The edition · Top Clinical Updates
A dual agonist delivers in diabetes with obesity, and two popular ideas fall flat
Survodutide, a glucagon/GLP-1 dual agonist, cut weight meaningfully in people with type 2 diabetes, while faecal transplant for IBS and added immunotherapy for early lung cancer both failed in phase 3, alongside a shorter antibiotic course that held up.
The edition in brief
Today's cross-specialty edition leads with SYNCHRONIZE-2, a phase 3 trial of survodutide, a glucagon/GLP-1 dual agonist, in adults with type 2 diabetes and obesity: weight fell about 9.8% at the higher dose versus 3.9% with placebo over 76 weeks, with modest HbA1c gains and the usual gastrointestinal effects. Two widely discussed ideas then fell flat in phase 3: faecal microbiota transplantation gave no benefit over placebo in moderate-to-severe IBS (40% vs 38% responders), and adding atezolizumab to stereotactic radiotherapy in inoperable early-stage non-small-cell lung cancer did not improve survival (hazard ratio 1.04) while trebling grade 3 or higher toxicity. A clinic pearl covers medication reconciliation at every transition of care. The edition closes on SOLARIO, which found that when a local-antibiotic carrier is implanted at orthopaedic infection surgery, a short systemic antibiotic course (7 days or less) was noninferior to four weeks or more for treatment failure, with far fewer treatment-related symptoms, a genuine stewardship gain in a defined setting.
A glucagon/GLP-1 dual agonist cuts weight in diabetes with obesity
Note survodutide as an investigational dual agonist with GLP-1-range weight loss and modest glycaemic benefit in diabetes with obesity; it is not yet available to prescribe.
Faecal transplant did not help irritable bowel syndrome
Do not offer or recommend faecal microbiota transplantation for IBS; a well-conducted phase 3 trial shows no benefit.
Immunotherapy added to radiotherapy did not help early lung cancer
Do not add atezolizumab to SBRT for inoperable early-stage NSCLC outside a trial; it did not improve survival and increased harm.
Reconcile the medication list at every transition of care
Reconcile medications from multiple sources at every transition and document why each change was made.
With local antibiotics, a short systemic course held up in bone infection
When a local-antibiotic carrier is implanted at orthopaedic infection surgery, consider a short (7-day or less) systemic antibiotic course rather than a prolonged one.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this one is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for top clinical updates, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free