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In adults with type 1 diabetes and chronic kidney disease with albuminuria, the decrease in the urinary albumin-to-creatinine ratio was significantly greater with finerenone than with placebo. Full phase 3 FINE-ONE trial results: https://www.nejm.org/doi/full/10.1056/NEJMoa2512854 Editorial: Finerenone for Diabetic Kidney Disease in Type 1 Diabetes — A Fine Answer? https://www.nejm.org/doi/full/10.1056/NEJMe2600575

Perspective by Sarah Lee, MD: An Incidental Finding Unraveled https://www.nejm.org/doi/full/10.1056/NEJMp2509681 #MedicalEthics #MedicalPractice

Mpox continues to spread in many communities. Tecovirimat has activity against orthopoxviruses in vitro. In a phase 3 trial involving patients with acute mpox, tecovirimat showed no evidence of clinical activity. Full STOMP/A5418 trial results and Research Summary: https://www.nejm.org/doi/full/10.1056/NEJMoa2506495

Images in Clinical Medicine: Subacute Sclerosing Panencephalitis after Measles Infection https://www.nejm.org/doi/full/10.1056/NEJMicm2504828 #Neurology #IDTwitter

A new review by Karen M. Puopolo, MD, PhD, describes the microbiologic and epidemiologic features, pathogenesis, treatment, and prevention of group B streptococcal disease. Read the full review: https://www.nejm.org/doi/full/10.1056/NEJMra2313146

𝐍𝐨𝐰 𝐚𝐯𝐚𝐢𝐥𝐚𝐛𝐥𝐞 𝐢𝐧 𝑵𝑬𝑱𝑴 𝑬𝒗𝒊𝒅𝒆𝒏𝒄𝒆! A new Public Health Alerts report, published in partnership with @CIDRAP: Antibodies Elicited by the 2025–2026 Influenza Vaccine https://eviden.cc/47fN8Oz #IDTwitter

Perspective by Sanjay V. Desai, MD (@sanjayvdesai), Sal Khan, MBA (@salkhanacademy), and Kimberly Lomis, MD (@KimLomisMD): AI-Enabled Precision-Education Systems — Transforming Lifelong Learning in Medicine https://www.nejm.org/doi/full/10.1056/NEJMp2512935 #ArtificialIntelligence #MedEd

In persons with HIV and barriers to adhering to antiretroviral therapy, a long-acting injectable treatment (monthly cabotegravir plus rilpivirine) resulted in better virologic control than standard oral ART. Full LATITUDE trial results and Research Summary: https://www.nejm.org/doi/full/10.1056/NEJMoa2508228

Can coffee and tea prevent dementia? @NEJMClinician Editor-in-Chief Raja-Elie Abdulnour, MD (@BageLeMage), shares his take on an observational study on whether caffeinated coffee and tea consumption could reduce the risk of dementia. Full context and comment by Lead Editor Christopher W. Goodman, MD: https://jwat.ch/4aMBZpt Visit http://clinician.nejm.org for all that's brewing this week, including: 👁️ Can GLP-1 Agonists Cause Vision Loss? ❤️ Updated Guidelines for Advanced Cardiac Life Support 🏃‍♂️ How Does Exercise Benefit Children with Autism? 🧪 Procalcitonin in the ICU: A Test That Promises More Than It Delivers

Real-time case review and clinical intervention, as prompted by the analysis of imminent hospitalization prediction models, are associated with lower odds of hospitalization for hemodialysis patients at risk of fluid overload or infection. 👉 https://nej.md/4aEGToC Patients with end-stage kidney disease (ESKD) have a high rate of hospitalizations related to fluid overload and infections. #ArtificialIntelligence (AI)–driven models may improve patient care by predicting the risk of hospitalization. Chaudhuri and colleagues conducted a retrospective, observational matched cohort study of adult patients with ESKD who were receiving value-based hemodialysis at integrated kidney care clinics across the United States in 2023. The results are now published in NEJM Catalyst Innovations in Care Delivery. Two AI-powered machine learning models calculated risk scores (range: 0–1) and the models identified patients with a risk score of 0.64 or above who were at risk for hospitalization within 7 days in relation to infections or fluid status abnormalities. To prevent avoidable hospitalizations, case reviews and interventions were conducted for the patients identified by the models. The AI models generated scores for all patients, but only high-risk scores triggered case review and possible intervention. The authors linked electronic medical records and Medicare claims data and conducted multivariate logistic regression analyses to examine the impact of AI-driven interventions on the odds of all-cause hospitalization in patients with ESKD. A total of 10,294 patients representing 83,928 risk scores were included in the analysis. AI-driven interventions were associated with a reduction in the odds of hospitalization among patients with ESKD receiving managed kidney care. These findings underscore AI’s potential to assist health care providers with targeted risk interventions for patients with ESKD. Read “AI-Driven Interventions for Imminent Hospital Admissions in Patients with End-Stage Kidney Disease: A Medicare and EMR-Based Analysis” by S. Chaudhuri et al. in the March 2026 issue of @nejmcatalyst Innovations in Care Delivery: https://nej.md/4aEGToC Explore the full issue: https://nej.md/40e5VG6

Images in Clinical Medicine: Primary Measles Infection https://nej.md/4tSKIiB #DermTwitter #IDTwitter

Group B streptococcal infection mostly affects newborns, infants, pregnant persons, and older adults. Perinatal prevention is successful but contributes to antibiotic exposure. Multivalent glycoconjugate vaccines are in development. Read the full review: https://nej.md/4aJJ6Pv

Hey look! @nejm moved my writing to a new spot. Here's the first post, a rant about a particularly annoying requirement for those of us in work in hospitals (link below) 1/3

This study demonstrates that an end-to-end, multitask deep learning framework applied to overnight sleep electroencephalography can derive a latent representation of brain health distilled into a single, interpretable score. Full study results: https://nejm.ai/4sbnrqw

Don't miss Eric Rubin, MD, PhD, Editor-in-Chief of @NEJM as he shares opening remarks at our free live web event Judgment Calls: Navigating Uncertainty in Clinical Practice. Learn more about this free event and sign up: https://events.nejm.org/events/790?promo=OCAYTN26&query=cli-social&utm_source=x&utm_medium=social&utm_campaign=2026_clievent0310

In patients with HER2-positive early breast cancer and residual disease after neoadjuvant therapy, trastuzumab deruxtecan improved invasive disease–free survival but carried a risk of interstitial lung disease. Full phase 3 DESTINY-Breast05 trial results and Research Summary: https://nej.md/4an3Az2

From an Original Article published March 10, 1966: A male infant was delivered by cesarean section after 32 weeks' gestation. The mother, a 37-year-old gravida 5, para 3, had previously given birth to twins. All infants had been delivered by cesarean section, the original operation being done for cephalopelvic disproportion. Five days before delivery the mother had had a nonspecific upper-respiratory-tract infection but had been afebrile and had received no antibiotics. There was no bleeding, vaginal discharge or symptoms of vaginitis at any time during the pregnancy. Premature labor began on January 4, 1965, and cesarean section was performed under spinal anesthesia after 14 hours of intermittent labor. The membranes were intact at the time of delivery. At birth the infant was apneic and cyanotic, with a heart rate of 80 per minute and with poor motor tone. The skin, umbilical cord and nails were meconium stained. Five milliliters of green, tenacious meconium was aspirated from the stomach. Intermittent positive-pressure oxygen was given. At the end of 5 minutes respirations were shallow but spontaneous. The color, cry and tone were good. Physical examination at birth revealed a diffuse, macular, erythematous rash involving the face, thorax, abdomen and upper and lower extremities excluding the palms and soles. Several petechiae were noted on the lower back. There was no conjunctivitis, and the mucous membranes were normal. Breath sounds were present bilaterally but were diminished. No rales were heard. The heart was unremarkable, and there was no hepatosplenomegaly. The extremities were normal. The birth weight was 2736 gm. (6 pounds and 1/2 ounce). Read the full case details in “Congenital Systemic Candidiasis — Report of a Case,” an article from 1966, in the NEJM Archive: https://nej.md/4tXIXks

Correspondence: Microbial Flora in War Wounds from the Ukrainian Front Line https://nej.md/4l1hpqk #IDTwitter #PublicHealth

The authors of a Perspective argue that recent FDA actions related to leucovorin have caused confusion. There is still a lack of scientific evidence establishing that the drug is a safe and effective treatment for autism. Learn more: https://nej.md/3NxgKjA

Effective therapeutics are needed for mpox. Tecovirimat is FDA-approved to treat smallpox, but its efficacy and safety in patients with mpox have been unclear. Research findings from the Phase 3 STOMP/A5418 trial are summarized in a new Quick Take video. https://nej.md/4chKFXz

A 47-year-old woman presented to the dermatology clinic with a 1-year history of a crawling sensation on her chin that caused her to scratch the area. Read the full case details and submit your answer or see how others responded: https://nej.md/IC02262026

A schematic diagram of components used in total knee arthroplasty shows the femoral component and tibial baseplate, which are constructed with metal such as cobalt–chromium or titanium alloy, and the tibial insert and patellar implant, which are made of highly cross-linked polyethylene. The patellar implant is included in many, but not all, procedures. Wear of these components may lead to shedding of particles, triggering an inflammatory response. Learn more in “A 91-Year-Old Man with Left Knee Pain,” a Case Record of the Massachusetts General Hospital, by S.B. Nelson et al., from Massachusetts General Hospital (@MassGeneralNews), @harvardmed, and @BrighamWomens: https://nej.md/4c6fw9k

The authors of a Perspective write that Medicare will achieve greater savings on the 15 drugs in its second round of price negotiations than it did in the first round. Despite new challenges, the effort should continue to pay growing dividends. Learn more: https://nej.md/4tz54h1

Phase 3 LATITUDE trial: Randomized trials of long-acting antiretroviral therapy are lacking in patients with HIV and challenges with adherence to oral therapy. Research findings with long-acting cabotegravir plus rilpivirine are summarized in a new Quick Take video. https://nej.md/4s6P7wP

Original Article: Tecovirimat for the Treatment of Mpox (phase 3 STOMP/A5418 trial) https://nej.md/4rdlMA9 #IDTwitter #GlobalHealth

Battlefield injuries are often contaminated with potentially infecting microbes. In this study, swabs obtained in the field after injury were profiled. Microbes and potential antimicrobial-resistance genes were characterized. Full study results: https://nej.md/4l1hpqk

A 7-year-old boy was brought to a hospital with a 3-month history of cognitive deterioration and seizures. He had contracted measles at 7 months of age while living in an area where the infection is endemic. Read the full case details in the Images in Clinical Medicine article “Subacute Sclerosing Panencephalitis after Measles Infection,” from Children’s Hospital of Orange County (@chocchildrens) and University of California, Irvine (@UCIrvine): https://nej.md/4qY4Ihk

Bruce A. Chabner, MD, discusses recent FDA statements regarding potential uses for leucovorin. Listen to the full interview with NEJM Executive Managing Editor Stephen Morrissey (@srm128): https://nej.md/4aNrG4J

Physicians throughout Minnesota bear witness to the devastation that U.S. Immigration and Customs Enforcement is wreaking. They implore physicians everywhere to raise their voices. Read “We Do Care” by Bernard E. Trappey, MD, for Minnesota Physician Voices: https://nej.md/4akke1G

Phase 3 DESTINY-Breast05 trial: Patients with HER2-positive early breast cancer who have residual disease after neoadjuvant therapy are at high risk for recurrence. Research evaluating postneoadjuvant trastuzumab deruxtecan is summarized in a new Quick Take video. https://nej.md/4az805J

Original Article: Cabotegravir plus Rilpivirine for Persons with HIV and Adherence Challenges (phase 3 LATITUDE trial) https://nej.md/4qFyjMm Editorial: From Efficacy to Access in Long-Acting HIV Therapy https://nej.md/4rRRyTT #IDTwitter #GlobalHealth

In clinical practice, medicine rarely follows a script. Guidelines help, but cases and patients don’t always fit neatly into obvious categories. How do you lead with confidence when evidence is lacking, the path forward is unclear, and the stakes couldn't be higher? Join @NEJMClinician for a free virtual event on practicing in the gray zones of care — where experience, values, and human judgment carry more weight than guidelines alone. Register now: https://nej.md/4pEIfVW

A 47-year-old woman presented to the dermatology clinic with a 1-year history of a crawling sensation on her chin that caused her to scratch the area. The right corneal reflex was decreased, and pinprick and temperature sensation around the mouth, lip, and chin on the right side was reduced. With occlusive dressings, the ulcer healed, but it later recurred after being left uncovered. What is the diagnosis? https://nej.md/IC02262026

When a physician’s own incidental finding sends her down a long and winding path to find answers, she finds herself overcome with worry — but also, eventually, a new appreciation for life. Read the Perspective essay by Sarah Lee, MD: https://nej.md/3OYtO24

Original Article: Phase 1 Study of Rezatapopt, a p53 Reactivator, in TP53 Y220C–Mutated Tumors (PYNNACLE study) https://nej.md/3OIQC5P Science behind the Study: Restoring Function to a Variant of p53 in Solid Tumors https://nej.md/3N0pQW8 #Oncology #Genetics

Original Article: Trastuzumab Deruxtecan in Residual HER2-Positive Early Breast Cancer (phase 3 DESTINY-Breast05 trial) https://nej.md/4an3Az2 Editorial: Hitting the Mark — Individualizing Therapy for HER2-Positive Early-Stage Breast Cancer https://nej.md/3MUi3Jq #Oncology

Case Record of the Massachusetts General Hospital (@MassGeneralNews): A 91-year-old man was evaluated in the orthopedic surgery clinic of this hospital because of left knee pain. The patient had been in his usual state of health, residing in a senior living community and independent in activities of daily living, until 6 months before the current presentation, when left knee pain developed. He had undergone left total knee arthroplasty 20 years earlier, after which knee pain had not recurred until this presentation. The pain occurred at rest and was exacerbated by weight-bearing activity. During the next 4 months, the left knee pain worsened in severity, and the patient felt unstable when walking; he began using a rolling walker in his apartment and a wheelchair for longer distances. Read the full case details in “A 91-Year-Old Man with Left Knee Pain,” a Case Record of the Massachusetts General Hospital, by S.B. Nelson et al., from Massachusetts General Hospital (@MassGeneralNews), @harvardmed, and @BrighamWomens: https://nej.md/4c6fw9k

In the latest episode of the Not Otherwise Specified podcast, host and NEJM National Correspondent Lisa Rosenbaum and her guests discuss the extent to which online influencers and AI could someday substitute for trustworthy, caring, broad-spectrum family doctors. Listen to the full episode: https://nej.md/4cLCRgG Read the full episode transcript: https://nej.md/4u38A3p

New in the February 26, 2026, issue of NEJM: Trastuzumab Deruxtecan in HER2-Positive Breast Cancer (phase 3 DESTINY-Breast05 trial) https://nej.md/4an3Az2 Cabotegravir plus Rilpivirine for Persons with HIV (phase 3 LATITUDE trial) https://nej.md/4qFyjMm Rezatapopt in TP53 Y220C–Mutated Tumors (PYNNACLE study) https://nej.md/3OIQC5P Tecovirimat for the Treatment of Mpox (phase 3 STOMP/A5418 trial) https://nej.md/4rdlMA9 Subscribe to NEJM for the latest medical research: https://nej.md/subscribe

A fast-acting, self-administered nasal spray for supraventricular tachycardias (SVTs)? @NEJMClinician Editor-in-Chief Raja-Elie Abdulnour, MD (@BageLeMage), describes the recently FDA-approved drug etripamil, a nasal spray for the outpatient treatment of SVTs. Full context and comment by Associate Editor Mark S. Link, MD: https://jwat.ch/4qx49L1 Visit http://clinician.nejm.org for Ten Key Insights This Week, including: 🩺 New Guidance for Managing Diabetes 🦠 Patterns of Prolonged Malaise in Lyme Disease ❤️ Angina without Obstructive CAD: What’s the Prognosis? 💉 IV Iron during Acute Infection: Is the Concern Justified?