Lancet
Audio Summaries

Primary sclerosing cholangitis

Mar 23, 2026

This article investigates the clinical features, pathogenesis, and management challenges of primary sclerosing cholangitis (PSC), a rare chronic liver disease often associated with inflammatory bowel disease. The authors aim to clarify the disease's variable presentation, the role of genetic and environmental factors, including the intestinal microbiome, and the limited treatment options available. The seminar highlights the need for a deeper understanding of PSC to improve patient outcomes and management strategies.

Efficacy and safety of oral semaglutide 14 mg (flexible dose) in early-stage symptomatic Alzheimer's disease (evoke and evoke+): two phase 3, randomised, placebo-controlled trials

Mar 22, 2026

The evoke and evoke+ trials aimed to evaluate the efficacy and safety of oral semaglutide (14 mg) in individuals with early-stage symptomatic Alzheimer's disease. The results indicated that semaglutide did not significantly slow clinical progression compared to placebo, and while safety profiles were consistent with other indications, the treatment did not demonstrate the expected benefits in this population.

Survival outcome of VATS compared with open lobectomy for lung cancer: an individual patient data meta-analysis of randomised trials

Mar 21, 2026

The authors aimed to determine whether video-assisted thoracoscopic surgery (VATS) for pulmonary lobectomy in early-stage lung cancer offers equivalent oncological outcomes compared to open lobectomy, specifically focusing on overall and disease-free survival. Their individual patient data meta-analysis of three randomized trials involving 1,185 patients found that VATS significantly improved overall survival by 21% without compromising disease-free survival. These findings suggest that VATS should be prioritized as the preferred surgical approach for eligible patients.

Angiography-derived fractional flow reserve versus coronary angiography to guide coronary artery bypass grafting in patients undergoing surgical valve procedures with concomitant coronary artery disease in China (FAVOR IV-QVAS): a multicentre, triple-blind, randomised trial

Mar 21, 2026

The study aimed to determine whether a physiologically guided strategy using angiography-derived fractional flow reserve (FFR) could improve clinical outcomes compared to the traditional anatomically guided approach for coronary artery bypass grafting (CABG) in patients undergoing surgical valve procedures with concomitant coronary artery disease. Results showed that the FFR-guided CABG significantly reduced the incidence of adverse perioperative outcomes and long-term complications compared to the standard method, suggesting that physiological assessment may enhance surgical decision-making in this patient population.

Prevention of urinary stones with hydration: a randomised clinical trial of an adherence intervention

Mar 21, 2026

This study aimed to evaluate the effectiveness of a multicomponent behavioral intervention designed to increase fluid intake in reducing symptomatic urinary stone recurrence compared to standard care. The results indicated that while the intervention modestly increased urine volume, it did not significantly reduce the rate of recurrent stone events over a two-year follow-up period. Overall, the findings suggest that enhancing fluid intake through behavioral strategies may not be sufficient to prevent urinary stones in recurrent stone formers.

More equitable preconception health: paternal life course opportunities for better pregnancy, child, and family outcomes

Mar 19, 2026

The authors aim to address the overlooked role of men in preconception health and its impact on pregnancy and family outcomes. They argue that integrating men's health into preconception care can correct historical biases and improve intergenerational health, particularly for marginalized communities. Through a transdisciplinary review and case studies, the paper advocates for more equitable health interventions that consider the experiences and health of young men.

Measuring progress in pregnancy planning and preconception health

Mar 19, 2026

The authors aim to address the lack of comprehensive surveillance systems for monitoring preconception health and pregnancy planning by proposing a new framework that incorporates both system-level and individual-level indicators. They emphasize the importance of including community perspectives in the development of these indicators and outline an international collaboration to establish a core set of indicators applicable across diverse economic contexts. The review ultimately seeks to enhance global monitoring efforts in this critical area of maternal health.

Pyruvate kinase activators in hereditary haemolytic anaemias: current evidence and clinical potential

Mar 15, 2026

The authors investigate the potential of pyruvate kinase activators as a therapeutic option for hereditary haemolytic anaemias, which are prevalent genetic disorders with limited treatment options. They highlight recent evidence showing that these activators can enhance glycolysis, improve ATP production, and alleviate symptoms in various haemolytic conditions, while also maintaining a favorable safety profile. The paper emphasizes the need for ongoing research to explore additional applications of pyruvate kinase activators in treating these disorders.

Integrated community-based versus facility-based care for people with HIV, diabetes, and hypertension in sub-Saharan Africa (INTE-COMM): an open-label, multicountry, cluster-randomised trial

Mar 14, 2026

The study aimed to compare the effectiveness of integrated community-based care versus facility-based care for managing HIV, diabetes, and hypertension in sub-Saharan Africa. The findings indicated that while there was no significant difference in blood pressure or glucose control between the two care models for patients with diabetes or hypertension, community care achieved high rates of viral suppression for individuals with HIV. This suggests that community-based care can maintain quality outcomes for HIV management while effectively addressing other chronic conditions.

Sickle cell disease

Mar 14, 2026

This Seminar aims to provide a comprehensive update on sickle cell disease, focusing on its complex pathophysiology and the spectrum of acute and chronic complications it causes. The authors review recent advancements in treatment options, including hydroxyurea, transfusion therapy, and gene therapies, while also addressing implementation strategies in low-resource settings and ongoing challenges in managing various disease variants. Ultimately, the paper seeks to enhance understanding and improve care for individuals affected by this genetic disorder.