidele Tayo, Dwomoa Adu, and Akinlolu Ojothe H3Africa Kidney Disease Research Network*From the Department of Pediatrics, Duke University Medical Center, Durham (R.A.G.), and the Departments of Medicine (..","doi":"10.1056/nejmoa2404211","DOIUrl":"https://doi.org/10.1056/nejmoa2404211","url":null,"abstract":"Apolipoprotein L1 gene (APOL1) variants are risk factors for chronic kidney disease (CKD) among Black Americans. Data are sparse on the genetic epidemiology of CKD and the clinical association of A...","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":158.5,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490817","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}
,William G Herrington,Natalie Staplin,Nikita Agrawal,Christoph Wanner,Jennifer B Green,Sibylle J Hauske,Jonathan R Emberson,David Preiss,Parminder Judge,Doreen Zhu,Rejive Dayanandan,Ryoki Arimoto,Kaitlin J Mayne,Sarah Y A Ng,Emily Sammons,Michael Hill,Will Stevens,Karl Wallendszus,Susanne Brenner,Alfred K Cheung,Zhi-Hong Liu,Jing Li,Lai Seong Hooi,Wen Liu,Takashi Kadowaki,Masaomi Nangaku,Adeera Levin,David Z I Cherney,Aldo P Maggioni,Roberto Pontremoli,Rajat Deo,Shinya Goto,Xavier Rossello,Katherine R Tuttle,Dominik Steubl,Dan Massey,Martina Brueckmann,Martin J Landray,Colin Baigent,Richard Haynes
BACKGROUNDIn the EMPA-KIDNEY trial, empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, had positive cardiorenal effects in patients with chronic kidney disease who were at risk for disease progression. Post-trial follow-up was designed to assess how the effects of empagliflozin would evolve after the discontinuation of the trial drug.METHODSIn the active trial, patients with chronic kidney disease were randomly assigned to receive either empagliflozin (10 mg once daily) or matching placebo and were followed for a median of 2 years. All the patients had an estimated glomerular filtration rate (eGFR) of at least 20 but less than 45 ml per minute per 1.73 m2 of body-surface area or an eGFR of at least 45 but less than 90 ml per minute per 1.73 m2 with a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of at least 200. Subsequently, surviving patients who consented were observed for 2 additional years. No trial empagliflozin or placebo was administered during the post-trial period, but local practitioners could prescribe open-label SGLT2 inhibitors, including open-label empagliflozin. The primary composite outcome was kidney disease progression or cardiovascular death as assessed from the start of the active-trial period to the end of the post-trial period.RESULTSOf the 6609 patients who had undergone randomization in the active trial, 4891 (74%) were enrolled in the post-trial period. During this period, the use of open-label SGLT2 inhibitors was similar in the two groups (43% in the empagliflozin group and 40% in the placebo group). During the combined active- and post-trial periods, a primary-outcome event occurred in 865 of 3304 patients (26.2%) in the empagliflozin group and in 1001 of 3305 patients (30.3%) in the placebo group (hazard ratio, 0.79; 95% confidence interval [CI], 0.72 to 0.87). During the post-trial period only, the hazard ratio for a primary-outcome event was 0.87 (95% CI, 0.76 to 0.99). During the combined periods, the risk of kidney disease progression was 23.5% in the empagliflozin group and 27.1% in the placebo group; the risk of the composite of death or end-stage kidney disease was 16.9% and 19.6%, respectively; and the risk of cardiovascular death was 3.8% and 4.9%, respectively. There was no effect of empagliflozin on death from noncardiovascular causes (5.3% in both groups).CONCLUSIONSIn a broad range of patients with chronic kidney disease at risk for progression, empagliflozin continued to have additional cardiorenal benefits for up to 12 months after it was discontinued. (Funded by Boehringer Ingelheim and others; EMPA-KIDNEY ClinicalTrials.gov number, NCT03594110; EuDRACT number, 2017-002971-24.).
{"title":"Long-Term Effects of Empagliflozin in Patients with Chronic Kidney Disease.","authors":",William G Herrington,Natalie Staplin,Nikita Agrawal,Christoph Wanner,Jennifer B Green,Sibylle J Hauske,Jonathan R Emberson,David Preiss,Parminder Judge,Doreen Zhu,Rejive Dayanandan,Ryoki Arimoto,Kaitlin J Mayne,Sarah Y A Ng,Emily Sammons,Michael Hill,Will Stevens,Karl Wallendszus,Susanne Brenner,Alfred K Cheung,Zhi-Hong Liu,Jing Li,Lai Seong Hooi,Wen Liu,Takashi Kadowaki,Masaomi Nangaku,Adeera Levin,David Z I Cherney,Aldo P Maggioni,Roberto Pontremoli,Rajat Deo,Shinya Goto,Xavier Rossello,Katherine R Tuttle,Dominik Steubl,Dan Massey,Martina Brueckmann,Martin J Landray,Colin Baigent,Richard Haynes","doi":"10.1056/nejmoa2409183","DOIUrl":"https://doi.org/10.1056/nejmoa2409183","url":null,"abstract":"BACKGROUNDIn the EMPA-KIDNEY trial, empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, had positive cardiorenal effects in patients with chronic kidney disease who were at risk for disease progression. Post-trial follow-up was designed to assess how the effects of empagliflozin would evolve after the discontinuation of the trial drug.METHODSIn the active trial, patients with chronic kidney disease were randomly assigned to receive either empagliflozin (10 mg once daily) or matching placebo and were followed for a median of 2 years. All the patients had an estimated glomerular filtration rate (eGFR) of at least 20 but less than 45 ml per minute per 1.73 m2 of body-surface area or an eGFR of at least 45 but less than 90 ml per minute per 1.73 m2 with a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of at least 200. Subsequently, surviving patients who consented were observed for 2 additional years. No trial empagliflozin or placebo was administered during the post-trial period, but local practitioners could prescribe open-label SGLT2 inhibitors, including open-label empagliflozin. The primary composite outcome was kidney disease progression or cardiovascular death as assessed from the start of the active-trial period to the end of the post-trial period.RESULTSOf the 6609 patients who had undergone randomization in the active trial, 4891 (74%) were enrolled in the post-trial period. During this period, the use of open-label SGLT2 inhibitors was similar in the two groups (43% in the empagliflozin group and 40% in the placebo group). During the combined active- and post-trial periods, a primary-outcome event occurred in 865 of 3304 patients (26.2%) in the empagliflozin group and in 1001 of 3305 patients (30.3%) in the placebo group (hazard ratio, 0.79; 95% confidence interval [CI], 0.72 to 0.87). During the post-trial period only, the hazard ratio for a primary-outcome event was 0.87 (95% CI, 0.76 to 0.99). During the combined periods, the risk of kidney disease progression was 23.5% in the empagliflozin group and 27.1% in the placebo group; the risk of the composite of death or end-stage kidney disease was 16.9% and 19.6%, respectively; and the risk of cardiovascular death was 3.8% and 4.9%, respectively. There was no effect of empagliflozin on death from noncardiovascular causes (5.3% in both groups).CONCLUSIONSIn a broad range of patients with chronic kidney disease at risk for progression, empagliflozin continued to have additional cardiorenal benefits for up to 12 months after it was discontinued. (Funded by Boehringer Ingelheim and others; EMPA-KIDNEY ClinicalTrials.gov number, NCT03594110; EuDRACT number, 2017-002971-24.).","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":158.5,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490757","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}
BACKGROUNDThe alternative complement pathway plays a key role in the pathogenesis of IgA nephropathy. Iptacopan specifically binds to factor B and inhibits the alternative pathway.METHODSIn this phase 3, double-blind, randomized, placebo-controlled trial, we enrolled adults with biopsy-confirmed IgA nephropathy and proteinuria (defined as a 24-hour urinary protein-to-creatinine ratio of ≥1 [with protein and creatinine both measured in grams]) despite optimized supportive therapy. Patients were randomly assigned, in a 1:1 ratio, to receive oral iptacopan (200 mg) or placebo twice daily for 24 months while continuing to receive supportive therapy. The primary objective of this prespecified interim analysis was to assess the efficacy of iptacopan as compared with that of placebo in reducing proteinuria at month 9; the primary end point was the change from baseline in the 24-hour urinary protein-to-creatinine ratio at month 9. The proportion of patients who had a 24-hour urinary protein-to-creatinine ratio of less than 1 at month 9 without receiving rescue or alternative medication or undergoing kidney-replacement therapy (dialysis or transplantation) was a secondary end point. Safety was also assessed. The effect of iptacopan on kidney function will be assessed at the end of the 2-year double-blind treatment period.RESULTSThe main trial population included 222 patients in the iptacopan group and 221 in the placebo group. The interim efficacy analysis included the first 250 patients who underwent randomization in the main trial population (125 patients in each group) and who remained in the trial until month 9 or discontinued the trial by month 9. Safety was assessed in all the patients in the main trial population. At month 9, the adjusted geometric mean 24-hour urinary protein-to-creatinine ratio was 38.3% (95% confidence interval, 26.0 to 48.6; two-sided P<0.001) lower with iptacopan than with placebo. The reduction in proteinuria was supported by consistent results in secondary end point analyses. There were no unexpected safety findings with iptacopan. The incidence of adverse events that occurred during the treatment period was similar in the two groups; most events were mild to moderate in severity and reversible. No increased risk of infection was observed.CONCLUSIONSAmong patients with IgA nephropathy, treatment with iptacopan resulted in a significant and clinically meaningful reduction in proteinuria as compared with placebo. (Funded by Novartis; APPLAUSE-IgAN ClinicalTrials.gov number, NCT04578834.).
{"title":"Alternative Complement Pathway Inhibition with Iptacopan in IgA Nephropathy.","authors":"Vlado Perkovic,Jonathan Barratt,Brad Rovin,Naoki Kashihara,Bart Maes,Hong Zhang,Hernán Trimarchi,Dmitrij Kollins,Olympia Papachristofi,Severina Jacinto-Sanders,Tobias Merkel,Nicolas Guerard,Ronny Renfurm,Thomas Hach,Dana V Rizk","doi":"10.1056/nejmoa2410316","DOIUrl":"https://doi.org/10.1056/nejmoa2410316","url":null,"abstract":"BACKGROUNDThe alternative complement pathway plays a key role in the pathogenesis of IgA nephropathy. Iptacopan specifically binds to factor B and inhibits the alternative pathway.METHODSIn this phase 3, double-blind, randomized, placebo-controlled trial, we enrolled adults with biopsy-confirmed IgA nephropathy and proteinuria (defined as a 24-hour urinary protein-to-creatinine ratio of ≥1 [with protein and creatinine both measured in grams]) despite optimized supportive therapy. Patients were randomly assigned, in a 1:1 ratio, to receive oral iptacopan (200 mg) or placebo twice daily for 24 months while continuing to receive supportive therapy. The primary objective of this prespecified interim analysis was to assess the efficacy of iptacopan as compared with that of placebo in reducing proteinuria at month 9; the primary end point was the change from baseline in the 24-hour urinary protein-to-creatinine ratio at month 9. The proportion of patients who had a 24-hour urinary protein-to-creatinine ratio of less than 1 at month 9 without receiving rescue or alternative medication or undergoing kidney-replacement therapy (dialysis or transplantation) was a secondary end point. Safety was also assessed. The effect of iptacopan on kidney function will be assessed at the end of the 2-year double-blind treatment period.RESULTSThe main trial population included 222 patients in the iptacopan group and 221 in the placebo group. The interim efficacy analysis included the first 250 patients who underwent randomization in the main trial population (125 patients in each group) and who remained in the trial until month 9 or discontinued the trial by month 9. Safety was assessed in all the patients in the main trial population. At month 9, the adjusted geometric mean 24-hour urinary protein-to-creatinine ratio was 38.3% (95% confidence interval, 26.0 to 48.6; two-sided P<0.001) lower with iptacopan than with placebo. The reduction in proteinuria was supported by consistent results in secondary end point analyses. There were no unexpected safety findings with iptacopan. The incidence of adverse events that occurred during the treatment period was similar in the two groups; most events were mild to moderate in severity and reversible. No increased risk of infection was observed.CONCLUSIONSAmong patients with IgA nephropathy, treatment with iptacopan resulted in a significant and clinically meaningful reduction in proteinuria as compared with placebo. (Funded by Novartis; APPLAUSE-IgAN ClinicalTrials.gov number, NCT04578834.).","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":158.5,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490758","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}
Hiddo J.L. Heerspink, Meg Jardine, Donald E. Kohan, Richard A. Lafayette, Adeera Levin, Adrian Liew, Hong Zhang, Amit Lodha, Todd Gray, Yi Wang, Ronny Renfurm, and Jonathan Barrattthe ALIGN Study Investigators*From the Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (H.J.L.H.), the National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney (M.J.), the Division of Nephrology, University of Utah Health, Salt Lake City (D.E.K.), Stanford University, Stanford, CA (R.A.L.), the University of British Columbia, Vancouver, Canada (A. Levin), Mount Elizabeth Novena Hospital, Singapore (A. Liew), Peking University First Hospital, Beijing (H.Z.), Chinook Therapeutics, Seattle (T.G.), Novartis, East Hanover, NJ (A. Lodha, Y.W.), Novartis, Basel, Switzerland (R.R.), and the University of Leicester, Leicester, United Kingdom (J.B.).
Patients with IgA nephropathy and severe proteinuria have a high lifetime risk of kidney failure. The efficacy and safety of the selective endothelin type A receptor antagonist atrasentan in reduci...
患有IgA肾病和严重蛋白尿的患者终生面临肾衰竭的高风险。选择性内皮素 A 型受体拮抗剂阿曲生坦（astrasentan）在降低 IgA 肾病患者蛋白尿方面的疗效和安全性，以及对肾衰竭患者的治疗效果都具有重要意义。
{"title":"Atrasentan in Patients with IgA Nephropathy","authors":"Hiddo J.L. Heerspink, Meg Jardine, Donald E. Kohan, Richard A. Lafayette, Adeera Levin, Adrian Liew, Hong Zhang, Amit Lodha, Todd Gray, Yi Wang, Ronny Renfurm, and Jonathan Barrattthe ALIGN Study Investigators*From the Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (H.J.L.H.), the National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney (M.J.), the Division of Nephrology, University of Utah Health, Salt Lake City (D.E.K.), Stanford University, Stanford, CA (R.A.L.), the University of British Columbia, Vancouver, Canada (A. Levin), Mount Elizabeth Novena Hospital, Singapore (A. Liew), Peking University First Hospital, Beijing (H.Z.), Chinook Therapeutics, Seattle (T.G.), Novartis, East Hanover, NJ (A. Lodha, Y.W.), Novartis, Basel, Switzerland (R.R.), and the University of Leicester, Leicester, United Kingdom (J.B.).","doi":"10.1056/nejmoa2409415","DOIUrl":"https://doi.org/10.1056/nejmoa2409415","url":null,"abstract":"Patients with IgA nephropathy and severe proteinuria have a high lifetime risk of kidney failure. The efficacy and safety of the selective endothelin type A receptor antagonist atrasentan in reduci...","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":158.5,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490553","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}
{"title":"Way Stations in Progress - Burgeoning Treatment Options for IgA Nephropathy.","authors":"Julie R Ingelfinger","doi":"10.1056/nejme2413288","DOIUrl":"https://doi.org/10.1056/nejme2413288","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":158.5,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490759","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 : 2024-10-24Epub Date: 2024-10-19DOI: 10.1056/NEJMp2403935
Douglas B White, Mark Wicclair
{"title":"Navigating Clinicians' Conscience-Based Refusals to Provide Lawful Medical Care.","authors":"Douglas B White, Mark Wicclair","doi":"10.1056/NEJMp2403935","DOIUrl":"10.1056/NEJMp2403935","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":96.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481181","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 : 2024-10-24Epub Date: 2024-10-19DOI: 10.1056/NEJMp2405572
Cori Uccello, Gretchen Jacobson, Melinda J B Buntin
{"title":"The Opportunity Costs of Medicare Advantage Plan Rebates.","authors":"Cori Uccello, Gretchen Jacobson, Melinda J B Buntin","doi":"10.1056/NEJMp2405572","DOIUrl":"10.1056/NEJMp2405572","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":96.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481182","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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