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Rheumatology
11th Mar, 2026
The New England Journal of Medicine
A 63-year-old woman with psoriatic arthritis presented with a 9-month history of pain in the left knee. A nontender, palpable mass was present in the left popliteal fossa, which had a “speech bubble” shape on ultrasonography.
In patients with SLE without advanced lupus nephritis, obinutuzumab plus standard therapy was superior to placebo plus standard therapy in conferring and sustaining a clinically meaningful reduction in disease activity over 52 weeks.
Microbe / Infectious Research
The Lancet
Controlled human infection models (CHIMs) can accelerate vaccine development for infectious diseases. Mycobacterium tuberculosis is a human-adapted pathogen that is the leading infectious cause of death worldwide. M tuberculosis infection results in a spectrum of clinical outcomes that are incompletely modelled in animals. To date, the risks of infection, prolonged treatment, and sequelae related to CHIMs with M tuberculosis have been considered ethically unacceptable. However, recent advances in bacterial engineering have resulted in safe strains that could permit M tuberculosis CHIM studies with reduced risks.
Antimicrobial resistance (AMR) remains a major global health threat. Despite increasing international attention, AMR governance has often neglected social and equity dimensions, and there is a crucial need to synthesise evidence from social sciences and humanities scholarship to devise more people-centred approaches. In this Personal View, we report a qualitative stocktake of the intended and unintended consequences of the most recent phase of global AMR governance that started around the year 2000 and reached a high point with the 2015 Global Action Plan (GAP) on AMR.
Antibacterial research and development (R&D) increasingly relies on public and philanthropic investments over private investments and on academia and small businesses over large pharmaceutical companies. To complement scientific reviews of the antibacterial pipeline, we examined global public and philanthropic funding for R&D of antibacterial therapeutics from 2017 to 2023 using data obtained from the Global AMR R&D Hub’s Dynamic Dashboard. Projects were analysed considering funders and recipients, geographical location, R&D stage, mechanism of action, antibacterial class, clinical novelty, spectrum of activity, and alignment with the WHO bacterial priority pathogen list 2024.
Pneumococcal invasiveness varies by serotype, age group, country income group, HIV status, and over time; however, substantial variation remains unexplained. Our CCRs represent the most representative estimates of invasiveness currently available for use in statistical or mathematical prediction models of disease incidence, where only carriage prevalence data are available.
In a prospective, representative sample of patients with Xpert-tested rifampicin-resistant tuberculosis, we found an elevated prevalence of bedaquiline resistance, particularly in patients with recent tuberculosis treatment. Efficient and accurate surveillance for bedaquiline resistance should be a high programmatic priority.
tNGS can recover near-complete B pertussis genomes directly from clinical specimens, enabling identification of macrolide resistance mutations and high-resolution phylogenetic analysis. These findings show that tNGS complements PCR-based surveillance by providing genome-wide assessment of resistance, virulence, and genomic diversity in a single workflow.
Lineage C appears capable of establishing endemic transmission in new regions, with ongoing diversification observed during interepidemic periods. These observations reinforce the value of continuous genomic surveillance, particularly during cryptic transmission phases when adaptive mutations might emerge. Although further evidence is needed, observed trends in climate variability and land-use change point to the potential benefit of targeted surveillance in settings that could be at increased risk, including urban centres and wetlands.
Some Cambodian P vivax parasites clear slowly after artesunate treatment, possibly due to a downregulation of haemoglobin metabolism that might reduce the efficiency of the artesunate. The slow clearance could allow parasites to outlast artesunate treatment and facilitate emergence of resistance to the artemisinin-combination therapy partner drug, threatening malaria elimination effort.
Our findings indicate partial direct protection by PCV13 against Spn3 colonisation acquisition, with differential protection against the clades and no protection by PPV23 against clade Iα. By contrast, PCV13 protected against Spn6B colonisation for at least 6 months. These findings align with epidemiological evidence, indicating that, although PCV13 vaccination against Spn6B offers sustained direct and indirect protection, its effect on Spn3 colonisation and therefore indirect protection is limited.
A single administration of lenacapavir, teropavimab, and zinlirvimab in the study population demonstrated similar efficacy to daily oral ART through to week 26. This regimen was well tolerated, with no serious adverse events, supporting its potential as the first complete twice-yearly, long-acting, injectable HIV-1 treatment.
Antimalarial regimens of APAP and AFC have unique characteristics to tackle the development and spread of drug-resistant P falciparum malaria. Given that APAP and AFC were safe, well tolerated, and highly efficacious in this clinical phase 2 study, they constitute promising multidrug combination regimens for further clinical development.
On Sept 24, 2025, two agreements were announced between funders and generic drug manufacturers. The two agreements ensured the availability of groundbreaking twice-yearly injectable HIV pre-exposure prophylaxis (PrEP) drug lenacapavir at an annual price of US$40 per patient in 120 low-income and middle-income countries (LMICs) from 2027.
Hopkins J, Lee SJ, Waithira N, et al. Prospective characterisation of drug-resistant bloodstream infections in Africa and Asia (ACORN2): a surveillance network assessment. Lancet Microbe 2026; 7: 101228—In this Article, in figure 1, the second-last line of the final box should have read 407 Staphylococcus aureus. This correction has been made as of Feb 13, 2026.
