ustekinumab (Qoyvolma)

Baricitinib for treatment of ustekinumab-induced paradoxical eczematous reactions in a patient with plaque psoriasis.

Shobatake Chinatsu C, Miyagawa Fumi F, Mitsui Yasuhiro Y, Nakanishi Yukiko Y et al.

Nonadherence to GLP-1 Receptor Agonists Among Individuals With Overweight or Obesity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Shegena Efrata A EA, Kiflu Mekdes M, Ahmed Muktar M, Bhagavathula Akshaya Srikanth AS et al.

Glucagon-like peptide 1 (GLP-1) agonists are widely used for obesity management in patients with or without diabetes. However, treatment persistence is often limited due to adverse drug reactions (ADRs). Understanding adherence patterns in randomized controlled trials (RCTs) is crucial for predicting real-world treatment acceptance. To estimate the pooled nonadherence rates and reasons for nonadherence to GLP-1 agonists in overweight or patients with obesity participating in RCTs. A systematic review and meta-analysis of RCTs was conducted to evaluate nonadherence to GLP-1 receptor agonists. A literature search was performed in PubMed, Embase, and Web of Science from inception to October 2, 2024. Studies were included if they evaluated GLP-1 receptor agonists for overweight or obesity management and reported adherence outcomes. The pooled RR for nonadherence to GLP-1 receptor agonists was 0.63 (95% CI: 0.48, 0.82, p = 0.01), indicating a 37% lower risk of nonadherence compared with the control group. However, ADR-induced nonadherence was significantly higher in the GLP-1 group (RR: 2.29 [95% CI: 1.47, 3.56, p = 0.04]), particularly due to gastrointestinal side effects. Nonadherence due to loss to follow-up was lower in the GLP-1 group (RR: 0.43 [95% CI: 0.27, 0.71, p = 0.18]). GLP-1 receptor agonists were associated with a lower overall nonadherence rate in RCTs compared with control treatments, suggesting higher persistence. However, ADR-related nonadherence was significantly higher, particularly due to gastrointestinal side effects. These findings highlight the need for strategies to improve treatment tolerability and adherence in real-world settings.

Discontinuation of glucagon-like peptide-1 receptor agonists among US adults: A national survey.

DiStefano Michael J MJ, Zon Juliet J, Olson Erik G EG, Levy Joseph F JF et al.

Although many people discontinue glucagon-like peptide-1 receptor agonists (GLP-1 RAs), the reasons for discontinuation are unclear. To identify self-reported reasons for GLP-1 RA discontinuation among US adults. Cross-sectional survey of US adults fielded in June 2025 using Ipsos Omnibus and incorporating survey weights calibrated to census benchmarks. We included individuals who initiated a GLP-1 RA between January 2022 and June 2025 and subsequently discontinued therapy. Outcomes included duration of use, self-reported reason(s) for discontinuation, medication source, out-of-pocket payment, and insurance coverage. Descriptive statistics and chi-square tests for statistical significance were used. Of 7,035 individuals screened, 440 respondents met eligibility criteria and completed the survey. Of these 440 participants, 51.1% were female, 42.3% were aged between 18 and 34 years, and 23.8% reported having type 2 diabetes. More than half of these discontinuers (54.6%) reported discontinuing a GLP-1 RA within 6 months of initiation, and 79.7% reported discontinuation within 12 months of use. Approximately 1 in 7 (14.4%) reported sourcing GLP-1 RAs from a friend or family member, and more than half reported using a copayment coupon (35.4%) or free sample (22.0%). Many respondents (31.3%) reported first filling a prescription without insurance. Approximately 1 in 5 reported sourcing their medicine from a compounding pharmacy (9.8%) or Internet-based (9.1%) source. The most frequently cited reasons for discontinuation were cost (36.1%), side effects (33.3%), no insurance coverage (28.2%), and achieving a weight-loss goal (26.1%). Compared with those without diabetes, respondents with diabetes were significantly more likely to discontinue because of side effects (50.1% vs 28.1%, P = 0.0008). Respondents who reported sourcing their GLP-1 RA from a compounding pharmacy or Internet-based source were significantly more likely to discontinue because they perceived the medication to be ineffective compared with those who obtained their medication from a retail or mail-order pharmacy (17.5% vs 6.6%, P = 0.009). Neither diabetes status nor GLP-1 RA source was significantly associated with early discontinuation (<6 months). In this national survey, most US adults who stopped GLP-1 RAs did so within 6 months because of cost, adverse effects, lack of coverage, or having achieved a weight loss goal. Differences in coverage, costs, and sourcing are modifiable targets that may decrease high rates of GLP-1 RA discontinuation.

Kidney Injury Molecule-1 (KIM-1) in Renal Cell Carcinoma: Biological Foundations and Emerging Clinical Applications.

Talao Jason King JK, Correa Rohann R, Gunaratnam Lakshman L, Fernandes Ricardo R

Renal cell carcinoma (RCC) is a biologically heterogeneous malignancy characterized by variable clinical behavior and diverse molecular phenotypes. Although immune checkpoint inhibitors and targeted therapies have transformed the treatment landscape of advanced RCC, clinically validated biomarkers capable of improving risk stratification, therapeutic-decision making and disease monitoring remain lacking. Kidney injury molecule-1 (KIM-1), also known as hepatitis A virus cellular receptor-1 (HAVCR1) or T-cell immunoglobulin and mucin domain-containing protein-1 (TIM-1), has emerged as a biologically compelling investigational biomarker e because of its close relationship to proximal tubular epithelial injury and renal carcinogenesis. KIM-1 is a transmembrane glycoprotein minimally expressed in normal kidney tissue but markedly upregulated in dedifferentiated proximal tubular epithelial cells following injury, and in clear cell RCC, where its extracellular domain can be shed into plasma and urine. Beyond its role as a marker of tubular injury, KIM-1 participates in immune regulation, phagocytosis, inflammatory signaling and tissue remodeling, supporting its potential relevance to tumor biology. Clinical studies have demonstrated associations between elevated circulating KIM-1 levels and RCC diagnosis, recurrence risk, and survival outcomes, particularly in localized and postoperative disease settings. KIM-1 has additionally been investigated as a therapeutic target through antibody-drug conjugate approaches. Despite promising translational data, important limitations yet remain. Current evidence is predominantly prognostic rather than predictive, and substantial analytical and biological challenges continue to limit implementation. Assay standardization, clinically meaningful cutoffs, specimen selection, timing of sampling, and confounding by chronic kidney disease or nonmalignant renal injury remain incompletely resolved. Furthermore, evidence supporting incremental value beyond established clinicopathologic models remains limited. This review critically evaluates the biological rationale, analytical considerations and clinical evidence supporting KIM-1 in RCC. Particular emphasis is placed on distinguishing prognostic, predictive, pharmacodynamic, and therapeutic applications, as well as defining the evidentiary gaps that must be addressed before clinical implementation. Current evidence is derived predominantly from retrospective and exploratory analyses, and important limitations remain regarding assay standardization, biological specificity, chronic kidney disease-related confounding, and prospective validation. The review concludes with a summary of the evolving landscape of KIM-1-directed biomarker strategies in RCC, which may ultimately contribute to improved biologic risk stratification and biomarker-driven clinical investigation in RCC.