[Comment] MS-STAT2: lessons from negative trials in multiple sclerosis
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)01673-3/fulltext?rss=yes

Treatment of multiple sclerosis has had extraordinary success in the past decade, with the availability of several disease-modifying treatments targeting different mechanisms involved in disease pathophysiology. Despite these advancements, approval of these drugs is largely limited to patients with relapsing-remitting disease given their proven efficacy on measures of inflammation (ie, annualised relapse rate or formation of inflammatory lesions at MRI) in phase 2 and phase 3 clinical trials. Use of these treatments in patients with progressive multiple sclerosis has yielded largely negative results, contributing to the gap of treatment accessibility for these forms of the disease.

[Articles] Effect of repurposed simvastatin on disability progression in secondary progressive multiple sclerosis (MS-STAT2): a phase 3, randomised, double-blind, placebo-controlled trial
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)01039-6/fulltext?rss=yes

The MS-STAT2 trial did not show a treatment effect of simvastatin in slowing disability progression in SPMS. Simvastatin use in multiple sclerosis should be confined to existing vascular indications.

[Articles] Global hospital-based disease management of acute diverticulitis: a prospective, international cohort study
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(25)00481-X/fulltext?rss=yes

This large, global study reveals significant variation in the management and outcomes of patients presenting to hospital with acute diverticulitis. Antibiotic use and hospital admission for uncomplicated disease was high, and significant variation in stoma formation was observed. Patients presenting in low-middle income units were more likely to undergo emergency surgery and this was associated with a higher 30-day mortality rate.

[Articles] Oesophageal cancer multi-disciplinary tool: a co-designed, externally validated, machine learning tool for oesophageal cancer decision making
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(25)00460-2/fulltext?rss=yes

We present a novel, responsibly developed, externally validated AI CDSS trained to predict oesophageal cancer MDT decisions. It represents the foundations of a transformative application of ML, personalised, consistent and efficient MDT decision-support within OC which aligns to RRI principles.

[Series] Anti-cytokine biologics for asthma in adults
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)01625-3/fulltext?rss=yes

An estimated 3–10% of patients with asthma are unable to reach full control with currently available inhaled therapies. In a large proportion of these patients, asthma can be driven in whole or in part by type 2 (T2) inflammation, which is usually initiated by an immunological response to stimulation at mucosal surfaces. The introduction of monoclonal antibodies, which target T2 inflammatory processes, provides important options for this population. In the past decade, five anticytokine biologics (ACBs) that block specific T2 inflammatory cytokines have been introduced.

[Articles] Budesonide–formoterol versus salbutamol as reliever therapy in children with mild asthma (CARE): a 52-week, open-label, multicentre, superiority, randomised controlled trial
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)00861-X/fulltext?rss=yes

In children aged 5–15 years with mild asthma, budesonide–formoterol reliever monotherapy is superior to salbutamol for preventing asthma attacks, with a similar safety profile.