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[Correspondence] Nephromegaly-driven malnutrition in autosomal dominant polycystic kidney disease – Authors’ reply

Published: October 24, 2026 00:00

We thank Matteo Brambilla Pisoni and colleagues for highlighting the importance of nutritional assessment in autosomal dominant polycystic kidney disease (ADPKD). Their comments provide an opportunity to expand on this important aspect of ADPKD care. We…

[Comment] Offline: Berlin diary

Published: October 24, 2026 00:00

ā€œWHO is a retirement home…We must reinvent multilateralism…We must be more candid with one another…We do not spend enough time talking with people who totally disagree with us…I have seen very few SDG badges…On trust, AI will not help…The paradox of using…

[Correspondence] Beyond imaging thresholds in large-core stroke thrombectomy

Published: October 24, 2026 00:00

Amrou Sarraj and colleagues reported an important individual patient data meta-analysis regarding endovascular thrombectomy (EVT) in patients with large-core ischaemic stroke, showing improved functional outcomes and reduced mortality up to 24 h after…

[Comment] Mitapivat in the RISE UP trial: a new therapy for sickle cell disease

Published: October 24, 2026 00:00

Sickle cell disease is the most common haemoglobinopathy, affecting more than 7 million people worldwide.1 Despite substantial morbidity and mortality, access to effective disease-modifying therapies remains limited.2,3 Hydroxyurea and chronic blood…

[Correspondence] Communication: the missing pillar of clinical trial governance

Published: October 24, 2026 00:00

On Sept 2, 2026, negative results of the phase 3 ASPIRE trial (NCT06617429) of apazunersen in Angelman syndrome were announced in a press release issued after the stock market closed.1 Angelman syndrome is a severe neurodevelopmental condition causing…

[Correspondence] Beyond imaging thresholds in large-core stroke thrombectomy – Authors’ reply

Published: October 24, 2026 00:00

We thank Jordan Bakhriansyah and colleagues for their thoughtful commentary on our manuscript from the ATLAS individual patient data meta-analysis.1 Although their conceptual arguments merit consideration, we respectfully disagree with the clinical…

[Articles] Efficacy and safety of mitapivat in patients with sickle cell disease (RISE UP): a phase 3, double-blind, global, randomised, placebo-controlled trial

Published: October 24, 2026 00:00

Mitapivat, an oral pyruvate kinase activator, with a novel mechanism that ameliorates haemolytic anaemia, has the potential to be an effective and convenient disease-modifying treatment for people with sickle cell disease.

[Correspondence] Cultural calibration is needed in global mental disorder burden estimates – Authors’ reply

Published: October 17, 2026 00:00

We thank Yasuhiro Kotera for commenting on our Article reporting the global prevalence and burden of mental disorders from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023.1 We welcome their emphasis on the importance of cultural…

[Comment] Offline: In praise of astrologers, sorcerers, and magicians

Published: October 17, 2026 00:00

ā€œProphecies are the grounds on which fights over the future take placeā€, writes Carissa VĆ©liz in Prophecy: Prediction, Power, and the Fight for the Future, from Ancient Oracles to AI (2026). That fight intensified this week with the publication of our…

[Perspectives] Beyond the battlefield: war and global health security

Published: October 17, 2026 00:00

During the Syrian war (2011–24), the Assad Government forces and their Russian allies conducted hundreds of strikes on medical facilities in opposition-held areas. Monitoring groups documented over 600 attacks on health care, resulting in the deaths of…

[Correspondence] Smoking rates: when should harm-reduction evidence be updated? – Authors’ reply

Published: October 17, 2026 00:00

The striking feature of recent New Zealand smoking trends is the statistically significant acceleration in smoking decline after 2019, not the subsequent plateau. The critical issue is why smoking declined so rapidly after vaping became widespread.

[Comment] Shortening treatment to accelerate hepatitis C elimination

Published: October 17, 2026 00:00

Simple oral direct-acting antiviral treatment for hepatitis C virus (HCV) infection has transformed clinical management and paved the way for elimination.1 The first pan-genotypic fixed-dose combination regimen, sofosbuvir–velpatasvir, was approved for use…

[Correspondence] Smoking rates: when should harm-reduction evidence be updated?

Published: October 17, 2026 00:00

In their Comment, Ruth Bonita and Robert Beaglehole use New Zealand as an example to argue that smoke-free nicotine products accelerate adult smoking declines, stating that annual decline increased ā€œaround four-foldā€ after vapes became widely available.1…

[Correspondence] Underuse of neuromodulation in depression care – Authors’ reply

Published: October 17, 2026 00:00

We thank Roel J T Mocking and colleagues for their comments on our Seminar;1 however, we would like to clarify any confusion over how we have classified neuromodulators and electroconvulsive therapy, as well as argue that they have no justification for…

[Correspondence] Optimising standard of care in non-small-cell lung cancer trials

Published: October 17, 2026 00:00

We read Anwen Xiong and colleagues’ study with great interest.1 Despite the established first-line role of immune checkpoint inhibitors in advanced non-small-cell lung cancer (NSCLC) without targetable genomic alterations, outcomes remain poor. In the…

[Correspondence] Optimising standard of care in non-small-cell lung cancer trials – Authors’ reply

Published: October 17, 2026 00:00

We thank Emma D A Wagener and Wouter H van Geffen for emphasising the importance of comparator selection. We agree that pembrolizumab plus platinum-based chemotherapy is commonly preferred for many patients with a programmed death ligand 1 (PD-L1) tumour…

[Perspectives] Temporal rationing: a man with gastric cancer in Colombia

Published: October 17, 2026 00:00

Pepe, a 45-year-old man living in the city of Cali, Colombia, worked as a self-employed hauler of goods with a wheelbarrow. In 2010, he presented to a general practitioner with several months of abdominal heaviness and non-exertional substernal burning.…

[Correspondence] Underuse of neuromodulation in depression care

Published: October 17, 2026 00:00

As members of the European College of Neuropsychopharmacology Neuromodulation Network, we welcome Gin S Malhi and colleagues’ valuable Seminar on depression.1 Yet neuromodulation is almost absent: electroconvulsive therapy and ā€œother neuromodulatorsā€ are…

[Correspondence] Cultural calibration is needed in global mental disorder burden estimates

Published: October 17, 2026 00:00

The Global Burden of Disease (GBD) 2023 Mental Disorder Collaborators provide an indispensable update on the global burden of mental disorders, estimating 1Ā·17 billion prevalent cases in 2023 and identifying mental disorders as the leading cause of years…

[Comment] Making every vial count: fractional dosing of yellow fever vaccine

Published: October 17, 2026 00:00

Yellow fever is an important public health problem, but vaccine manufacturing cannot be scaled up easily, making it necessary to use existing vaccine stocks to protect as many people as possible. Fractional doses, usually one-fifth of a vial, have been…

[Comment] Establishing cardiovascular safety of the small-molecule GLP-1 receptor agonist orforglipron in type 2 diabetes

Published: October 17, 2026 00:00

Cardiovascular outcomes trials with GLP-1 receptor agonists, which to date have largely comprised peptide analogues of the incretin hormone GLP-1, have evolved from studies primarily designed to establish cardiovascular safety to trials demonstrating…

[Correspondence] WHO should adjust its cervical cancer plan – Authors’ reply

Published: October 17, 2026 00:00

We agree with Eric J Suba that current global inequalities in cervical cancer burden are driven largely by unequal access to effective screening programmes. This point was highlighted by Brisson and colleagues1 and in an accompanying Comment2 that warned…

[The Lancet Commissions] The Lancet Commission on 21st century global threats to health

Published: October 10, 2026 23:01

This report from the Lancet Commission on 21st century global threats to health lays out a foresight-driven, health-focused approach to identifying and prioritising major threats to global health over the remainder of the century. We argue that recent…

[Review] Addressing threats to future global health—what is the right timeframe?

Published: October 10, 2026 23:01

Our decisions today can support or threaten future human health. Insofar as we protect the planet or invest in fruitful research on pandemic countermeasures, we promote future wellbeing and health, sometimes at the present generation's expense. As we warm…

[Comment] 21st century global threats to health are not what you think

Published: October 10, 2026 23:01

The Lancet Commission on 21st century global threats to health's report by Christopher J L Murray and colleagues uses forecasts based on expected cumulative amenable disability-adjusted life-years (DALYs) to quantify and compare threats from 2025 to 2100.1…

[Perspectives] John Wong: making an impact on population health at scale

Published: October 10, 2026 23:01

ā€œI’m concerned that the narrative now around ageing populations is one of doom and gloom. But long-lived populations are not the problem. The problem is that we haven’t allowed people to get to an older age healthyā€, says John Wong, Executive Director of…

[Correspondence] Colonoscopy screening and colorectal cancer outcomes: the NordICC trial

Published: October 10, 2026 00:00

The NordICC trial1 should be considered in context with previous colorectal cancer screening studies.2,3 Four randomised controlled trials with more than 458 000 participants show consistent colorectal cancer incidence reductions of 18–23% and larger…

[Correspondence] Colonoscopy screening and colorectal cancer outcomes: the NordICC trial – Authors’ reply

Published: October 10, 2026 00:00

We thank JoĆ£o Martins and Aneel Bhangu, Hermann Brenner and colleagues, and Uri Ladabaum and colleagues for their interesting comments on our report from the NordICC trial.1 We agree with Martins and Bhangu that colorectal cancer incidence is an…

[Correspondence] Regulate prospective development of medical AI now

Published: October 10, 2026 00:00

Artificial intelligence (AI) is advancing through medicine at a pace that regulation, ethics, and professional reflection have struggled to match. The prevailing assumption appears to be that if a technology can be developed, it should be developed—and…

[Comment] Retatrutide in adults with obesity and type 2 diabetes: what have we learned from TRIUMPH-2?

Published: October 10, 2026 00:00

It is a general observation that the degree of weight loss obtained with GLP-1 receptor agonists is less in individuals with type 2 diabetes than in people without diabetes and similar BMI. Could this difference be overcome with the new triple agonists…

[Comment] Closing the gap on mortality for adolescents living with HIV

Published: October 10, 2026 00:00

Despite major advancements in antiretroviral therapy (ART), a substantial mortality gap remains for adolescents living with HIV compared with the general population.1 Adolescents’ access to ART lags behind that of adults—approximately 60% for adolescents…

[Correspondence] The health literacy crisis in the age of AI: lessons from PISA 2025

Published: October 10, 2026 00:00

The 2025 Programme for International Student Assessment (PISA) results should concern the health community.1 PISA does not measure health literacy directly, but it assesses several cognitive competencies that increasingly underpin people's ability to…

[Correspondence] Colonoscopy screening and colorectal cancer outcomes: the NordICC trial

Published: October 10, 2026 00:00

In their recent Article, Michal F Kaminski and colleagues reported the effects of offering one-time screening colonoscopy at ages 55–64 years after a 13-year follow-up of the NordICC trial.1 Their findings should be interpreted in the context that this…

[Correspondence] Colonoscopy screening and colorectal cancer outcomes: the NordICC trial

Published: October 10, 2026 00:00

Michal F Kaminski and colleagues report that colonoscopy screening reduced colorectal cancer incidence, but not mortality, during a 13-year follow-up.1 The response from the public health field will focus, as it always does, on mortality. We think this…

[Correspondence] Personalising maintenance after tirzepatide weight loss

Published: October 10, 2026 00:00

Deborah B Horn and colleagues’ SURMOUNT-MAINTAIN trial provides important evidence that continued tirzepatide is superior to treatment withdrawal for maintaining pharmacologically induced weight loss.1 The trial also shows that reducing tirzepatide to 5 mg…