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Gastroenterology & Hepatology
15th Jan, 2026
The Lancet
Worldwide, colorectal cancer is the second leading cause of cancer-related mortality and the third most common cancer, with incidence rates increasing among individuals younger than 50 years.1 Although there are multiple effective colorectal cancer screening modalities, uptake is variable. Disparities in screening participation are driven, in part, by social determinants of health, including educational attainment, income, and living environment. For example, in the USA, screening rates are lowest among non-White individuals, the uninsured, those with low income, and individuals without a high school degree.
Inflammatory bowel disease (IBD) has expanded beyond its initial confines of early industrialised countries in North America, Europe, and Oceania and now constitutes a global illness. Once rare in the Middle East and north Africa region, analyses using the Global Burden of Disease 2019 Study database showed a 30% increase in age-standardised IBD incidence from 1990 to 2019, with prevalence estimates at 48·3 per 100 000 people;1 a study by Hracs and colleagues analysing the global epidemiological evolution of IBD indicates that the Middle East and north Africa region is currently at stage 2, with growing incidence and rising prevalence.
Interleukin-23 (IL-23) plays a pivotal role in the complex pathogenesis of both ulcerative colitis and Crohn's disease, making it a promising therapeutic target.1 Mirikizumab is a humanised IgG4 monoclonal antibody that selectively inhibits IL-23 by binding to its p19 subunit. The drug has been approved for moderate-to-severe adult ulcerative colitis; however, clinical trials in the paediatric population are still in earlier stages of development. In The Lancet Gastroenterology & Hepatology, Jess L Kaplan and colleagues report data from SHINE-1, the first phase 2 trial of mirikizumab in children with moderate-to-severe ulcerative colitis.
The Advisory Committee on Immunization Practices (ACIP), a panel that advises the US Centers for Disease Control and Prevention (CDC) on national vaccine policy, voted on Dec 5, 2025, to abandon recommendations for universal hepatitis B vaccination in newborns, revoking guidance that had seen the number of childhood cases of hepatitis B virus (HBV) infection in the USA fall by 99% since being adopted in 1991.
Haematology
β-thalassaemia is an inherited haemoglobinopathy characterised by ineffective erythropoiesis and chronic anaemia of varying severity, which is predominant in the region extending from the Mediterranean basin and Middle East towards southeast Asia. Patients with severe phenotypes require lifelong transfusions, iron overload monitoring, and chelation. Suboptimal management due to access challenges continues to be directly linked to increased morbidity and mortality in many regions. In the past few decades, an improved understanding of the underlying pathogenesis of β-thalassaemia has led to the development of several disease-modifying therapies and curative gene manipulation techniques.
During extended treatment for cancer-associated VTE, four predictors of clinically relevant bleeding were identified in the overall population, with no evidence of interaction with the dosing regimen. Although the API-CAT study was not designed to specifically address anticoagulation discontinuation, our findings might help clinicians to more effectively balance the benefits and risks of extended anticoagulant therapy.
In patients with Richter transformation, epcoritamab monotherapy showed clinically meaningful antitumour activity, although the investigator-assessed overall response rate was below the alternative hypothesis of 50%, with a safety profile consistent with previous studies. These findings support further investigation of epcoritamab as a potential treatment option for patients with Richter transformation.
The conduct of thalassaemia-related clinical trials in Lebanon, a nation recently afflicted by armed conflict, reflects the exceptional resilience, ingenuity, and adaptability of its health-care professionals. Despite enduring an escalating threat of armed violence, clinical research in Lebanon has not only survived, but it has also evolved. This Global haematology article outlines how thalassaemia clinical trials were managed under wartime conditions at the Chronic Care Center, a specialised long-term care thalassaemia centre located in Hazmieh, Lebanon, and affiliated with the American University of Beirut in Lebanon.
I was 8 years old when my spleen nearly ruptured. The first sign was not pain but the sudden inability to finish dinner—dangerous ground in a Cypriot immigrant family. My mother rubbed warm olive oil on my abdomen, a home remedy that offered comfort but no cure. Days later we learned my spleen had grown so large it pressed against my stomach, making eating impossible. Despite days in hospital and a transfusion, my greatest relief was being absolved of the cardinal sin of leaving my mother's louví (black eyed peas) unfinished.
“The patient voice, especially when informed and reflective, can illuminate blind spots that data alone cannot,” writes Roanna Maharaj, a patient with β-thalassaemia, emphasising the importance of patients being active participants in decision making, and one of several articles on thalassaemia in this issue of The Lancet Haematology. That there are now multiple treatment options is a testament to the work that has gone into improving outcomes for patients in recent years and is also discussed in a Viewpoint that presents a prioritisation-based matrix for deciding how best to treat transfusion-dependent β-thalassaemia in settings with limited resources.
The development of bispecific antibodies to treat B-cell non-Hodgkin lymphoma has marked a substantial advance that offers new hope for patients. The bispecific T-cell engager epcoritamab joins a growing list of treatments for several lymphoma settings, with encouraging results presented at the American Society of Hematology (ASH) annual meeting. In the EPCORE FL-1 trial, 488 patients with relapsed or refractory follicular lymphoma received lenalidomide and rituximab with and without epcoritamab, with a positive result for the dual primary endpoint of overall response rate and progression-free survival leading to this combination being approved by the US Food and Drug Administration (FDA) on Nov 18, and it joins mosunetuzumab as a bispecific antibody treatment option for this disease setting.
Regional Health – Europe
Stigma from HCPs is a quantifiable contributor of treatment disengagement, representing a direct threat to patient safety and a major contributor to the SUD treatment gap. These findings underscore the urgent need for evidence-based interventions, including training HCPs across all specialties in non-stigmatizing communication, to improve healthcare engagement for this vulnerable population and narrow the substantial treatment gap.
General Medicine
Climate change inflicts substantial economic damage on developing African nations, threatening progress towards the UN Sustainable Development Goals. There are synergies between actions needed to tackle climate change and other ongoing development priorities for Africa, including infectious disease control, facilitating clean energy access, reducing air pollution, tackling malnutrition and food insecurity, and providing universal health coverage. Action to protect human health against climate change needs to be integrated into all systems that are responsible for delivering essential services and implementing policies across all sectors that underpin the attainment of key development priorities for Africa.
Epcoritamab plus R2 resulted in significantly higher response rate and longer progression-free survival versus R2 among participants with follicular lymphoma who had received at least one line of therapy. Epcoritamab plus R2 had more grade 3 or higher adverse events versus R2. Adverse events were manageable and consistent with the established safety profiles of the individual components, with no new safety findings identified. These findings position epcoritamab plus R2 as a new standard of care for second-line or subsequent treatment of follicular lymphoma.
Workowski KA. Zoliflodacin shows benefit as an oral treatment for uncomplicated gonorrhoea. Lancet 2026; 407: 108–109—In the last sentence of the first paragraph in this Comment, the name of the Global Antibiotic Research and Development Partnership has been corrected. In the second paragraph, the 11th sentence has been amended to read: “Microbiological cure rates at the urogenital site were 460 (90·9%, 95% CI 88·1–93·3) of 506 participants for the zoliflodacin group and 229 (96·2%, 92·9–98·3) of 238 participants for the comparator group, with the difference between groups meeting the prespecified non-inferiority margin.” Additionally, the last sentence in the second paragraph has been amended to read: “For the secondary endpoints of microbiological cure at the rectal and pharyngeal sites, 79% of participants in the microbiological intent to treat population and over 90% of participants in the evaluable population in both treatment groups were cured;however, the study was underpowered for extragenital endpoints.” These corrections have been made to the online version as of Jan 8, 2026, and the printed version is correct.
What's New: Drugs
6th Apr, 2026
FDA
Center,
Research
7th Apr, 2026
