Sickle cell drug priorities, home infliximab in paediatric IBD, and what helps HbA1c

The edition in brief

Five findings for paediatricians and the clinicians who see children first. A WHO-convened Paediatric Drug Optimization process for sickle cell disease confirmed hydroxyurea as the leading near-term priority and called for age-appropriate soluble or dispersible formulations to improve access, with pyruvate kinase activators and decitabine-based regimens flagged as promising. A meta-analysis of five cohorts (162 children) found subcutaneous infliximab maintained clinical remission in about 90% of children with inflammatory bowel disease after switching from intravenous therapy, with roughly doubled drug levels and rare new antidrug antibodies, though certainty was low and the data are switch-only. A three-arm randomised trial in 630 Latino caregiver-infant dyads showed text reminders, with or without referral to community resources, improved child language, social-emotional development and parenting behaviours. A pearl covers the must-not-miss basics of childhood sickle cell care. The practice-changer is an updated meta-analysis of 46 randomised trials showing behavioural interventions still modestly improve HbA1c in youth with type 1 diabetes despite better technology, with family-focused, multicomponent approaches clearly outperforming youth- or parent-only strategies.