Benzodiazepines in early pregnancy: four million pregnancies show no rise in malformations

The edition in brief

An Annals of Internal Medicine cohort of more than 4.2 million US pregnancies found that a benzodiazepine prescription filled in the first trimester was not associated with a higher risk of major congenital malformations (pooled adjusted RR 0.99, 95% CI 0.96–1.03; absolute risk about 4–5% in both groups), with no dose-response and similar results across individual drugs. Co-exposure with other psychoactive drugs gave inconsistent signals. In the SYNCHRONIZE-2 phase 3 trial, weekly survodutide, a glucagon and GLP-1 receptor dual agonist, reduced body weight by 8.2% and 9.8% at 76 weeks against 3.9% with placebo in 752 adults with type 2 diabetes and obesity, with gastrointestinal effects in about three-quarters. In RAPIDe-3, oral deucrictibant relieved hereditary angioedema attacks with a median onset of 1.3 hours against more than 12 hours with placebo. A single-centre feasibility study of a patient-facing conversational AI before 98 urgent primary care visits required no safety stops but recorded one hallucination. The pearl separates histamine-mediated from bradykinin-mediated angioedema.