Podcasts about Takeda

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we're diving into a series of remarkable updates that highlight the dynamic evolution of drug development, regulatory landscapes, and industry strategies. Takeda has made waves with its TYK2 inhibitor, Zasocitinib, which recently outperformed Bristol Myers Squibb's Sotyktu in a pivotal Phase 3 trial for plaque psoriasis. This trial is particularly noteworthy as it involves TYK2 inhibitors, a class of drugs targeting tyrosine kinase 2 to modulate immune responses. The success of Zasocitinib not only strengthens Takeda's competitive position but also underscores the potential of these inhibitors in treating autoimmune conditions like psoriasis. As we look forward to its market launch next year, this development represents a significant stride in the realm of targeted therapies aimed at complex diseases. Shifting gears to regulatory advancements, Johnson & Johnson's Darzalex (daratumumab) has received endorsement from NICE for its quadruplet therapy in newly diagnosed transplant-ineligible multiple myeloma cases. This approval is based on favorable Phase 3 trial results and highlights the therapeutic potential of targeting CD38 on myeloma cells. This marks a crucial step in offering potent treatment options to patients who cannot undergo transplants, emphasizing the growing importance of combination therapies in oncology. In another significant development, Johnson & Johnson is expanding its rare disease portfolio with promising Phase 2/3 trial data for Imaavy. Poised to become the first approved treatment for warm autoimmune hemolytic anemia, this advancement highlights the industry's pivot towards addressing rare diseases with limited treatment options. In India, AstraZeneca has secured CDSCO approval for Enhertu (trastuzumab deruxtecan) combined with pertuzumab as a first-line treatment for HER2-positive unresectable or metastatic breast cancer. This approval signifies a milestone in HER2-targeted therapies, spotlighting the pivotal role of antibody-drug conjugates that deliver cytotoxic agents directly to cancer cells, enhancing efficacy while minimizing systemic exposure. Moving on to business developments, Servier's partnership with N-Lorem Foundation to develop antisense oligonucleotide therapies for rare neurological disorders reflects the industry's increasing focus on precision medicine. This collaboration underscores the burgeoning interest in nucleic acid-based therapies aimed at addressing genetic disorders lacking effective treatments. On the financial front, Kardigan's planned $320 million IPO signals robust confidence in advancing cardiovascular pipeline assets. This move highlights Kardigan's commitment to tackling substantial unmet needs in cardiovascular diseases—an area still rife with challenges despite existing therapies. From a regulatory perspective, China's update of its Good Clinical Practice guidelines aims to streamline clinical trial processes, fostering biotech innovation. This change is expected to enhance drug development efficiency and attract global biotech investments to China's rapidly growing pharmaceutical market. Meanwhile, Pfizer CEO Albert Bourla has raised concerns about Germany's healthcare reform plans, warning that they might deter future investments. His comments underscore the delicate balance between cost containment policies and maintaining an environment conducive to pharmaceutical innovation. Additionally, Novo Nordisk's CEO Mike Doustdar expressed optimism about the company's strategic focus on market positioning through innovation and efficiency improvements. This aligns with broader industry trends where large pharma companies strive to maintain leadership roles amid fierce competition. Eli Lilly's sponsorship of short films premiered at Tribeca Festival illustrates an industry-wide trend toward patient-centric approaches and authentic portrayals of people with diseases onscreen. Such efforts aim to enhance communication strategies that resonate with diverse audiences. Furthermore, transformative technologies like cell and gene therapies are gradually moving towards mainstream clinical adoption. This transition necessitates zero-tolerance logistics to ensure these complex therapies reach patients safely and effectively—a paradigm shift offering potential cures but also posing logistical challenges. Finally, industry events such as ASCO continue to spotlight cutting-edge research developments in oncology. Such conferences are pivotal in advancing treatment paradigms and fostering collaborations that drive innovation across the sector. These updates reflect a period marked by groundbreaking scientific advances and strategic initiatives poised to reshape patient care and global healthcare solutions. As companies navigate these complexities while addressing regulatory and economic challenges, maintaining a focus on innovation will be key in charting future growth trajectories within the pharmaceutical and biotech sectors.Support the show

This episode covers: Cardiology This Week: A concise summary of recent studies Transcatheter treatment of tricuspid regurgitation Carcinoid heart disease Milestones: MADIT-II Trial Host: Wilfried Mullens Guests: Stephan Baldus, Heidi Connolly and Konstantinos Koskinas Want to watch that episode? Go to: https://esc365.escardio.org/event/2560 Want to watch that extended interview on transcatheter treatment of tricuspid regurgitation, go to: https://esc365.escardio.org/event/2560?resource=interview   Disclaimer  ESC TV Today is supported by Novartis and Novo Nordisk through an independent funding. The programme has not been influenced in any way by its funding partners. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode. The ESC is not liable for any translated content of this video. The English language always prevails. ESC TV Today uses a range of tools and resources (including AI) to support content production. All content is reviewed and approved by the editorial team. Statements and opinions expressed by guest speakers are their own.   Declarations of interests Stephan Achenbach, Yasmina Bououdina, Heidi Connolly, Nicolle Kraenkel and Wilfried Mullens have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Novo Nordisk, Pfizer, Sanofi, Servier, Takeda, Tecnimede, Viatris. Stephan Baldus has declared to have potential conflicts of interest to report: research grant from Abbott, lecture fees from Abbott and Edwards. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. David Duncker has declared to have potential conflicts of interest to report: lecture honoraria from Abbott, Astra Zeneca, Biotronik, Boehringer Ingelheim, Boston Scientifics, Bristol Meyers Squibb, CVRx, Daiichi Sankyo, Medtronic, Microport, Pfizer, Sanofi, Zoll. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Host: Wilfried Mullens Guest: Stephan Baldus Want to watch that extended interview, go to: https://esc365.escardio.org/event/2560?resource=interview Want to watch that entire episode? Go to: https://esc365.escardio.org/event/2560   Disclaimer ESC TV Today is supported by Novartis and Novo Nordisk through an independent funding. The programme has not been influenced in any way by its funding partners. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode. The ESC is not liable for any translated content of this video. The English language always prevails. ESC TV Today uses a range of tools and resources (including AI) to support content production. All content is reviewed and approved by the editorial team. Statements and opinions expressed by guest speakers are their own.   Declarations of interests Stephan Achenbach, Yasmina Bououdina, Nicolle Kraenkel and Wilfried Mullens have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Novo Nordisk, Pfizer, Sanofi, Servier, Takeda, Tecnimede, Viatris. Stephan Baldus has declared to have potential conflicts of interest to report: research grant from Abbott, lecture fees from Abbott and Edwards. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. David Duncker has declared to have potential conflicts of interest to report: lecture honoraria from Abbott, Astra Zeneca, Biotronik, Boehringer Ingelheim, Boston Scientifics, Bristol Meyers Squibb, CVRx, Daiichi Sankyo, Medtronic, Microport, Pfizer, Sanofi, Zoll. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Directrice des ressources humaines de Takeda France, Céline Petit a construit toute sa carrière autour d'une double conviction : les ressources humaines et la santé. Elle accompagne aujourd'hui les transformations d'un groupe pharmaceutique international en mettant l'accent sur le développement des compétences, l'acculturation à l'IA et l'employabilité à long terme. Convaincue que la technologie doit libérer du temps pour renforcer l'accompagnement humain, elle défend une fonction RH stratégique, au service des collaborateurs comme des patients.Hébergé par Ausha. Visitez ausha.co/politique-de-confidentialite pour plus d'informations.

Join HAEA Director of Health & Research Services, Troyce Venturella, and HAEA Health Services Manager, Mandy Granat, as they discuss important summer safety considerations for individuals and families living with HAE. The conversation is designed to help the HAEA community stay safe, healthy, and prepared while enjoying summer activities with family and friends!Thank you to our 2026 Sponsors: BioCryst, CSL, IONIS, and Takeda

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we delve into a series of significant advancements shaping the landscape of our industry. As technology continues to redefine traditional paradigms, the collaboration between Pfizer and Chai Discovery exemplifies this trend. By harnessing artificial intelligence, particularly through custom models like Chai-3, this partnership aims to revolutionize drug discovery. The integration of AI promises not only to accelerate the identification of biologics and antibodies but also to optimize resource allocation in research and development. Such technological integration could pave the way for an enhanced pipeline of innovative treatments, marking a transformative shift in how therapeutic candidates are developed. In the realm of regulatory developments, Lupin's Ranluspec has recently received FDA approval as an interchangeable biosimilar targeting VEGF-A for various retinal conditions. This move underscores the importance of biosimilars in providing cost-effective alternatives to expensive biologics, thereby expanding patient access to essential treatments for conditions like macular degeneration. Additionally, the MHRA's marketing authorization for Aujemflu, an adjuvanted trivalent influenza vaccine for adults aged 50 and over, reflects ongoing efforts to bolster protection against infectious diseases among vulnerable populations. Clinical trial advancements continue to highlight significant progress in therapeutic development. Otsuka Pharmaceuticals' Phase 3 data on Voyxact has shown promising stabilization of kidney function in patients with Immunoglobulin A nephropathy. This protein therapy targets autoimmune pathways, offering new hope for managing this chronic kidney condition. Similarly, Autobahn Therapeutics' Elunetirom has advanced to a pivotal trial following Phase 2 success in treating bipolar depression. This showcases the potential of small molecule therapies targeting thyroid hormone receptors. Meanwhile, Hikma Pharmaceuticals' victory in a landmark patent case regarding skinny labels marks an important development in pharmaceutical intellectual property rights. The unanimous Supreme Court ruling against Amarin supports the legitimacy of using skinny labels to market generic versions of drugs for non-patented indications. This decision could enhance market competition and drive down healthcare costs, setting a precedent for future intellectual property disputes. On the business front, strategic partnerships and mergers continue to shape industry dynamics. Gilead Sciences' acquisition of Ouro Medicines for $1.675 billion strengthens its autoimmune inflammation pipeline. This transaction exemplifies how major deals are reshaping therapeutic portfolios in response to growing demand for treatments targeting rare diseases. Financially, Solix Pharmaceuticals' success in raising $71 million to advance its siRNA pipeline across multiple therapeutic areas demonstrates investor confidence in RNA-based therapeutics as a promising frontier for innovative treatments. Conversely, challenges persist as evidenced by Takeda's $2.5 billion legal provision over an antitrust case related to Amitiza, underscoring ongoing financial risks associated with litigation in the pharmaceutical sector. Corporate restructuring also signals shifts within the industry landscape. Fulcrum Therapeutics' decision to lay off 85% of its workforce following the discontinuation of its sickle cell disease candidate highlights the volatility and high stakes inherent in drug development. Overall, these developments illustrate a dynamic landscape where scientific innovation is propelled by AI-driven approaches and strategic collaborations while regulatory victories and financial maneuvers shape market dynamics. These trends have profound implications for patient care by potentially accelerating the availability of novel therapies and fostering a competitive environment that drives down costs. As we look ahead, stakeholders must navigate these complexities effectively to harness opportunities and address challenges within this rapidly evolving industry landscape. The ability to adapt and capitalize on emerging trends will be crucial as these sectors continue to evolve, ultimately enhancing patient care and advancing therapeutic frontiers globally. Thank you for joining us today on Pharma Daily; stay tuned for more insights into the ever-changing world of pharmaceuticals and biotech.Support the show

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we'll explore a landscape teeming with strategic partnerships, groundbreaking clinical trial results, regulatory shifts, and innovative therapeutic approaches that are redefining patient care and drug development. Pfizer's monumental $10 billion collaboration with Innovent Biologics stands out as a testament to the shifting dynamics of the oncology sector. This partnership aims to develop 12 antibody-drug conjugate (ADC) and multispecific antibody programs, spotlighting these therapies' growing significance in oncology. The precision of antibodies in delivering cytotoxic agents directly to cancer cells offers a new frontier in minimizing collateral damage to healthy tissues—a crucial advancement in cancer treatment. The deal not only highlights Pfizer's commitment to expanding its oncology pipeline but also underscores the strategic importance of leveraging China's accelerated drug development ecosystem. In regulatory news, AstraZeneca's Imfinzi has garnered FDA approval for BCG-naive high-risk non-muscle-invasive bladder cancer. This milestone for PD-L1 inhibitors reflects the evolving landscape of immunotherapy. By harnessing monoclonal antibodies in combination therapies, the potential for enhanced anticancer efficacy is significant. With few therapeutic alternatives available, this approval presents a lifeline for many bladder cancer patients. Clinical trial outcomes also continue to capture attention. Eli Lilly's Nectin-4 targeting ADC showed promising results in advanced urothelial cancer, positioning itself as a potential competitor to Padcev. This innovation in ADC technology demonstrates the industry's relentless pursuit of targeted therapies that can revolutionize treatment paradigms. Bristol Myers Squibb's mezigdomide offers another example by showing a 52% reduction in progression risk for relapsed or refractory multiple myeloma patients, emphasizing the focus on addressing specific molecular pathways. In the realm of bispecific antibodies, Phanes Therapeutics' CLDN18.2/CD47 targeting therapy reported encouraging Phase 2 results in metastatic pancreatic ductal adenocarcinoma. These antibodies' ability to simultaneously engage multiple targets enhances their therapeutic efficacy against stubborn cancers, broadening the horizon for treatment possibilities. Meanwhile, Replimune's resubmission of its RP1 melanoma Biologics License Application (BLA) highlights the intricate dance between drug development and regulatory processes amid organizational shifts at the FDA. Such efforts reflect the continual adaptation required within the industry to navigate complex regulatory landscapes. On the funding front, Psilera's successful $8.8 million seed round indicates growing interest in psychedelic therapies for neurological conditions. Similarly, Reprogram Biosciences raised $6 million for its AI-driven cell reprogramming oncology platform, illustrating how artificial intelligence is becoming integral to advancing drug discovery and development. However, not all updates were positive. Agios Pharmaceuticals faced setbacks as their pyruvate kinase activator failed a Phase 2b trial for lower-risk myelodysplastic syndromes, serving as a sobering reminder of the inherent risks involved in drug development. Dizal Pharma emerges as a beacon of hope in lung cancer treatment following Takeda's EGFR exon 20 drug setback. By challenging existing treatments with promising small molecule data, Dizal exemplifies precision medicine's role in redefining oncology protocols—offering personalized patient options that could set new standards in treatment efficacy. The issue of drug pricing remains contentious, particularly highlighted by an AARP analysis showing an 81% increase post-launch prices stateside compared to a 13% decrease abroad. This disparity raises critical questions about achieving equitable access across markets amid Medicare negotiations and global pricing strategies like "most favored nation" policies. Regulatory updates continue with Johnson & Johnson's Tremfya label expansion stateside and AbbVie's EU extension for Venclyxto—moves that reflect efforts to maximize therapeutic reach and commercial viability across diverse geographies. Finally, Gilead Sciences' decision to discontinue its lead rheumatoid arthritis drug from MiroBio underscores ongoing challenges within emerging fields like BTLA agonists—a reminder of both innovation's promise and its perilous nature when faced with unproven therapeutic avenues. As these varied developments unfold, they collectively signal an era characterized by rapid scientific innovation and strategic collaborations across geographies alongside evolving regulatory landscapes—all driving towards enhanced patient care through more effective treatments globally. This concludes today's insights from Pharma Daily—a world where dynamic change continues reshaping healthcare delivery standards towards unprecedented possibilities for patient outcomes worldwide. Thank you for joining us; stay tuned for more updates on tomorrow's horizon-shaping advancements.Support the show

Plant a Simple Seed and Watch Your Mindset Grow with Katie Wood  What if the smallest shift in perspective could change the entire trajectory of your life? In this powerful and heartfelt episode, Carrie sits down with thought leader, educator, and bestselling author of Simple Seed, Katie Wood—fresh off her recent appearance on the Today Show—for a conversation that will stay with you long after it ends. Get ready for goosebumps as Katie shares deeply personal stories that reveal how life's hardest moments are often the very ones shaping our resilience, character, and grit. From a moving story about her daughter's stitches that beautifully mirrors how we heal and grow, to the transformational journey of a teacher who went from burnout to Teacher of the Year by using the powerful practices inside Katie's journal—this episode is packed with moments that will shift the way you see your own story. Together, Carrie and Katie explore how planting simple, intentional “seeds” of gratitude and perspective can create lasting change—not just for ourselves, but for the next generation. As a former teacher turned mission-driven entrepreneur, Katie is on a path to bring these life-changing tools into schools—teaching what many of us were never taught, but needed most. In this episode, you'll discover: Why your hardest moments may be shaping your greatest strength How a simple shift in perspective can transform your entire story The real impact of gratitude practices—inside classrooms and beyond And don't miss the unforgettable moment at the end—when Katie shares the one sentence from a college basketball coach that completely changed the course of her life. This is more than a conversation—it's a reminder that the story you're telling yourself matters… and you have the power to change it. Tune in this Monday 5/25/26 at 5am & 5pm ET to listen live on the radio https://dreamvisions7radio.com/look-for-the-good/ Hey friends, although this is my last episode airing on Dreamvisions7Radio Network, the podcast is not going anywhere! You can still listen and download your weekly episodes at your favorite podcast platform  AND if you prefer to watch it live, find all the videos here: https://carrierowan.com/look-for-the-good-podcast-carrie-rowan/ Thank you Dreamvisions7Radio for spreading the goodness across the international airwaves! Forever grateful!  xoxo Carrie BIO: Katie Wood is a thought leader, entrepreneur, and author of the bestselling journal A Simple Seed who transitioned from a 10-year career in special education teaching to entrepreneurship in 2014 to help others grow through mindset, leadership, and personal development. She speaks at schools across the country as well as organizations including Athenahealth, Takeda, Splunk, Boston College, and Providence College, and has shared stages with Herm Edwards and Matthew Slater while also being featured on Today and in Entrepreneur Magazine. Her journal, A Simple Seed, became an Amazon bestseller and was recently acquired by Penguin Random House, while Katie continues to inspire audiences through her speaking, writing, and dedication to her family as a mom of four and proud fire-wife. FIND out MORE about A Simple Seed and Katie's powerful work with kids and schools at: www.GrowwiththeGoodness.com Want to find out when the next incredible episode of Look for the Good is dropping? Sign up for the Look for the Good Podcast Chat weekly newsletter to get behind the scenes insights, special tips, and insider only offers. Click HERE to sign up today! Learn More about Carrie here: https://carrierowan.com/

This episode covers: Cardiology This Week: A concise summary of recent studies The heart in high altitude Mitral annular disjunction Mythbusters: Weekend mortality Host: Rick Grobbee Guests: JP Carpenter, Kristina Haugaa, Silvia Ulrich Want to watch that episode? Go to: https://esc365.escardio.org/event/2563 Want to watch that extended interview on mitral annular disjonction, go to: https://esc365.escardio.org/event/2563?resource=interview   Disclaimer ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode. The ESC is not liable for any translated content of this video. The English language always prevails. ESC TV Today uses a range of tools and resources (including AI) to support content production. All content is reviewed and approved by the editorial team. Statements and opinions expressed by guest speakers are their own.   Declarations of interests Stephan Achenbach, Yasmina Bououdina, Rick Grobbee, Kristina Haugaa, Nicolle Kraenkel and Silvia Ulrich have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Novo Nordisk, Pfizer, Sanofi, Servier, Takeda, Tecnimede, Viatris. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. David Duncker has declared to have potential conflicts of interest to report: lecture honoraria from Abbott, Astra Zeneca, Biotronik, Boehringer Ingelheim, Boston Scientifics, Bristol Meyers Squibb, CVRx, Daiichi Sankyo, Medtronic, Microport, Pfizer, Sanofi, Zoll. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada.  Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Host: Rick Grobbee Guest: Kristina Haugaa Want to watch that extended interview on https://esc365.escardio.org/event/2563?resource=interview Go to: Want to watch that episode? Go to: https://esc365.escardio.org/event/2563   Disclaimer ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode. The ESC is not liable for any translated content of this video. The English language always prevails. ESC TV Today uses a range of tools and resources (including AI) to support content production. All content is reviewed and approved by the editorial team. Statements and opinions expressed by guest speakers are their own.   Declarations of interests Stephan Achenbach, Yasmina Bououdina, Rick Grobbee, Kristina Haugaa and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Novo Nordisk, Pfizer, Sanofi, Servier, Takeda, Tecnimede, Viatris. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. David Duncker has declared to have potential conflicts of interest to report: lecture honoraria from Abbott, Astra Zeneca, Biotronik, Boehringer Ingelheim, Boston Scientifics, Bristol Meyers Squibb, CVRx, Daiichi Sankyo, Medtronic, Microport, Pfizer, Sanofi, Zoll. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

In this week's episode of the Xtalks Life Science Podcast, host Ayesha Rashid, Senior Life Science Journalist at Xtalks, spoke with Awny Farajallah, MD, Chief Medical Officer at Takeda, about the growing role of real-world evidence in improving clinical trial inclusivity and diversity. Also hear Dr. Farajallah discuss innovations in diseases such as narcolepsy type 1 and polycythemia vera, and how new technologies are transforming healthcare data into actionable insights. With over two decades of experience in the healthcare industry, Dr. Farajallah has led numerous medical affairs teams and contributed to the development and commercialization of therapeutics in oncology and other disease areas, including rare disease, hematology, neuroscience and immunology. Prior to his current role, Dr. Farajallah served as the Head of Global Medical Affairs for Oncology at Takeda, and held global, regional and local roles at Ipsen and Bristol Myers Squibb. Tune in to hear about how real-world evidence is driving more inclusive clinical trials, shaping patient-centered care and accelerating access to treatments. For more life science and medical device content, visit the Xtalks Vitals homepage. https://xtalks.com/vitals/ Follow Us on Social Media Twitter: https://twitter.com/Xtalks Instagram: https://www.instagram.com/xtalks/ Facebook: https://www.facebook.com/Xtalks.Webinars/ LinkedIn: https://www.linkedin.com/company/xtalks-webconferences YouTube: https://www.youtube.com/c/XtalksWebinars/featured

Co-hosts Ryan Piansky, a graduate student and patient advocate living with eosinophilic esophagitis (EoE) and eosinophilic asthma, and Holly Knotowicz, a speech-language pathologist living with EoE who serves on APFED's Health Science Advisory Council, interview Phillip Arceneaux, PhD, on his journey with EoE and balancing his career. Disclaimer: The information provided in this podcast is designed to support, not replace, the relationship between listeners and their healthcare providers. Opinions, information, and recommendations shared in this podcast are not a substitute for medical advice. Decisions related to medical care should be made with your healthcare provider. Opinions and views of guests and co-hosts are their own.   Key Takeaways: [:50] Co-host Ryan Piansky introduces this episode, brought to you thanks to the support of Education Partners GSK, Sanofi, Regeneron, and Takeda. Ryan introduces co-host Holly Knotowicz.   [1:12] Holly introduces today's topic. It's May, and each year in May, there are several awareness observances for eosinophilic-associated diseases, including National Eosinophil Awareness Week, World Eosinophilic Diseases Day, and World EoE Day.   [1:29] Throughout May, APFED is sharing stories from individuals and families living with eosinophil-associated diseases to highlight the impact of these chronic conditions.   [1:38] Ryan says, Today, we'll be discussing eosinophilic esophagitis (EoE). EoE is a chronic allergic inflammatory disease of the esophagus. It occurs when eosinophils, a type of white blood cell, accumulate in the esophagus in elevated numbers, causing inflammation that can make eating or swallowing difficult or uncomfortable.   [1:56] Holly introduces today's guest, Dr. Phillip Arceneaux, a patient advocate living with EoE since 2019.   [2:18] Phil is 35. He was born and raised in Lafayette, Louisiana. He received his undergraduate degree there. He worked at the U.S. Naval Academy in Annapolis, Maryland. Then he worked at the University of Oregon.   [2:38] Phil moved to Florida and did his Ph.D. in Mass Communication at the University of Florida. Since 2020, he has been based out of the Cincinnati area, working at Miami University of Ohio.   [3:05] Phil was diagnosed with EoE in March of 2019, while finishing his degree at UF.   [3:12] Phil was eating dinner with his girlfriend. He took a bite of a roast beef sandwich, and it didn't go down smoothly, it became impacted.    [3:56] Phil thought he had food stuck in his windpipe. He was running around banging his chest. He calmed down and was able to get some of the food out, and he was breathing again.   [4:12] Phil thought he was fine. He quickly realized he wasn't. He still had a partial impaction. He didn't know what was going on in his chest. He spent about 30 minutes moving around, coughing, and trying to get his chest to feel right.   [4:44] After about an hour, Phil decided to go to the ER. His girlfriend insisted on driving him to the hospital. It was spring break, so the ER was not busy. It still took a couple of hours to be seen and treated.   [5:25] The doctors assessed him. They gave him medicine to induce vomiting. About 12 hours after the initial choking, his impaction cleared. They kept him overnight and gave him an endoscopy in the morning to check his esophagus and take biopsies.   [6:31] Phil was in the ER for four to six hours before anyone told him what they thought he had. Then the ER doctor told him he was 95% certain Phil had eosinophilic esophagitis. Phil had never heard of it.   [7:04] The ER doctor gave Phil a rundown of EoE. He said Phil would have an endoscopy, and then he would be referred to a GI and set up for treatment. The doctor said he couldn't confirm it before the endoscopy, but he thought it was EoE.   [7:31] Ryan says he's talked to people who have had months-long processes of getting their diagnosis. Phil gives all the credit to the hospital. He was fortunate that his experience was good.   [7:55] Phil says that the staff at the ER and the GI specialist were so knowledgeable about the research and where things were going in this area of medicine. They were very confident about the diagnosis and treatment plan.   [8:11] Dr. Arcenaux gives a shout-out to his GI. He spent well over an hour with him during his initial consult. He explained how EoE would impact him, from diet, grocery shopping, and challenges eating at restaurants, because of cross-contamination.   [8:42] The GI specialist talked him through impacts on dating and dining out  and how to approach social activities.   [9:09] Phil's GI specialist talked to him about employers. He would need employers with health insurance that will cover the endoscopies and treatments for EoE. Phil appreciated the initial onboarding for his EoE diagnosis.   [9:41] Ryan says he needs to discuss this with Phil, as he just finished his Ph.D. a few months ago, and he's looking at insurance for his new job, and how to figure out business lunches.   [9:51] Ryan says Ph.D. students are so motivated by free food. As someone with EoE, that never applied to him. Ryan says shifting from normal eating habits to an EoE diet is a major shift.   [10:27] Phil knows now that there were signs and symptoms, but he had no idea about them before his diagnosis.   [10:33] Phil is on a special diet for his EoE. When he's not great at avoiding his trigger foods, he starts to see dysphagia symptoms in his swallowing, and he has quite a bit of regurgitation. He had been seeing that for months before this initial major food impaction and ER visit.   [10:54] Phil had no idea what was going on. He just thought it was weird that he was regurgitating more than he used to. Sometimes food didn't go down well. Once or twice, he had a small aspiration event. He thought he needed to chew better.   [11:11] He didn't know what those symptoms meant, and he wrote them off. None of it made sense until that diagnosis. Even then, it took a while to wrap his head around it. Years removed, he sees there were so many signs and symptoms he never processed.   [11:28] Holly asks what Phil means by aspiration. He says he means water going down his windpipe, making it hard to breathe, with liquid in his lungs. Holly says that aspiration can be caused by inflammation in people who have EoE.   [12:07] Holly says people with EoE can be sent for a swallow study to look at the anatomy of their swallow function. That's a subject for another episode!   [12:35] Ryan says Phil noticed he was regurgitating more than normal and remarks that people with chronic illnesses don't realize that most people don't normally regurgitate at all. It's a sign that something's wrong.   [13:03] The ER doctor didn't offer Phil any other diagnosis than EoE. The doctor was 95% sure he had EoE, but confirmed it with an endoscopy.   [13:20] Holly asks Phil what food allergies he has. As an infant, he had an egg allergy that limited his vaccines. Now he knows his primary allergen is egg, and it led to his EoE issues.   [13:51] When Phil started his Ph.D. program, he wanted to eat healthier foods. He cut out fast food, and he ate more eggs. He consumed many eggs during his Ph.D. program. A snack was scrambled eggs or something with scrambled eggs.   [14:22] Phil went through a carton of 18 eggs in less than a week. He knew that when he was younger, he'd had egg sensitivity, but as an adult, he'd eaten eggs and nothing happened that registered as an issue. He thought he had outgrown it.   [14:40] Phil says he had outgrown other food allergies. He assumed eggs were fine, so he adopted a heavy egg diet to increase his protein intake and be healthier. Then all these symptoms manifested.   [15:00] Phil never associated the symptoms with eggs. His treatment plan is dieting and minimizing egg as much as possible. That is not easy in the United States, where everything is processed and often contains egg.   [15:19] Holly says she has seen an influx of adult-onset EoE patients with a history of a dairy or egg allergy who were putting cottage cheese and eggs in everything, and all of a sudden, started having regurgitation and food getting stuck.   [15:51] Phil doesn't eat scrambled eggs anymore. One slice of a cake with eggs in it will not send him to the ER. It takes a couple of days of high exposure to reach that point. He knows what he can have daily that will not impact him in the long term.   [16:20] Holly and Ryan agree that it's important to know your limits, and consult with your physicians about foods. Rice is a trigger for Ryan, but if brown rice syrup is about the 20th ingredient, he can have it and be fine. If he were to eat a lot of rice, he will have issues. [17:21] Phil says he recently got married, and his wife is a health nut. She has radically changed his diet. They eat very high-protein, low-fat, and low-carb. It's been easy to manage that without eggs. They eat a lot of chicken, turkey, and fish.   [17:41] Being from Louisiana, Phil says if he had to give up seafood, he doesn't know what he would do. He's a huge craft beer lover. If he had to give up gluten, he doesn't know what he would do. He can manage without eggs.   [18:21] Ryan says dairy was a big trigger for him when he was younger, but now he's on dupilumab, a biologic approved for treating EoE, and that's helped him a lot. He's started to integrate whey protein and milk protein back into his diet.   [18:47] Phil says once he finished with school, he graduated and lost health insurance. He didn't have a source of income or health insurance, so he declined to have dilation therapy. That's also why he deferred to dietary therapy. He removed his allergens one by one.   [19:12] Phil was diagnosed in 2019, not long before the pandemic hit. He lived in a bubble for two to three years and kept to a very regimented diet. That's where he started to find his balance.   [19:30] Phil travels quite a bit as a professor. He goes to international conferences. In 2022, a big annual conference opened in Paris, France. He was living his best life, but didn't register that every pastry he put in his mouth had an egg wash.   [20:14] Phil was there for seven days. On the sixth night, he was eating a tough, dry steak. He had a severe food impaction, worse than the one in 2019. He was with colleagues who didn't know what he had.   [20:40] He paid, excused himself, went to his hotel room, and tried to vomit it up. He couldn't do it. He called an Uber and went to the nearest ER. He had an emergency endoscopy. It's not easy to navigate another country's healthcare system, but he did it.   [21:14] When Phil returned from the conference, he said he needed to get serious. He had a GP, but he needed a GI specialist. Cincinnati has multiple great health systems, so he got a GI specialist and started down a path of treatment.   [21:38] He told his GI specialist, this has happened to me, and I never want it to happen again. What can we do? He started with proton pump inhibitors. No effect. He doesn't have acid reflux. Next was the topical corticosteroid, swallowed budesonide.    [22:22] Phil used a pump for asthma, but this was to swallow. After two weeks, he developed a bad case of thrush that took a long time to get rid of. He had never had thrush and didn't know what it was. It took a couple of rounds of treatment to clear up.   [22:43] After that, in 2022, he moved to dupilumab. The FDA had just approved it as a course of treatment for EoE. Phil did not do well with the treatment, and has since gone back to  back to a diet-only course of treatment.    [24:13] Phil says the dupilumab shots did help. He had been having reactions to some foods for years, and after a couple of weeks on the shot, those reactions went away, and he could eat the foods, like avocado and watermelon, again.   [24:39] The dupilumab did him some good, as he returned to some foods that he loved, but it wasn't a long-term solution for him.   [24:50] Ryan shares that he started his Ph.D. in 2019. He felt great, he had no symptoms, and he was following up with his GI every year. With no symptoms, he wasn't scoped until 2025 for insurance reasons. His scope was horrible.   [25:11] His symptoms were in remission, but his esophagus looked terrible. He had to switch up his treatment plan. Ryan advises all listeners to follow up with their GI.   [26:14] Phil says he thinks he's in a very lucky position that what his allergen is, what his dietary preferences are, and how he manifests symptoms, do not significantly impact his day-to-day.   [26:36] Phil's doctor in 2019 had advised him that EoE would impact his work and his business lunches. With the treatment plan he has opted into, it doesn't impact his day-to-day. He says he is very lucky, compared to what other patients deal with.   [26:50] It hasn't impacted his day-to-day, but the problem is, when it does impact something. It's very big, very noticeable, and it's in front of everyone. He recalls his Paris episode. He's very vocal about it. That's why he reached out to APFED.   [27:13] Phil likes talking about it. The only way we know more about it is when we talk about it and share our stories. His colleagues all know he has EoE. They don't understand exactly what it is, but when he's having trouble, they understand.   [27:44] When Phil has an issue, he doesn't tell anyone; he just gets up and walks out of the room and paces the hall, doing his stretches.   [28:09] Largely, it's just letting people know he has EoE. They recognize that he manages it himself, and he's OK.   [28:24] Phil says figuring out your medical treatment plan and balancing your quality of life is different from having a disease that can eventually be treated.   [28:51] This is something you have to deal with the rest of your life. That's going to fundamentally change things, not drastically, but in fairly subtle ways.    [29:18] No matter how comfortable you get, you have to be diligent. You always have to be cognizant of your symptoms and stay on whatever your treatment plan is, whether that's dieting or medication. This will not go away. You're always going to have it.   [29:37] Phil says you have to frame it as a lifelong marathon and find a very sustainable pace. That's where the quality of life is so important. We're human beings. We have to enjoy life. Settle in for the long haul. That's how it will be sustainable.   [30:18] Ryan thinks self-advocacy is important, whether talking with doctors, co-workers, or friends. Take care of yourself and make sure you're doing OK. Make sure you're putting yourself in a position to stay healthy, especially while balancing a career.   [30:45] Ryan says those are great things for our listeners to keep in mind.   [30:49] For our listeners who do want to learn more about eosinophilic disorders, we encourage you to visit APFED.org and check out the links in the show notes below. [30:55] If you're looking to find a specialist who treats eosinophilic disorders, we encourage you to use APFED's Specialist Finder. available at APFED.org/specialist.   [31:04] If you have personally been impacted by eosinophilic disorders and are interested in sharing your experience, please check out APFED.org/shareyourstory.   [31:12] If you'd like to connect with others impacted by eosinophilic diseases, please join APFED's online community on the Inspire Network at APFED.org/connections.   [31:23] Ryan thanks Phil for joining us today. This was a super interesting conversation. Phil thanks Ryan and Holly for having him on. He is happy to represent on the podcast.   [31:35] Holly thanks APFED's Education Partners GSK, Sanofi, Regeneron, and Takeda for supporting this episode.   Mentioned in This Episode:   APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast Apfed.org apfed.org/specialist apfed.org/connections Phillip Arceneaux, PhD Education Partners: This episode of APFED's podcast is brought to you thanks to the support of GSK, Sanofi, Regeneron, and Takeda.   Tweetables (Edited):   "I took a bite of a roast beef sandwich, and it wasn't going down smoothly. I drank some water. The bite became an impaction. The water stayed in my esophagus, and I started to aspirate." — Phillip Arceneaux, Ph.D.   "The ER doctor told me he was 95% certain I had eosinophilic esophagitis. I had never heard of it. He gave me a quick rundown of what it was." — Phillip Arceneaux, Ph.D.   "I want to give a shout-out to my GI. He spent well over an hour in my initial consult. He explained how [EoE] would impact me, from diet, grocery shopping, and eating at restaurants, because of cross-contamination." — Phillip Arceneaux, Ph.D.   "I never associated the symptoms with eggs. My treatment plan is diet and minimizing egg as much as possible. That is not easy in the United States." — Phillip Arceneaux, Ph.D.   "This is something you have to deal with the rest of your life. That's going to fundamentally change things, not drastically, but in fairly subtle ways." — Phillip Arceneaux, Ph.D.   "No matter how comfortable you get, you have to be diligent. You always have to be cognizant of your symptoms and stay on whatever your treatment plan is, whether that's dieting or medication. This will not go away. You're always going to have it." — Phillip Arceneaux, Ph.D.   Guest Bio: Dr. Phillip Arceneaux is an Assistant Professor of Strategic Communication at Miami University in Ohio, where he teaches mass communication courses focusing on media psychology and content strategy. Phil was diagnosed with EoE in 2019 following an ER visit to UF Health Shands Hospital that required an emergency endoscopy. A Cajun French native of Lafayette, Louisiana, he earned his Ph.D. from the University of Florida and has resided in Cincinnati since 2020.  

Marco Quarta is co-founder and Chief Scientific Officer of Rubedo Life Sciences, a precision-therapeutics company developing medicines that target the pathological cell states that drive age-associated disease. Marco's first appearance on the show was three years ago, in February 2023 (Episode 35), when Rubedo was a much earlier-stage company committed to the then-contrarian premise that "the senescent cell" is not a single entity but a heterogeneous family of cell states that needs to be deconvoluted at the single-cell level. In March 2026, Rubedo reported preliminary Phase 1b/2a clinical data for its lead candidate, RLS-1496, a first-in-class topical GPX4 modulator. Marco returns to the show to discuss what survived contact with human biology.In this episode, Chris and Marco unpack the readout from Rubedo's basket trial across four skin indications — psoriasis, atopic dermatitis, actinic keratosis, and photoaged skin — and the biology that underlies it. RLS-1496 came clean on safety in all four indications, with significant efficacy signals despite small patient numbers and short (20–30 day) treatment courses. More provocatively, the clinical and translational data have pushed Marco to redefine what kind of drug this actually is. Rather than a next-generation senolytic, GPX4 modulation appears to act as a state-gating intervention: it triggers ferroptosis in deeply senescent cells that have already crossed a redox threshold, while inducing a hormetic "redox reset" in stressed-but-recoverable cells that restores them to a healthier state. Marco proposes a new category to capture this dual action — adaptive senotherapeutics, or senoadaptive drugs — distinct from senolytics and senomorphics.The conversation traces the arc from Rubedo's founding thesis to a clinically validated platform (ALEMBIC, the AI-enabled single-cell multiomics engine that surfaced GPX4 as a target), through the strategic logic of leading with skin, into the broader question every longevity-biotech founder eventually has to answer: when does a disease-by-disease franchise become a credible preventive geroscience platform? Marco lays out the GLP-1 analogy explicitly — an anchor indication and a label-expansion roadmap that could carry GPX4 modulation from dermatology into respiratory, neurodegenerative, and metabolic disease, and ultimately into the use case where biomarkers of cellular senescence flag patients for therapy decades before disease becomes clinically apparent.The Finer Details:How Marco's 2023 contrarian view — that "senescent cells" hide a tissue- and state-specific reality — has been reinforced by the clinic, and how Rubedo's framing has shifted from "targeting senescent cells" to "targeting pathological cell states"The biology of GPX4 as a lipid-peroxidation gatekeeper, why senescent cells have intrinsic vulnerabilities (p16, p21, CDK4/6 inhibition) that make them ferroptosis-sensitive, and how Rubedo's approach differs from oncology-focused GPX4 programs at Takeda and othersThe "senoadaptive" mechanism — RLS-1496 eliminates GPX4-dependent senescent cells via ferroptosis while triggering NRF2/Keap1-driven redox reset, autophagy, and epigenetic remodeling in recoverable cells, restoring tissue trajectory from degenerative to regenerativeWhy Rubedo led with skin: clean regulatory path, accessible tissue, the ability to read out aging biology anddisease in the same trial, and a label-expansion runway into systemic indicationsPhase 1b (Europe) and Phase 2a (US) basket-trial results across psoriasis, atopic dermatitis, photoaged skin, and actinic keratosis: clean safety in 4/4 indications and significant efficacy signals — itch reduction in atopic dermatitis, decreased lesional thickness in psoriasis, target-engagement-correlated clinical improvement in photoaged skinThe richness of the translational dataset: biopsies, tape-stripping, spatial transcriptomics, proteomics, multiplex histomics, plasma biomarkers — all feeding back into ALEMBIC to refine the platformWhy actinic keratosis is the most strategically important indication — an age-related, chronic-inflammatory, precancerous condition where Rubedo can simultaneously test disease modification and biological-age reversalThe Rubedo–Beiersdorf partnership and the cosmetic vertical as a parallel commercial axisPipeline beyond skin: targeting aberrant basaloid stem cells in IPF and other pulmonary indications using different modalities (prodrugs, PROTACs, ADCs) to achieve cell-state selectivityThe longer-arc vision: senescence biomarkers as a "prediabetes-style" early signal, with senoadaptive drugs deployed decades before disease — and what a GLP-1-scale franchise might look like for GPX4 modulationQuotes:"There is not such a thing as a senescent cell — like there is not a cancer cell. And that was the initial idea. I'm glad that over time the field evolved. Now this is an accepted concept in the senotherapeutic space.""We are really talking about a dual function of RLS-1496 that can modulate the cell state depending on the adaptive response. That's why we call this — de facto — a new class of senotherapeutics. We call them adaptive senotherapeutics, or senoadaptive drugs — not a senolytic or a senomorphic, but working by modulating the cell state.""The best animal model for human therapies is human. As much as you can do preclinical work in animal models, it's always an approximation. We were able to test this directly in patients for safety, and in 4 out of 4 indications, we didn't have any safety signal.""Imagine you're taking care of a growing tree, and this tree has some dead leaves and some are a little bit stressed. If you shake the tree, the dead leaves will fall; the healthy leaves will not, because they're healthy and they resist the shake. But that shake actually gives the stressed leaves space and breathing room, and helps them to regain vitality. That's a little bit what GPX4 modulation does.""Senotherapeutics is a large, growing field — an untapped therapeutic opportunity. There is no such thing as a pan-senolytic or a pan-senotherapeutic, like there is no pan-oncotherapeutic. You need to understand the context. But these will all be part of the arsenal for true longevity medicine.""I don't see this as prevention of disease. The way I see therapies like ours, and the way the field of longevity is developing, is treating diseases decades before they develop. That's not a new concept — that's what we're doing in diabetes. You can be diagnosed with prediabetes today and reverse those biomarkers with lifestyle changes or metformin, and maybe never develop diabetes. That's exactly what we're doing here.""First of all, celebrating the first approved drugs from Rubedo — I don't think we're too far from that. But that's also a beginning, because you learn from the big momentum the GLP-1 agonists created: how a drug can start in one indication, create a new field, and prove that you can go beyond that. I hope in a few years we come back and talk about the next GLP-1 — this could be GPX4 modulators, or the senoadaptive drugs that are first in our pipeline."Links:Rubedo Life Sciences: https://www.rubedolife.comMarco Quarta's previous appearance on Translating Aging: Ep 35 — Targeting Pathologic Cells to Preserve Biological Youth

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Let's dive into the latest happenings shaping the landscape of this dynamic industry. The pharmaceutical and biotech sectors are navigating a complex landscape replete with scientific advancements and regulatory challenges. A significant legal development comes from Takeda, which faces an $885 million verdict in a landmark pay-for-delay antitrust case. This ruling highlights the intense scrutiny of pharmaceutical companies over antitrust regulations, with potential implications for drug pricing strategies and industry practices. The possibility of tripling damages under these laws could set a precedent affecting future business operations, as Takeda plans to appeal, underscoring the high stakes involved in such litigation. Meanwhile, on the regulatory front, the White House's decision to include 600 generic medications in the TrumpRx purchasing portal marks a strategic effort to improve drug affordability. While its overall impact remains uncertain, this initiative aims to bridge gaps in medication accessibility for cost-sensitive populations. Similarly, Roche's licensing agreement with the Medicines Patent Pool to allow generic versions of Xofluza in 129 developing countries is a noteworthy step towards enhancing global access to essential medicines. These efforts underscore ongoing attempts to address affordability and accessibility concerns on a global scale. In clinical developments, UCB's Bimzelx has shown promising results against AbbVie's Skyrizi in treating psoriatic arthritis, demonstrating a statistically significant reduction in disease activity compared to Skyrizi in a Phase 3b trial. With nearly half of the patients showing improved outcomes at week 16, Bimzelx is poised to become a competitive therapeutic option, potentially redefining treatment protocols for psoriatic arthritis. Novartis's termination of its contract with Chinese CDMO Porton Pharma Solutions due to regulatory issues underscores the challenges inherent in cross-border pharmaceutical partnerships. The $64 million legal claims looming over this decision highlight the financial and operational risks associated with international collaborations. Meanwhile, biopharmaceutical buyers are increasingly turning to artificial intelligence and local expertise to navigate rising licensing costs in China. Sanofi and Wave Life Sciences are making progress in addressing α1-antitrypsin deficiency (AATD), a genetic disorder that has witnessed limited therapeutic innovation for decades. Their efforts were highlighted at the American Thoracic Society meeting, showcasing ongoing attempts to bridge treatment gaps for rare diseases through next-generation approaches. Strategic investments continue to shape the industry, as evidenced by Lauxera Capital Partners' successful EUR520 million fundraising aimed at advancing healthcare technologies. Additionally, Merck's agreement to supply Keytruda for Exelixis' colorectal cancer trial exemplifies collaborative efforts crucial for advancing cancer research. These developments reflect an industry balancing innovation with regulatory compliance and market dynamics. Scientific progress is also evident in Relay Therapeutics' advancement with its PI3K inhibitor, which has shown promising Phase 2 data in treating blood vessel disorders. This underscores the potential of PI3K inhibitors to address unmet medical needs by targeting pathways significant in cancer and other diseases. The integration of artificial intelligence into drug discovery processes is another critical trend. Incyte's collaboration with Edison Scientific aims to enhance decision-making and streamline drug discovery, showcasing AI's potential to revolutionize R&D efficiency. However, persistent challenges remain as AI scales up but doesn't yet resolve clinical trial protocol issues fully. On the business front, Bristol Myers Squibb considers investing $1 billion in a Houston manufacturing plant, emphasizing strategic infrastructure investments crucial for meeting growing pharmaceutical demands. In drug approvals, AstraZeneca's Baxfendy has received FDA approval for treating uncontrolled hypertension by targeting aldosterone synthesis—offering a novel approach as a combination therapy. Moreover, Merck & Co.'s sacituzumab tirumotecan has achieved Phase 3 success in endometrial cancer trials, demonstrating superior survival outcomes compared to chemotherapy. This highlights the growing impact of targeted therapies in oncology and the ongoing shift towards precision medicine. Despite these positive developments, challenges persist. BioMarin Pharmaceutical's BMN 401 faced setbacks after missing key Phase 3 endpoints for skeletal healing in ENPP1 deficiency patients—highlighting complexities in rare disease drug development. In conclusion, these diverse developments reflect an industry steadfastly committed to advancing healthcare through scientific innovation while navigating regulatory hurdles and operational challenges. As these sectors evolve further, maintaining a balance between rapid innovation and rigorous oversight remains essential to ensuring impactful treatments reach patients worldwide promptly. Thank you for tuning in to Pharma Daily—stay informed and stay ahead of industry trends with us tomorrow!Support the show

What happens when some of healthcare's most trusted workers are still operating outside the systems that document, reimburse, and scale care? In this episode, Colby Takeda, Co-Founder & CEO of Pear Suite, joins Saul Marquez live at ViVE to explore why community health workers are becoming a more essential part of the healthcare ecosystem. Drawing from his background in senior living and public health, Colby explains how Pear Suite helps community-based providers move beyond paper and spreadsheets with tools to document care, navigate credentialing and contracting, submit claims, and get paid for the value they deliver. The conversation also looks at Pear Suite's broader vision for connecting community-based organizations, health plans, and providers in a more coordinated system of care. Colby shares why AI should reduce administrative burden instead of replacing trusted relationships, how co-design with frontline workers has shaped the platform, and where he sees the biggest opportunity to make community-based care more sustainable and accessible at scale. Tune in to hear how community health workers are becoming more essential to the healthcare ecosystem, and how better infrastructure and smarter technology can make community-based care more sustainable and scalable. Resources: Connect with Colby Takeda on LinkedIn Learn more about Pear Suite Explore Pear Suite for Providers Follow Pear Suite on LinkedIn

In this episode of Bowel Sounds, hosts Dr. Temara Hajjat and Dr. Peter Lu talk to Dr. Maureen Leonard, a pediatric gastroenterologist and Associate Professor at Massachusetts General Hospital. Dr. Leonard discusses the latest research on early life factors that can increase celiac disease risk for susceptible children, including potentially modifiable risk factors. Dr. Leonard's disclosures include:  Consultant for Takeda, Chugai, Anokion, Sonoma, and Interlude Biopharma and research support from Takeda, Pfizer, Regeneron, Moderna, and Mead Johnson Nutrition.Learning objectivesUnderstand early life determinants for celiac diseaseUnderstand environmental influences on developing celiac diseaseSend us Fan MailSupport the showThis episode may be eligible for CME credit!  Once you have listened to the episode, click this link to claim your credit.  Credit is available to NASPGHAN members (if you are not a member, you should probably sign up).  And thank you to the NASPGHAN Professional Education Committee for their review!As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Check out our merch website!Follow us on Bluesky, Twitter, Facebook and Instagram for all the latest news and upcoming episodes.Click here to support the show.

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we explore a series of transformative events shaping the industry landscape, from scientific breakthroughs to regulatory shifts and strategic realignments. Eisai's progress with its Alzheimer's treatment, Leqembi, marks a significant milestone in addressing one of the most challenging neurological disorders. With a sales forecast of $900 million, this development underscores the growing demand for effective Alzheimer's treatments. Eisai's partnership with Biogen plays a crucial role in this context, aiming to provide a solution to a disease that has long eluded effective therapeutic intervention. This collaboration highlights the intricate interplay between scientific innovation and strategic alliances in tackling complex health challenges. Biogen's recent data on Alzheimer's disease advances our understanding of neurodegenerative disorders by reinforcing the tau hypothesis alongside longstanding amyloid-beta research. This insight opens new avenues for therapeutic interventions targeting tau proteins—a potentially pivotal shift given prior limited success with amyloid-centric approaches. Denali Therapeutics may benefit from this paradigm shift thanks to its proprietary technology that enhances central nervous system drug delivery—a crucial factor for effective tau-targeting therapies. Concurrently, organizational restructuring at Novartis reflects broader industry trends. As companies increasingly focus on optimizing operations and honing in on core therapeutic areas, Novartis's strategy to streamline its biomedical research arm could potentially impact innovation timelines and resource allocation. This move is indicative of a wider industry shift aimed at enhancing research efficiency and maintaining competitive edges in a rapidly evolving market. Regulatory updates continue to be pivotal, as seen with the U.S. Supreme Court's decision to temporarily restore telehealth access to the abortion pill mifepristone. This ruling not only underscores the intersection between healthcare access and legal frameworks but also highlights potential implications for patient accessibility to medications across the U.S. Meanwhile, AstraZeneca's Imfinzi received swift regulatory endorsement from NICE for perioperative use in stomach cancer just 17 days post UK approval. Such rapid endorsements are crucial in expanding treatment options and improving patient outcomes, particularly in oncology where timely interventions can be life-saving. In market dynamics, Novo Nordisk's Wegovy pill has experienced its first decline in total prescriptions, as tracked by Fierce Pharma through their new oral GLP-1 tracker. This development suggests shifting preferences among clinicians and patients within the competitive landscape of weight management therapies. It points to an environment where continuous innovation and adaptation are necessary to maintain market presence. Biopharmaceutical pipelines are increasingly dominated by biologics, presenting both opportunities and challenges. A report highlights manufacturing complexities that pose hurdles for new product launches, emphasizing the industry's shift from small molecules to biologically-derived therapies. As demand grows, advancements in manufacturing technologies and processes become essential to meeting these needs effectively. Aardvark Therapeutics' decision to unblind its phase 3 Prader-Willi syndrome study data following an FDA-imposed hold illustrates the regulatory hurdles that can occur during drug development. These holds often delay critical data analyses but also present opportunities for reevaluating trial strategies, ensuring that patient safety remains paramount. Aardvark Therapeutics faces regulatory challenges as its Prader-Willi syndrome trials encounter an FDA-imposed hold due to cardiac safety concerns. These developments highlight both scientific promise and the stringent safety standards essential within drug development processes. Technological innovation is reshaping drug discovery efforts through targeted protein degradation—a method allowing researchers to address previously "undruggable" targets. This approach signifies a potential revolution in developing novel therapeutic modalities across various diseases, highlighting the industry's capacity for groundbreaking advancements. On the policy front, bipartisan lawmakers have reintroduced legislation aimed at preventing pharmacy benefit managers from owning retail pharmacies. This legislation seeks to address conflicts of interest that could impact drug pricing and access, underscoring the ongoing scrutiny on practices affecting healthcare costs. In oncology, Genmab's recalibration of its antibody-drug conjugate pipeline signals competitive pressures within this innovative space where differentiation is key to maintaining market leadership. Similarly, Create Medicines' entry into CAR T-cell therapies—backed by substantial funding—reflects ongoing investment in breakthrough cancer treatments while balancing immediate clinical opportunities with strategic long-term goals. Amidst these transformative developments are broader industry trends involving employment shifts and funding dynamics. Despite workforce reductions like those at Takeda as part of its transformation strategy, there remains strong momentum within sectors such as California's vibrant biotech scene—illustrating resilience amid economic pressures. These stories exemplify an industry characterized by transformation driven by scientific insights into disease mechanisms coupled with regulatory vigilance ensuring patient safety remains paramount throughout all stages—from discovery through commercialization—ultimately striving towards improved patient care outcomes addressing various unmet medical needs worldwide.Support the show

This episode covers: Cardiology This Week: A concise summary of recent studies Biomarkers in heart failure Digoxin in HFrEF Scientific Highlights from Heart Failure 2026 Host: Wilfried Mullens Guests: Lynne Stevenson, Dirk van Veldhuisen, Theresa McDonagh Want to watch that episode? Go to: https://esc365.escardio.org/event/2565 Disclaimer: ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. A ny views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode. The ESC is not liable for any translated content of this video. The English language always prevails. ESC TV Today uses a range of tools and resources (including AI) to support content production. All content is reviewed and approved by the editorial team. Statements and opinions expressed by guest speakers are their own. Declarations of interests: Stephan Achenbach, Yasmina Bououdina, Nicolle Kraenkel, Dirk van Veldhuisen and Lynne Warner Stevenson have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Novo Nordisk, Pfizer, Sanofi, Servier, Takeda, Tecnimede, Viatris. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report:Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. David Duncker has declared to have potential conflicts of interest to report: lecture honoraria from Abbott, Astra Zeneca, Biotronik, Boehringer Ingelheim, Boston Scientifics, Bristol Meyers Squibb, CVRx, Daiichi Sankyo, Medtronic, Microport, Pfizer, Sanofi, Zoll. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi.  Theresa McDonagh has declared to have potential conflicts of interest to report: honoraria from Boeringer Ingelheim. Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we're diving into the dynamic shifts and breakthroughs shaping this ever-evolving industry. In a significant regulatory update, the resignation of FDA Commissioner Marty Makary has stirred discussions across the pharmaceutical landscape. Over his 13-month tenure, Makary faced considerable scrutiny for his controversial decisions, including the rejection of several rare disease drugs. This leadership change at the FDA may herald a period of uncertainty as the agency searches for new direction amidst criticisms and operational challenges. The implications are vast, potentially affecting drug approval processes and public health policies, making it crucial for stakeholders to watch closely how the agency adapts to this transition. Simultaneously, Takeda's announcement to lay off 4,500 employees marks a strategic move to streamline operations and focus on core competencies. This decision reflects a broader industry trend where companies are optimizing their structures to enhance financial health in a highly competitive market. The cost savings from this restructuring are expected to be substantial, allowing Takeda to pivot towards more sustainable business models and focus on areas that promise future growth. Eli Lilly and Novo Nordisk continue to lead in drug development with their GLP-1 receptor agonists. Both companies have reported promising data on early response and long-term weight loss maintenance in patients, positioning their therapies as pivotal in treating obesity. Eli Lilly's obesity treatments Foundayo (orforglipron) and Zepbound (tirzepatide) have shown sustained weight-loss maintenance in Phase 3 trials, reinforcing their efficacy in metabolic health interventions. These developments not only highlight the intense competition in the GLP-1 space but also underscore the potential impact on addressing global obesity challenges effectively. The strategic landscape of mergers and acquisitions is also evolving with Merck KGaA's announcement to bolster its pipeline through strategic M&A activities. This move is emblematic of an industry-wide strategy where companies seek external innovation to fill pipeline gaps, ensuring sustained growth and competitiveness. In a related vein, BioMarin's $4.8 billion acquisition of Amicus Therapeutics signifies a firm commitment to addressing unmet needs in rare diseases, illustrating how consolidation can enhance capabilities in niche markets with significant potential. In vaccine development, Valneva's decision to reduce its workforce by up to 15% highlights ongoing challenges in the sector, particularly for travel-related vaccines affected by global market trends. This restructuring is indicative of the volatility faced by companies as they adapt strategies for long-term sustainability amidst shifting consumer behaviors. Pfizer's expansion into Europe with its hemophilia treatment Hympavzi marks a critical regulatory milestone, broadening its market presence and offering expanded therapeutic options for patients. This approval not only strengthens Pfizer's foothold in the hemophilia market but also exemplifies the global reach of innovative treatments. Technological integration continues to revolutionize R&D processes, as evidenced by AstraZeneca's licensing agreement with Owkin for AI capabilities. This partnership aims to harness AI-driven insights for drug discovery, showcasing how technology is reshaping traditional research methodologies and enhancing efficiency. Similarly, advancements in AI-powered diagnostics are evidenced by Boehringer Ingelheim's collaboration with Brainomix in pulmonary fibrosis imaging, reflecting broader trends towards personalized medicine through precise disease characterization. Kyverna Therapeutics is advancing in cell therapy with Support the show

Co-hosts Ryan Piansky, a graduate student and patient advocate living with eosinophilic esophagitis (EoE) and eosinophilic asthma, and Holly Knotowicz, a speech-language pathologist living with EoE who serves on APFED's Health Science Advisory Council, interview Dr. Chukwuemeka Oko, MD, MBA, on clinical trials. Disclaimer: The information provided in this podcast is designed to support, not replace, the relationship between listeners and their healthcare providers. Opinions, information, and recommendations shared in this podcast are not a substitute for medical advice. Decisions related to medical care should be made with your healthcare provider. Opinions and views of guests and co-hosts are their own.   Key Takeaways: [:49] Co-host Ryan Piansky introduces this episode, brought to you thanks to the support of Education Partners GSK, Sanofi, Regeneron, and Takeda. Ryan introduces co-host Holly Knotowicz.   [1:13] Holly introduces today's topic — clinical trials — and today's guest, Dr. Chukwuemeka Oko, a Clinical Research and Medical Affairs Professional supporting Duke University Hospital's Department of Gastroenterology and Transplant Hepatology.   [1:33] Dr. Oko explains that he is sharing general, educational information from his perspective and experience, not speaking on behalf of Duke University, nor any industry sponsor, nor any company he has worked for.   [1:50] Dr. Oko's goal today is to help the listeners feel clearer, more confident, and more in control when they are thinking about clinical research.   [2:29] Dr. Oko's work sits mainly at the intersection of clinical research and medical affairs. He helps translate evolving science into practical, patient-centered decisions.   [2:40] From an academic standpoint, he supports clinical trials and evidence generation from feasibility through education.   [2:49] Dr. Oko also engages investigators and thought leaders from industry sponsors in scientific exchanges that lead to insights, study design, and real-world care pathways.   [3:03] Dr. Oko had two reasons to study eosinophilic esophagitis and eosinophilic disease. The first is the patient journey and biology.   [3:11] On the patient side, many people spend a long time seeking answers. Sometimes they feel dismissed before they get a clear diagnosis and a plan that fits their life.   [3:24] On the biology side, eosinophilic disease teaches us a lot about how our immune signals can drive information differently across tissues like the esophagus and airways.   [3:40] Dr. Oko supported an EoE study experience with an industry sponsor in the past. The best research doesn't just test; it helps patients and clinicians make clearer decisions.   [4:12] Dr. Oko explains that a clinical trial is a carefully designed, carefully crafted study in people that answers specific medical questions, most often about safety, effectiveness, or dosing of the study drug or how a treatment should be used.   [4:32] A key structure of a study is a written protocol where safety monitoring is in place, and the defined outcome or results are very reliable. The FDA always oversees clinical trials in the U.S.    [4:44] Dr. Oko often describes a trial as a highly-monitored learning system. It's how medicine moves from "We think this might help" to "We know what helps, for whom, and also at what risk."   [5:09] Dr. Oko says clinical trials usually study what improves patient outcomes, for whom, and at what risk, using methods that we can trust. Trials may evaluate new medicines, devices, dosage strategies, or even procedures.   [5:31] Clinical trials can also study non-drug approaches such as diet interventions, symptom tracking, monitoring tools, and education strategies.   [5:44] Many trials have also included biomarkers, or signals in the blood or tissue, helping to support an EoE diagnosis so that the patients can get treated in an early and effective manner.   [6:36] Dr. Oko says patients sometimes ask him if they are guinea pigs. In reality, trials are heavily regulated and closely monitored, with strict safety reporting requirements. Participants are not guinea pigs.   [7:06] Dr. Oko also hears patients ask if they are "stuck" once they join the clinical trial. No, a trial is a completely voluntary participation, and they can withdraw at any time.   [7:25] Other patients ask if trials are only for people who are out of options. Many trials are designed for earlier stages, especially when the goal is to prevent complications or reduce steroid exposure.   [7:46] The last question Dr. Oko hears a lot is "Will I be in the placebo group?" He says it's an understandable fear. They are asking if they will go untreated in the placebo group.   [8:29] In many trials, a placebo is not the same as "no care". Often, the participants continue the standard-of-care treatment, and the study drug or placebo is added to the standard-of-care treatment.   [8:45] Trials typically involve symptom monitoring and a plan for what happens if the symptoms worsen. There are exit criteria.   [9:01] From the pharmaceutical side, it's the end of treatment once you decide to voluntarily exit the study.   [9:10] Dr. Oko's advice is, if you participate, ask the study team physicians to explain in plain language what you'll receive, what you can continue, and what happens if you flare up. Clear answers are always a part of ethical research.   [10:33] Holly asks what it means to participate in a Phase 1, Phase 2, or Phase 3 trial. Dr. Oko says a Phase 1 trial is focused mostly on the safety and the dosing regimen. It's usually a small group of five to 100 or so.   [10:52] A Phase 2 trial always looks for the drug's effectiveness and continues monitoring safety. It's usually a group of 100 to 300 subjects. They look for meaningful signals of the outcomes derived from the trial.   [11:10] A Phase 3 trial is usually large. It's multi-centered. It's called a complementary study. It involves thousands of patients. It can even be across nations and states.   [11:26] This is where they compare new interventions against a placebo or against a standard of treatment to provide clinical benefits and support for regulatory approval.    [12:03] Participating in any phase of a trial includes fitting the eligibility criteria of inclusion for that particular phase. If you are a good match, you can be in either a Phase 1, Phase 2, or Phase 3 trial.   [12:52] Holly says she knows that a lot of people with EoE or EGIDs are very curious about trials and how to participate in them.   [13:00] Ryan says we have a very active patient community, and everyone's looking for ways to get involved in research and new diagnostics or medications to improve their own outcomes and help everyone else.   [13:35] Dr. Oko says the benefits of participating in a clinical trial include access to potentially disease-modifying therapies years before they reach the market.   [13:47] Another benefit is extraordinarily close medical monitoring. When you're in a clinical trial, you have more frequent visits and more frequent labs than usual.   [14:01] Endoscopies are out of the normal standard of care, but will be more frequent than normal to analyze the efficacy of the study drug.   [14:11] Dr. Oko says one of the risks is the unknown side effects the study drug comes with, because we are still understanding the biology.   [14:21] The time commitment for visits can be more than typical for a patient, especially if there is a long travel time involved. Patients may arrive at 7:00 or 8:00 a.m. They may need to find a place to live nearby, depending on the pace of the trial.   [14:57] Holly lives in Maine, and a lot of the trials are in Boston. It's a lot of travel. For people with any kind of chronic illness, all we think about is money. Holly asks if people pay to be part of a clinical trial.   [15:25] Dr. Oko states that the patients do not have to pay anything to be part of a clinical trial. Patients do get compensated by the trial sponsor for travel, accommodation, parking, and a meal for the days they are onsite.   [16:33] Dr. Oko says that patients tend to bring up insurance. It is a misconception that the study will pay for their standard-of-care medication during the study. Patients need to ask the study team what insurance will pay for and what the study will pay for.   [16:59] Dr. Oko says the insurance usually covers the regular standard-of-treatment, but any other additional treatment, procedures, and visits are all covered by the study sponsor.    [17:29] The study sponsor may ask for an endoscopy to be done six months before the study to determine eligibility for the study. If it is done within a year, the study sponsor will determine if you are qualified. That is part of the eligibility criteria in some cases.   [18:26] Dr. Oko tells patients to always ask questions, like what the schedule of events is in the clinical trial.   [18:35] The schedule of events tells you how many visits are required for you to be part of this study. They will list the activities to be done. They will list the labs you will need at what week. They will list when you need endoscopies, at week one and later.   [19:05] If you exit from the study, if you don't want to participate anymore, you are still required to come on site just to make sure that you are in good shape. Those are called formal visits.   [10:29] Dr. Oko explains that formal visits are necessary for the patient's safety and to make sure that the data points collected in the study will be effective.   [20:01] Patients enrolling in a clinical trial can also ask about the known risks of the symptom monitoring plan. They can ask what is covered and what is not covered by insurance, and what will be considered out of pocket.   [20:20] If patients are in the placebo group, what will happen if symptoms worsen? In the protocol, there is always a rescue plan. If a symptom flares up, the Principal Investigator carries out the rescue plan.   [20:58] The study team is available on a 24/7 hotline. The questions you ask are very important. No question is too small to ask. Every question and every symptom you report is important. You can withdraw at any time, and there is always a follow-up.   [22:19] Dr. Oko says the trial data that has already been collected from part of our eosinophilic studies has led to various FDA approvals of the biologics. We are working  to try to transform EoE from a steroid-dependent or diet-only disease into a position of long-term control.   [22:37] Trial findings have shaped care, expanding evidence-based options, clarifying which patients benefit the most, and improving how we measure our outcomes, the symptoms, and quality of life, as measured by patients' quality-of-life surveys.   [23:06] Quality-of-life surveys are very important for the study team. They help to measure safety, too. The evidence generated from this data leads to insights and improves study design, protocol design, and ultimately, improves patient care.   [23:40] Ryan says the community is interested in clinical trials because they benefit patients, researchers, and clinicians. We're thankful for the clinicians and researchers putting in all the work to make these clinical trials happen.   [24:01] Ryan adds, we're also thankful for the patients who are interested in these trials. For patients who are looking to participate, how can they find clinical trials to participate in and join?   [24:15] Dr. Oko says people can find the website ClinicalTrials.gov. It's an important tool in looking for various clinical research. Scientists are recruiting at a given time. You can use the Advanced Search option to narrow the search by state and criteria.   [24:54] You can always discuss clinical trials with your primary care physicians. You can look for major academic medical centers. Most of them always have clinical research studies going on.   [25:07] Dr. Oko says APFED.org is a very good tool. It always maintains up-to-date trial listings and patient-friendly summaries where patients can read about the studies.   [25:30] Ryan says he's very appreciative of the mention of APFED. There is a link on APFED.org so people can find studies. There are clinical trials listed that people can research more and join.   [25:46] Holly asks Dr. Oko to share advice for listeners who are considering participating in a clinical trial. He shares, "I want each one of you to approach the decision with the same care you would with any major medical choice. Review the Informed Consent Form (ICF)."   [26:23] "The word informed means you should be informed. It's your right to get informed with every line, every detail. The Consent Form can be 30 pages long, but please just know that you are not in a rush to answer."   [26:43] "You can take the Consent Form and discuss it with your friends, your family, your primary care physician, your gastroenterologist, and your allergist and get more information."   [27:00] "When you join an interventional trial, or a registry, your contribution accelerates the science and benefits the entire eosinophilic community."   [27:12] "From my years of reviewing medical charts and supporting new recruitments, I feel patients feel most satisfied when they are fully informed and genuinely partnered with the study team. That's how I partner with the patients. I am always there to help."    [27:40] Ryan says that is great advice for patients, and hopefully, some of our listeners to this episode will go out there and look for clinical trials to participate in or ask their physicians, next time they're getting care.   [27:52] For patients who would like to know more about eosinophilic disorders, we encourage you to visit APFED.org and check out the links in the show notes below, specifically to research opportunities listed on APFED.org. [28:08] If you've been personally impacted by eosinophilic disorders and are interested in sharing your experiences, we encourage you to please check out APFED.org/shareyourstory.   [28:17] Ryan thanks Dr.Oko for joining us today. This was really helpful and insightful, and hopefully, we'll have many new patients interested in joining clinical trials. Dr. Oko thanks Ryan and Holly for having him on and thanks every listener who has joined us.   [28:33] Dr. Oko says it has been a genuine pleasure and privilege for him. He has spent years seeing patients, reviewing their charts, and hearing their stories. We see you, we hear you. Science is advancing rapidly and shaping outcomes. You are not alone.   [30:17] Holly thanks Dr. Oko for his research and clinical trials, and thanks APFED's Education Partners GSK, Sanofi, Regeneron, and Takeda for supporting this episode.   Mentioned in This Episode:   APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast Apfed.org apfed.org/specialist apfed.org/connections apfed.org/research/clinical-trials Duke University Hospital's Department of Gastroenterology Education Partners: This episode of APFED's podcast is brought to you thanks to the support of GSK, Sanofi, Regeneron, and Takeda.   Tweetables:   "Many people spend a long time seeking answers. Sometimes they feel dismissed before they get a clear diagnosis and a plan that fits their life." — Chukwuemeka Oko, MD, MBA   "On the biology side, eosinophilic disease teaches us a lot about how our immune signals can drive information differently across tissues like the esophagus and airways." — Chukwuemeka Oko, MD, MBA   "In many trials, a placebo is not the same as no care. Often, the participants continue the standard-of-care treatment, and the study drug or placebo is added to the standard-of-care treatment." — Chukwuemeka Oko, MD, MBA   "I tell patients to always ask questions, like what the schedule of events is in the clinical trial." — Chukwuemeka Oko, MD, MBA   "[If a patient exits the study], formal visits are necessary for the patient's safety and to make sure that the data points collected in the study will be effective." — Chukwuemeka Oko, MD, MBA   "From my years of reviewing medical charts and supporting new recruitments, I feel patients feel most satisfied when they are fully informed and genuinely partnered with the study team." — Chukwuemeka Oko, MD, MBA   Guest Bio: Chukwuemeka Oko, MD, MBA

This episode covers: Cardiology This Week: A concise summary of recent studies Genetics and genetic testing in HCM Asymptomatic aortic valve stenosis Statistics Made Easy: Mediation analysis Host: Wilfried Mullens Guests: JP Carpenter, Caroline Coats, Marc Dweck Want to watch that episode? Go to: https://esc365.escardio.org/event/2564 Want to watch that extended interview on asymptomatic aortic valve stenosis, go to: https://esc365.escardio.org/event/2564?resource=interview   Disclaimer  ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode. The ESC is not liable for any translated content of this video. The English language always prevails.  ESC TV Today uses a range of tools and resources (including AI) to support content production. All content is reviewed and approved by the editorial team. Statements and opinions expressed by guest speakers are their own.    Declarations of interests Stephan Achenbach, Yasmina Bououdina, Antonio Greco and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. Caroline Coats has declared to have potential conflicts of interest to report: in the last 5 years, consultant/advisor to Bayer, Bristol Myers Squibb, Cytokinetics, Sanofi, Roche Diagnostics. Marc Dweck has declared to have potential conflicts of interest to report: consultancy fees from Novartis, Silence, and AstraZeneca related to aortic stenosis and development of a medical therapy. David Duncker has declared to have potential conflicts of interest to report: lecture honoraria from Abbott, Astra Zeneca, Biotronik, Boehringer Ingelheim, Boston Scientifics, Bristol Meyers Squibb, CVRx, Daiichi Sankyo, Medtronic, Microport, Pfizer, Sanofi, Zoll. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Host: Wilfried Mullens Guest: Marc Dweck Want to watch that extended interview on https://esc365.escardio.org/event/2564?resource=interview Go to: Want to watch that episode? Go to: https://esc365.escardio.org/event/2564   Disclaimer ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode. The ESC is not liable for any translated content of this video. The English language always prevails. ESC TV Today uses a range of tools and resources (including AI) to support content production. All content is reviewed and approved by the editorial team. Statements and opinions expressed by guest speakers are their own.   Declarations of interests Stephan Achenbach, Yasmina Bououdina, Antonio Greco and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. Marc Dweck has declared to have potential conflicts of interest to report: consultancy fees from Novartis, Silence, and AstraZeneca related to aortic stenosis and development of a medical therapy. David Duncker has declared to have potential conflicts of interest to report: lecture honoraria from Abbott, Astra Zeneca, Biotronik, Boehringer Ingelheim, Boston Scientifics, Bristol Meyers Squibb, CVRx, Daiichi Sankyo, Medtronic, Microport, Pfizer, Sanofi, Zoll. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Send us Fan MailIt's a rare piece of good news. A single-dose dengue vaccine developed in Brazil as part of an international collaboration protected people against at least two strains of the virus for five years or longer, and did so safely. The vaccine was already being tested across Brazil and the findings helped boost confidence in its use. “This is a big deal,” says Dr. Andre Siqueira, Head of the Dengue Global Program at the Drugs for Neglected Diseases Initiative (DNDI).  Dr. Siqueira, who is also an Infectious Diseases Consultant at Brazil's Instituto Nacional de Infectologia Evandro Chagas, a hospital that is part of the Oswaldo Cruz Foundation (Fiocruz), helped develop the vaccine. He chatted with One World, One Health about the work in 2024. The new vaccine worked almost perfectly to keep people from being hospitalized with severe dengue symptoms, Dr. Siqueira and the team reported in Nature Medicine.  That's a big deal. Dengue can cause terrible symptoms, including severe abdominal pain, internal bleeding, severe muscle aches, and long term fatigue. From January 2025 to January 2026, dengue killed more than 4,000 people. The only other dengue vaccines currently available are a two-dose formula made by Japanese manufacturer Takeda and Sanofi's Dengvaxia, which the company is discontinuing because of a lack of demand. In this episode, Siqueira updates host Maggie Fox about the latest findings on the new vaccine's efficacy and its rollout in Brazil. 

This episode covers: Cardiology This Week: A concise summary of recent studies Time for physiological pacing in heart failure? Same-day discharge after EP procedures: from evidence to practice EHRA 2026 Scientific Highlights Host: Gerd Hindricks Guests: Haran Burri, Emma Svennberg, Julia Vogler Want to watch that episode? Go to: https://esc365.escardio.org/event/2555    Disclaimer ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode. The ESC is not liable for any translated content of this video.  The English language always prevails. ESC TV Today uses a range of tools and resources (including AI) to support content production. All content is reviewed and approved by the editorial team. Statements and opinions expressed by guest speakers are their own.   Declarations of interests Stephan Achenbach, Yasmina Bououdina and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Haran Burri has declared to have potential conflicts of interest to report: institutional research and fellowship support or speaker honoraria from Abbott, Biotronik, Boston Scientific, Medtronic, Microport. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. David Duncker has declared to have potential conflicts of interest to report: lecture honorary from Abbott, Astra Zeneca, Biotronik, Boehringer Ingelheim, Boston Scientifics, Bristol Meyers Squibb, CVRx, Daiichi Sankyo, Medtronic, Microport, Pfizer, Sanofi, Zoll. Gerd Hindricks has declared to have potential conflicts of interest to report: institutional research and fellowship support or speaker honoraria from Abbott, Biotronik, Boston Scientific, Medtronic, Microport. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Helmut Puererfellner has declared to have potential conflicts of interest to report: speaker fees, honoraria, consultancy, advisory board fees, investigator, committee member, etc., including travel funding related to these activities for the following companies: Abbott, Biotronik, Biosense Webster, Boston Scientific, Daiichi Sankyo, Medtronic. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson. Julia Vogler has declared to have potential conflicts of interest to report: honoraria for talks: Abbott.

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we delve into some of the most intriguing advancements and strategic moves shaping the future of drug development and patient care. Regeneron has recently ventured into the radiopharmaceuticals market through a substantial $2.1 billion agreement with Australia's Telix Pharmaceuticals. This move marks a significant diversification from Regeneron's traditional focus, such as obesity treatments, to an area that combines radioactive isotopes with targeting molecules for diagnosing and treating diseases like cancer more effectively. The strategic alliance positions Regeneron as a formidable player in this emerging field, promising to expand its therapeutic portfolio and revenue streams. In oncology innovation, GSK is pushing forward with a bold initiative, conducting Phase 3 trials for antibody-drug conjugates (ADCs) in collaboration with Hansoh Pharmaceutical. This effort underscores GSK's commitment to expanding its oncology pipeline, particularly in targeting unmet medical needs through innovative therapies. Antibody-drug conjugates are designed to deliver cytotoxic agents directly to cancer cells, minimizing damage to healthy tissues and offering a precision approach to cancer treatment. Allogeneic CAR-T therapies are also making waves, with Allogene Therapeutics reporting promising early data from their off-the-shelf CAR-T therapy, cema-cel. This therapy effectively eradicated minimal residual disease in lymphoma patients, highlighting the potential of allogeneic approaches to provide accessible cancer treatments without the logistical complexities of autologous methods. In another significant milestone, Ideaya Biosciences, in collaboration with Servier, achieved success with their eye cancer drug candidate meeting its primary endpoint in a crucial Phase 2/3 trial. This success sets the stage for an accelerated FDA approval filing, offering new hope for patients dealing with this challenging condition. Revolution Medicines has made notable progress in oncology as well, with its highly anticipated RAS inhibitor demonstrating improved survival outcomes in a Phase 3 trial for pancreatic cancer. Extending survival by an average of six months compared to chemotherapy could redefine treatment paradigms for one of the most aggressive cancer types. Not every development has been favorable, however. Replimune faced its second FDA rejection for its melanoma candidate RP1, leading to workforce reductions—a testament to the rigorous nature of regulatory approvals and the challenges companies face when bringing novel therapies to market. Meanwhile, BioNTech and Synox Therapeutics are advancing towards FDA approval for their tumor-targeting therapies. These efforts could intensify competition within the oncology space, challenging established giants like AstraZeneca and Daiichi Sankyo. In pain management, AbbVie has expanded its portfolio through a $745 million deal with Haisco Pharmaceutical Group for two non-opioid pain treatment candidates. This move aligns with growing demand for non-opioid alternatives amid the opioid crisis, reflecting a strategic shift towards safer pain management solutions. Spyre Therapeutics has also reported positive Phase 2 results for its ulcerative colitis drug, setting it up as a potential competitor against Takeda's Entyvio. Success here could enhance therapeutic options for patients struggling with this chronic condition, highlighting continued innovation in gastrointestinal disorders. Eli Lilly's recent success with its BTK inhibitor Jaypirca marks a pivotal moment in chronic lymphocytic leukemia (CLL) treatment strategies. Having demonstrated substantial efficacy in a Phase 3 clinical trial—the fourth positive readout—Jaypirca establishes itself as an industry first. Its fixed-duratioSupport the show

Does it fee like food gets stuck when you swallow? Or like swallowing takes more effort than it should?  These symptoms are often dismissed—but they may be signs of Eosinophilic Esophagitis (EoE), a condition that frequently goes undiagnosed for years. In this episode of Gastro Girl, Jacqueline Gaulin sits down with Dr. Neil D. Parikh to break down what these symptoms really mean—and when it's time to take action.  In this episode: Why food may feel like it's getting stuck The difference between reflux and something more Early warning signs many people overlook When swallowing problems need medical evaluation How EoE is diagnosed and why timing matters If you've ever adjusted how you eat, avoided certain foods, or felt like swallowing just isn't right—this episode will help you connect the dots. Produced by Gastro Girl, a trusted digestive health education platform and official patient education partner of the American College of Gastroenterology. This educational initiative was developed with support from Takeda.  

This Biotech CEO Created The RedTail Platform To Fight Cancer. Guest:Eric PomaCEO of Calidi Bio CLDI Company Name:Calidi BiotherapeuticsWebsite: https://www.calidibio.com/Ticker: NYSE: CLDIEric's Bio:Eric Poma, Ph.D. has served as Chief Executive Officer and board director of Calidi since April 2025 and brings more than 30 years of experience in the biopharmaceutical industry, with a strong record of capital fundraising, big pharma collaboration agreements, and clinical program development.Prior to joining Calidi, Dr. Poma served as CEO of Molecular Templates (NASDAQ: MTEM), a clinical-stage biotech focused on the development of a novel class of therapeutic agents with unique biology in oncology. At Molecular Templates he raised over $250 million in equity financing and secured over $150 million in strategic capital through agreements with Takeda, Vertex and BMS. He previously served as Vice President, Business Development of Innovive Pharmaceuticals. Prior to that he held various senior level positions at Imclone Systems, Inc., primarily in business development. Earlier, Dr. Poma served as a Healthcare & Biotechnology Analyst with the healthcare fund Eagle Growth Investors, LLC.Dr. Poma received a Ph.D. in Microbiology and Immunology from the University of North Carolina at Chapel Hill, an M.B.A. from the Leonard N. Stern School of Business and a Bachelor of Science in Biology from the University of North Carolina at Chapel Hill.Company Bio:Calidi Biotherapeutics is a biotechnology company pioneering the development of targeted genetic medicines for cancer and other diseases through its RedTail platform. The company's lead compound, CLD-401, is a systemically delivered oncolytic virus that expresses high levels of IL-15 superagonist only in the tumor microenvironment. The company expects to file an IND to initiate clinical studies for CLD-401 by the end of 2026. The company continues to advance what the RedTail platform can achieve and will be presenting additional data throughout the year.

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we delve into a series of remarkable advancements and challenges shaping these dynamic sectors. AstraZeneca has reported promising results with an immunotherapy combination involving Imfinzi (durvalumab) and Imjudo (tremelimumab) for treating locoregional liver cancer. This combination has demonstrated a significant progression-free survival benefit, potentially setting a new standard in liver cancer treatment. The success of this regimen highlights the critical role of immunotherapies in oncology, offering new hope for patients with cancers that have been historically difficult to treat. Turning to regulatory news, Eli Lilly's new GLP-1 receptor agonist pill, Foundayo, has received FDA approval. This marks a significant milestone as it's the first new molecular entity approved under the FDA's National Priority Voucher Program. Foundayo's approval intensifies the competition in the obesity treatment market, challenging Novo Nordisk's established position with Wegovy. Analysts forecast a major rollout for Foundayo, predicting over 5 million prescriptions by 2026. This advancement underscores the increasing focus on addressing obesity, a critical global health challenge. In geopolitical news, former U.S. President Donald Trump is reportedly considering imposing a 100% tariff on certain pharmaceutical imports from non-Most Favored Nation countries. Such a policy could significantly impact international pharmaceutical trade and supply chains, forcing companies to reevaluate their global manufacturing and distribution strategies. In vaccine development news, a Belgian court has ordered Poland and Romania to pay Pfizer $2.2 billion over contested COVID-19 vaccine doses, underscoring the complexities of international vaccine agreements and their financial ramifications during the pandemic. Conversely, Pfizer and BioNTech have halted their US Phase 3 trial for the Comirnaty COVID-19 vaccine due to recruitment challenges. This reflects ongoing difficulties in maintaining participant engagement for booster studies post-pandemic. On the clinical trial front, Valneva's Lyme disease vaccine program with Pfizer remains a topic of interest despite missing its primary endpoint in Phase 3 trials. Valneva's CEO remains optimistic about its regulatory future, framing it as a matter of negotiation. This situation highlights the intricate nature of clinical trial outcomes and regulatory negotiations. Meanwhile, Gilead Sciences has faced setbacks with its HIV drug pipeline due to an ongoing FDA clinical hold on a mid-stage trial. This incident underscores the challenges companies encounter while navigating regulatory hurdles to ensure drug safety. In other industry trends, there's an increased reliance on pharmacovigilance outsourcing to enhance efficiency within pharmaceutical companies. This allows firms to concentrate more on core activities impacting patient care and drug innovation directly. The industry also saw exciting advancements in radioligand therapy, which holds promise for targeting up to 80% of cancers with precision therapies. Such developments illustrate how understanding biological pathways can lead to significant breakthroughs in cancer treatment paradigms. In business developments, Axsome Therapeutics has partnered with Takeda for Balipodect, a schizophrenia asset involving undisclosed payments. This partnership highlights the trend towards strategic collaborations in neurological disorders aimed at fostering therapeutic innovation. Furthermore, Zai Lab and Amgen are collaborating on a global Phase 1b trial focusing on small cell lung cancer using antibody-drug conjugates and bispecific T-cell engagers. This research emphasizes growing interest in precision oncology treatments offering targeted therapeutic oSupport the show

This episode covers: Cardiology this Week: A concise summary of recent studies What's new in hypertension? Why I favour a critical approach in cardiology Snapshots Host: Sabiha Gati Guests: Konstantinos Koskinas, Gianfranco Parati, John Mandrola, Yasmina Bououdina Want to watch this episode? Go to: https://esc365.escardio.org/event/2561 Disclaimer: ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode. The ESC is not liable for any translated content of this video. The English language always prevails. Declarations of interests: Stephan Achenbach, Yasmina Bououdina, Sabiha Gati, Nicolle Kraenkel and John Mandrola have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. David Duncker has declared to have potential conflicts of interest to report: honorary from Abbott, Astra Zeneca, Biotronik, Boehringer Ingelheim, Boston Scientifics, Bristol Meyers Squibb, CVRx, Daiichi Sankyo, Medtronic, Microport, Pfizer, Sanofi, Zoll. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi.  Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Gianfranco Parati has declared to have potential conflicts of interest to report: Merck Sharp and Dohme, Omron Healthcare, Viatris. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Host: Sabiha Gati Guest: Gianfranco Parati Want to watch this extended interview? Go to: https://esc365.escardio.org/event/2561?resource=interview Want to watch the episode? Go to: https://esc365.escardio.org/event/2561 Disclaimer: ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode. The ESC is not liable for any translated content of this video. The English language always prevails. Declarations of interests: Stephan Achenbach, Yasmina Bououdina, Sabiha Gati and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. David Duncker has declared to have potential conflicts of interest to report: honorary from Abbott, Astra Zeneca, Biotronik, Boehringer Ingelheim, Boston Scientifics, Bristol Meyers Squibb, CVRx, Daiichi Sankyo, Medtronic, Microport, Pfizer, Sanofi, Zoll. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi.  Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Gianfranco Parati has declared to have potential conflicts of interest to report: Merck Sharp and Dohme, Omron Healthcare, Viatris. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we're diving into a series of transformative developments that underscore the continual evolution of this dynamic industry.First, let's explore the latest strategic move from Takeda Pharmaceuticals, which has embarked on a $1.3 billion restructuring plan in the United States. This has resulted in layoffs affecting 634 employees, a decision aimed at streamlining operations and cutting annual costs by over $1.26 billion. Such significant restructuring efforts are likely to alter market dynamics, as Takeda reallocates resources to focus on its core competencies and innovation-driven growth. The industry may witness shifts as Takeda aims to bolster its competitive edge amid a rapidly evolving market landscape.In a significant regulatory development, Biogen has successfully secured FDA approval for a high-dose version of Spinraza, designed to treat spinal muscular atrophy (SMA). This approval, following the resolution of prior manufacturing concerns, is a strategic effort to enhance therapeutic efficacy and maintain Biogen's competitive positioning against newer market players. The high-dose formulation of Spinraza promises improved patient outcomes, reinforcing Biogen's dedication to addressing unmet medical needs in SMA and offering hope to patients and families affected by this debilitating condition.Meanwhile, Samsung Biologics faces internal challenges as its labor union votes in favor of striking over unresolved governance issues and rigid labor policies. This potential strike highlights growing tensions within the company and raises concerns about operational continuity, which could affect production timelines and contractual obligations with partners. It's a reminder of the delicate balance between corporate governance and employee relations within major organizations.On the innovation front, Idorsia's investigational drug Quviviq has shown promise in treating pediatric insomnia following successful Phase 2 trials. If approved, Quviviq could be a pioneering treatment for children with insomnia, setting a new standard of care for this underserved patient population. This development highlights the importance of addressing specific medical needs across different demographics within the broader field of sleep disorders.Financial investments in research and development continue to shape the industry, with Eli Lilly embracing insilico medicine's AI technology through a $2.75 billion collaboration. This partnership aims to leverage AI-driven insights for drug discovery, reflecting an industry-wide trend toward integrating digital technologies into R&D processes. By adopting AI, companies like Eli Lilly are poised to accelerate drug discovery timelines and enhance precision in identifying potential therapeutic candidates. Additionally, Eli Lilly is spearheading research efforts into GLP-1 receptor agonists for treating substance use disorders, based on emerging scientific evidence suggesting these compounds could play a role in managing addiction by modulating reward pathways linked to addictive behaviors.In cardiovascular health advancements, Boston Scientific's Watchman heart implant has demonstrated substantial clinical benefits by reducing bleeding risks compared to traditional anticoagulants while maintaining non-inferiority in stroke prevention and mortality outcomes among atrial fibrillation patients. This advancement is likely to influence future clinical practice guidelines by offering safer long-term management options for atrial fibrillation.Moreover, Advocate Health's ambitious hospital drone delivery program, in partnership with Zipline, seeks to revolutionize logistics within healthcare delivery systems across major U.S. cities. By enhancing supply chain efficiencies and ensuring timely access to critical Support the show

Co-hosts Ryan Piansky, a patient advocate living with eosinophilic esophagitis (EoE) and eosinophilic asthma, and Holly Knotowicz, a speech-language pathologist living with EoE who serves on APFED's Health Sciences Advisory Council, interview Angelica Lackey Mirzoca, MPH, about her research on social vulnerability and EoE. Disclaimer: The information provided in this podcast is designed to support, not replace, the relationship between listeners and their healthcare providers. Opinions, information, and recommendations shared in this podcast are not a substitute for medical advice. Decisions related to medical care should be made with your healthcare provider. Opinions and views of guests and co-hosts are their own.   Key Takeaways: [:51] Co-host Ryan Piansky introduces this episode, brought to you thanks to the support of Education Partners GSK, Sanofi, Regeneron, and Takeda. Ryan introduces co-host Holly Knotowicz.   [1:13] Holly introduces today's topic — research on social vulnerability and eosinophilic esophagitis (EoE) — and today's guest, Angelica Lackey Mirzoca, a fourth-year medical student at the University of North Carolina School of Medicine in Chapel Hill.   [1:38] Angelica will start an internal medicine residency this summer and is planning to do a fellowship in GI and liver disease. Before medical school, she studied public health nutrition at UNC and worked in clinical research in eosinophilic diseases.   [1:58] Angelica has been able to use her analytic and public health skills as a member of UNC's EoE Research Group, which is part of the larger Center for Esophageal Diseases and Swallowing, led by Dr. Evan Dellon.   [2:15] Ryan sees Dr. Dellon as his GI. Dr. Dellon has been a guest on the Real Talk: Eosinophilic Diseases podcast. Ryan says Dr. Dellon is wonderful, and many in the community look up to him. It's exciting that Angelica is doing research alongside him.   [2:38] Dr. Craig Reed, part of the EoE Group, who works closely with Dr. Dellon, invited Angelica to a research meeting. She's always had an interest in digestive tract function and diseases.   [2:55] When Angelica was growing up, her father had Barrett's Esophagus. She saw him choking a lot when he was swallowing. It was really scary.   [3:04] Angelica says that being in the EoE space and appreciating the impact that problems swallowing have, not only on the patient's everyday life but on the people around the patient, it was important to her to dedicate her skills and time to EoE.   [3:37] Angelica researched EoE and social vulnerability. Her abstract at the 2025 Digestive Diseases Week was titled "Increasing Social Vulnerability Impacts Presentation and Decreases Treatment Response in Eosinophilic Esophagitis."   [3:58] Angelica explains that social vulnerability is a term to describe the context of people's day-to-day lives and the barriers and obstacles they navigate.   [4:07] In this context, their lived experience has a dramatic impact on people's ability to anticipate and recover from different stressors.   [4:16] Some groups are notably more vulnerable, including kids, older adults, single-parent households, and people who live with physical and mental disabilities.   [4:28] Social vulnerability can be measured qualitatively in terms of socio-economic status and household composition. Other composite scores or variables can serve as quantitative assessments of social vulnerability.   [4:50] Ryan says he does research for graduate school associated with climate vulnerability and infrastructure. He has done some work with the CDC's Social Vulnerability Index and the Climate and Environmental Justice Screening Tool.   [5:20] Angelica says they used the CDC's Social Vulnerability Index in the study. It's a 16-variable composite score with four overarching themes. It's down to the Census Track level. You can associate it with patient zip codes.   [5:37] The SVI can populate into patient charts or a QI database. It was very easy to incorporate into the database.   [5:50] The QI database was developed to help people understand what neighborhoods and communities might need additional support in natural disasters. It includes variables that impact people's health day-to-day.    [6:18] Angelica says health equity is core to everything she does. Participating in the EoE research, it was important to her to consider the social vulnerability, or people's lived reality, and how it impacts their ability to feel empowered to access care.   [6:42] Angelica talks about people not knowing what's wrong with them, choking. Angelica worked in restaurants for 12 years before going to medical school. She listened to a lot of people share their struggles to communicate with the doctors.   [7:09] Holly says when she worked at a major children's hospital in an EoE clinic, they had local patient families and patients that flew in from farther away. The local patients got to see her weekly for feeding therapy. That's when she started doing telehealth.   [8:04] Angelica says the biggest strength of the database is its size. Having 1,400 people and adding every new diagnosis they get at UNC, and every new diagnosis over the past 23 years.   [8:25] There are adult (60%) and child (40%) patients in the database. There is also a good range of social vulnerability among the patients.   [8:42] Ryan notes that one of the findings of this research was that people with higher social vulnerability often experience delays in diagnosis.    [8:52] Angelica says most of the work was postulating on what could be the things that kept people from being diagnosed early, which is important. Angelica hopes that all institutions work to ensure that early endoscopies and biopsies are done.   [9:!2] The new guidelines help. Having that high index of suspicion for everyone, not basing it on demographics or judging by appearance, for whether someone needs biopsies or not.   [9:28] Social vulnerability includes access to care, getting endoscopies and biopsies, having health insurance, and ER care, which is expensive even with insurance. Specialty copays are expensive. Transportation is expensive.   [9:53] Taking time off work can be hard. People take time off to get care for their children, but often not for themselves.   [10:18] Ryan was diagnosed in 2002. Knowledge of EoE was not widespread, but his parents took off work and took him to doctors out of state. They had insurance that covered it. He saw five or six physicians in multiple states before he got a diagnosis.   [10:42] Ryan's situation is not feasible for most people. He says he is fortunate to have gotten to a doctor who had the expertise to diagnose EoE.   [10:51] Ryan says Dr. Emily McGowan was a guest on the Real Talk: Eosinophilic Diseases podcast (Episode 15), speaking on access to specialty care for EoE. She had researched urban and rural populations getting diagnosed with EoE.   [11:05] Her research showed that if you're near a center that can diagnose you, you get diagnosed more frequently, which brings it back to access to care.   [11:19] Angelica's research did not look at the urban/rural divide. That's something that may be a future direction of research. Eighty percent of North Carolina, where the study was located, is rural.   [11:41] The Social Vulnerability Index shows there is the highest vulnerability in more rural areas, especially Eastern North Carolina. Angelica imagines that the urban/rural divide plays a big role.   [11:59] Holly grew up in rural New York. She wasn't diagnosed until her twenties. She had issues, but her parents couldn't take her to be diagnosed. It's reassuring to have someone look into this, because when people do research, things change.   [12:30] Ryan says all of these points make a lot of sense on the diagnostic side. If you are in a more socially vulnerable place, you don't have the resources. You can't go and get that diagnosis.   [12:41] Ryan mentions the study found a difference in symptoms, such as vomiting, nausea, and abdominal pain. Ryan asks what that tells us about how EoE may affect patients differently in these different circumstances.   [12:53] Angelica says the study group was 40% children, and children can present with different symptoms, like belly pain and regurgitation. They're eating different foods and may not be noticing solid foods getting stuck as often.   [13:20] Anglica says there can be a lot of overlap with GERD and EoE. There may be some gut-brain interaction. There's a lot of psycho-social stress among people who have higher social vulnerability. That often manifests with the motility of the GI tract.   [13:56] Angelica says their database doesn't include people who have eosinophilic GI diseases outside of EoE.   [14:13] Holly says the study also showed that patients with higher social vulnerability were less likely to respond to swallowed steroid treatments, even after accounting for factors like age and insurance. Holly asks Angelica to explain this finding.   [14:34] Angelica says this is really important. The way you manage EoE is very patient-specific. The new guidelines give jurisdiction to you, as a patient, and your provider in deciding other things.   [14:51] You can choose dietary therapy first, or topical steroids first. People can take PPIs. They used to be required first, but now they are not. Topical steroids, the ones that you swallow, are common. Cutting out foods from your diet can be challenging.   [15:17] Some people don't love the idea of taking medicine daily in their twenties or thirties.   [15:32] The fact that you would start a patient on something and not see a histologic response opens up the door to follow-up questions of why it is not working.   [15:50] Holly says the pattern wasn't shown in people using diet-based treatments and asks what might explain that difference. She mentions that dietary elimination groceries are expensive, compared to having good insurance covering the medicine.   [16:14] Angelica says Dr. Dellon and part of the group did a study a couple of years ago looking at the cost of dietary elimination for patients. There was a lot of heterogeneity in diet elimination. It wasn't all six food elimination. It was different for everybody.   [16:36] They found that it was cheaper for patients to do elimination diets than to pay for the compounded medicines.   [16:44] Angelica was doing interviews recently for her residency, and a patient told her that when they were first diagnosed, it was hundreds of dollars for their compounded medicine, and they couldn't afford it.   [17:00] Angelica says diet therapy can be different for children versus adults. Adults are sometimes very motivated to try diet therapy. The team wondered if that motivation could influence their outcomes or their ability to adhere to eliminating things.   [17:23] Holly remembers sitting with the social worker at the Children's Hospital of Colorado GDP Clinic, talking about explaining when you're dairy-free, looking at ingredients like whey. There's so much that comes with it. It's confusing.   [17:41] Ryan says he has used swallowed steroids; he's now on a biologic. He's done diet elimination. Groceries are expensive, but there are ways to work around that. Insurance can be frustrating with step therapies, so sometimes diet is the best option.   [18:18] Ryan asks if a delayed diagnosis can impact symptom severity and disease progression, and therefore, the response to treatment options. Is the later diagnosis you see with more socially vulnerable populations playing into the treatment response?   [18:34] Angelica says the delayed diagnosis can lead to a more acute change in the lining of the esophagus, to become more fibrotic and tougher, and the esophagus loses some of its natural flexibility. She says we do wonder if that can be a component of it.   [18:59] Angelica says that's one of the limitations of the study. We need follow-up information to look longitudinally at some of the more recent endoscopies and the outcomes for these patients. She says that's something that we hope to do.   [19:16] Ryan asks about information about disease severity within the data set. Angelica says they have information on the severity scores of patients.   [19:54] The data showed that patients with higher social vulnerability had more of a mixed inflammatory phenotype compared to people with lower social vulnerability.   [20:09] Ryan notes that there are so many different angles to look at. He says in doing research, especially when working with medical charts, you can't get everything for such a large population. What you're able to figure out from all this is so cool.   [20:24] Holly says she was the person who ended up in the ED with a food impaction, and that could have been avoided. She loves that Angelica is researching it.   [20:44] Holly asks what the key takeaways are for clinicians from this research.   [20:54] Angelica says a key takeaway for all clinicians caring for people with EoE is that you have to take into consideration the vulnerabilities that patients are navigating. We operate within a complicated health system that needs to be more efficient.   [21:14] Angelica says you get more messages daily and have a lot of competing needs. It can be easy to assume that this patient in front of me is doing well enough and has access to what they need to be supported.   [21:31] Patients having space to ask a question about something important to them can be validating and affirming. Whether patients want to share at that encounter, or at the next. It normalizes that we humans need help navigating life, because it's hard.   [22:20] Holly talks about providers sitting down with you and asking if you have access to drive to this specialty pharmacy, or if you live in a home where this medicine can be delivered to you safely. It's nice to have someone ask what's going to work best for you.   [22:49] Angelica agrees. She says the Social Vulnerability Index can be incorporated into Epic. You can look at a high score and make sure the patient has a social worker and care management. Make it standard procedure to discuss it with patients.   [23:10] Ryan explains to listeners that Epic is where all patient information and records are stored. Holly mentions that her office doesn't have Epic, and she misses having electronic medical records.   [23:34] Ryan says as a patient, it's impactful that his healthcare team considers his life outside the doctor's office and that he is sticking with his care and can find care that works well for him.   [24:11] Angelica says it's important that patients understand that the spaces they are in outside the clinic do impact their health. Up to 80% of our health is influenced by things outside of the hospital and clinic, like health behaviors, exercise, smoking, and alcohol.   [24:36] Angelica says your physical environment is so important: the quality of your housing, your carpet, the pollution in your air, working in a factory, working with animals, that's important to consider.   [25:00] Angelica says your general stress level is important. That can be worse when you live in an environment that's very noisy or where you don't feel physically safe. Those are very important things to share with your doctors.   [25:25] Ryan speaks of research he does on California wildfires, where the power might be turned off for days at a time to avoid starting fires, which can spoil refrigerated foods or medicines that are difficult to replace. Where you live has major impacts.   [26:31] Angelica says something we want to do is to look at a pooled subset of around 80 patients to see what is going on with their swallowed steroid treatment. You can discern quite a lot from a chart review by the questions patients send to their team.   [26:56] Questions might be things like confusion about how to take the medication, any trouble with insurance claims, or if the medicines are touching the throat the way they're supposed to be. Is the throat not getting adequate exposure to the medicine?   [27:20] A thought the team had was that if there's increased chronic stress, that increases the allostatic load, and that can impact total inflammation. Will that make the mucosa in some people inherently resistant, and do they need bigger doses to treat the disease?   [27:42] Angelica says we're also going to incorporate the jobs they are working and the potential exposures they have there. How far they live from UNC Main, and if they are living in a rural county or not. They are trying to identify specific areas to help patients.   [28:08] Ryan speaks of the benefits and drawbacks of integrating AI into patient records. In chronic cases, the AI summaries are skimming over important details.   [28:45] Angelica says they are using AI at UNC, a lot of times when people are being admitted to the ED. It's also being used in the clinic. Angelica sees that AI edits out important details of a patient's social history.   [29:27] Holly says her office is trialing an AI, and she has learned she can teach it what is necessary to include in the notes. It can be good if you use it appropriately and train it.   [30:03] Ryan says his father recently had a prescription denied because the AI said he didn't have the disorder. He was diagnosed 20 years ago. It took several phone calls to override the AI and see in his chart that he needed this medication.   [30:54] Angelica says she hopes that this study can be the beginning of a conversation.   [31:00] Health equity is important in all of medical care. Angelica hears more about it in a primary care setting. She looks forward to health equity becoming the core of GI and liver diseases and to how we approach that care.   [31:20] Having the conversation can be the beginning of advocacy. It will be the beginning of having medications be more affordable, so you do not have to try and fail so many medications before you get the one that works for you.   [31:40] Angelica says every hour of not having the medication that works for them is hard for people. This research was a relatively simple project that answered some very important questions and left us with many more important questions to answer.   [32:00] Angelica hopes it shows the feasibility of using these tools that we already have in the community, to start making everyone's health better, and not just people who have access.   [32:15] Ryan says we're excited that you're here talking about this with us. We'd also like to congratulate you on receiving an award last year at Digestive Disease Week.   [32:23] It was an honor to recognize you with the American Gastroenterological Association APFED Abstract Award for your outstanding research that we've been discussing today.   [32:31] The abstract, "Increasing Social Vulnerability Impacts Presentation and Decreases Treatment Response in Eosinophilic Esophagitis," was selected in recognition of its significant contributions to the field.   [32:47] Angelica says it was such an honor. It means a lot to her because she conceptualized and executed this project, with so much support from Dr. Dellon and the larger EoE Group. She says she couldn't have done it without them.   [33:05] Angelica says, most importantly, the project was a small win for health equity. She hopes that it starts a lot of important conversations and that we continue to be more attuned to the social drivers that impact our really vulnerable patient population.   [33:30] Angelica's final words: For patients, caregivers, and loved ones, I encourage you to ask questions. There are no stupid or silly questions. If you feel silly asking, how you feel is valid, but it's really important that you get your questions answered.   [33:55] It's OK to say you don't know what questions to ask. You are the expert on what you need and what is important to you. Ask questions, and say when you don't know what to ask.   [34:40] Holly thinks that's great for people with a new diagnosis, or children. Ask, what would you ask, if you were in my shoes?   [34:54] Ryan thinks this is a great start for listeners who are newly diagnosed. If you'd like to learn more about eosinophilic disorders, we encourage you to visit apfed.org and check out the links in the show notes.   [35:09] If you're looking for a specialist who treats eosinophilic disorders, we encourage you to use APFED's Specialist Finder at APFED.org/specialist.   [35:18] If you'd like to connect with others impacted by eosinophilic diseases, please join APFED's online community on the Inspire Network at APFED.org/connections.   [35:28] If you've been personally impacted by eosinophilic disorders and are interested in sharing your experience, please check out APFED.org/shareyourstory.   [35:37] Ryan thanks Angelica for joining us today. This was a super insightful conversation. Angelica thanks Ryan and Holly for having her on. It was a pleasure getting to talk today.   [35:54] Holly thanks Angelica and also thanks APFED's Education Partners GSK, Sanofi, Regeneron, and Takeda for supporting this episode.   Mentioned in This Episode:   APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast Apfed.org apfed.org/specialist apfed.org/connections apfed.org/research/clinical-trials Angelica Lackey Mirzoca, MPHpubmed.ncbi.nlm.nih.gov/41551662 apfed.org/blog/may-2025-research-roundup-ddw-edition gastro.org/news/introducing-the-2025-aga-research-foundation-awardees   Education Partners: This episode of APFED's podcast is brought to you thanks to the support of GSK, Sanofi, Regeneron, and Takeda.   Tweetables:   "When I was growing up, my Dad had Barrett's Esophagus. I saw him choking a lot when he was swallowing. It was really scary. And so, being in the EoE space…was really important and attractive to me." — Angelica Lackey Mirzoca, MPH   "We used the CDC's Social Vulnerability Index in the study. It's a 16-variable composite score with four overarching themes. It's down to the Census Track level. You can associate it with patient zip codes." — Angelica Lackey Mirzoca, MPH   "Health equity is core to everything I do. Having the opportunity to participate in the EoE research, I felt it was important that we considered the social vulnerability, or people's lived reality, and how that impacts their ability to access care." — Angelica Lackey Mirzoca, MPH   "Most of the work was postulating on what could be the things that kept people from being diagnosed early, something that's really important." — Angelica Lackey Mirzoca, MPH   "I encourage you to ask questions…It's OK to say you don't know what questions to ask. You are the expert on what you need and what is important to you. Ask questions, and say when you don't know what to ask." — Angelica Lackey Mirzoca, MPH   Guest Bio: Angelica Lackey Mirzoca, MPH

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world.Today, we delve into recent significant advancements and strategic maneuvers reshaping the landscape in these dynamic industries. AstraZeneca has made a notable stride with its chronic obstructive pulmonary disease (COPD) drug candidate, achieving remarkable efficacy in Phase 3 trials. This success is particularly significant given the historical challenges in this therapeutic area, where competitors like Roche and Sanofi have struggled to deliver consistent results. AstraZeneca's achievement not only highlights its innovative clinical development strategies but also offers renewed hope for COPD patients who have long awaited more effective treatment options.In a parallel move, AstraZeneca is pioneering in vivo CAR-T cell therapies, showcasing their potential despite safety concerns following a patient death during trials in China. The therapy's ability to eradicate cancer in three out of five patients underscores its promise as a revolutionary treatment for cancer, illustrating the need for ongoing safety evaluations as this technology develops.Meanwhile, Novartis continues to strategically expand its allergy treatment portfolio with a significant $2 billion acquisition of Excellergy. This deal centers around an anti-IgE program poised to potentially replace Xolair, Novartis's leading allergy medication. Such strategic moves underscore Novartis's commitment to remaining at the forefront of allergy therapeutics by harnessing biotechnological innovations to develop next-generation treatments. This acquisition complements existing assets like Xolair, an IgE blocker now approved for treating food allergies across different age groups, aiming to bolster Novartis's competitive edge in allergy therapeutics by providing a broader array of solutions.Otsuka Pharmaceutical is also making waves with its $1.2 billion acquisition of Transcend Therapeutics. This acquisition focuses on an MDMA analog for psychiatric conditions, marking Otsuka's deepening interest in mental health therapeutics and the burgeoning field of psychedelic compounds as viable psychiatric treatments. This move reflects a broader industry trend towards exploring unconventional therapeutic avenues to address complex mental health issues.On the regulatory front, Takeda is undergoing significant restructuring efforts aimed at achieving $1.3 billion in annual savings through reorganization. This reflects a broader industry trend towards optimizing operations to enhance efficiency and maintain competitiveness in an ever-evolving market landscape.In another noteworthy development, Rocket Pharmaceuticals has secured accelerated FDA approval for Kresladi, a gene therapy targeting severe leukocyte adhesion deficiency-1. This approval highlights the growing potential of gene therapies to meet unmet medical needs for rare diseases and sets an important precedent for other companies seeking expedited regulatory pathways for their gene therapy pipelines.In Alzheimer's research, both Eisai and Alzheon have made significant contributions, especially regarding high-risk patient subsets. Eisai presented real-world data on Leqembi at the AD/PD annual meeting, demonstrating safety and efficacy in patients with specific genetic profiles like APOE4 homozygotes. Concurrently, Alzheon provided insights into its candidate's performance in similar cohorts. These findings underscore personalized medicine's growing importance in neurodegenerative disease treatment.Oncology remains a critical area with Merck's announcement of its planned acquisition of Terns Pharmaceuticals for $6.7 billion. Driven by Terns' promising leukemia drug developments, this acquisition exemplifies how major players are diversifying their oncology pipelines to maintain market leadership amid approaching patent expiraSupport the show

What happens when some of healthcare's most trusted workers are still operating outside the systems that document, reimburse, and scale care? In this episode, Colby Takeda, Co-Founder & CEO of Pear Suite, joins Saul Marquez live at ViVE to explore why community health workers are becoming a more essential part of the healthcare ecosystem. Drawing from his background in senior living and public health, Colby explains how Pear Suite helps community-based providers move beyond paper and spreadsheets with tools to document care, navigate credentialing and contracting, submit claims, and get paid for the value they deliver. The conversation also looks at Pear Suite's broader vision for connecting community-based organizations, health plans, and providers in a more coordinated system of care. Colby shares why AI should reduce administrative burden instead of replacing trusted relationships, how co-design with frontline workers has shaped the platform, and where he sees the biggest opportunity to make community-based care more sustainable and accessible at scale. Tune in to hear how community health workers are becoming more essential to the healthcare ecosystem, and how better infrastructure and smarter technology can make community-based care more sustainable and scalable. About the Guest: Colby Takeda is Co-Founder & CEO of Pear Suite. With a background in public health, senior living, and community-based care, he founded the company to help community health workers and community-based organizations better navigate the operational side of delivering meaningful support. Under his leadership, Pear Suite has built a tech-enabled model that combines workflow tools, reimbursement support, credentialing, contracting, and claims infrastructure to help community-based providers work more effectively with health plans and the broader healthcare system. Things You'll Learn: Why community health workers are becoming more central to modern, whole-person care models. How Pear Suite helps community-based providers document care, manage compliance, and get reimbursed for their work. Why policy shifts and Medicaid reimbursement are creating new momentum for community-based care. How AI can support community health workers by reducing administrative burden without replacing trust-based relationships. Why connecting health plans, providers, and community organizations is key to making community-based care sustainable at scale. Resources: Connect with Colby Takeda on LinkedIn Learn more about Pear Suite Explore Pear Suite for Providers Follow Pear Suite on LinkedIn

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we're delving into a series of transformative events that underscore the dynamic nature of our industry.First on our radar is Merck's acquisition of Terns Pharmaceuticals for a staggering $6.7 billion. This strategic move is rooted in the looming patent expiration of Keytruda, Merck's blockbuster drug. By acquiring Terns, Merck gains access to a promising chronic myeloid leukemia asset, potentially diversifying its oncology portfolio and offsetting anticipated revenue losses. This acquisition is part of a broader industry trend where companies consolidate and acquire to maintain competitive advantages and ensure pipeline robustness amidst patent challenges.In the diabetes arena, Novo Nordisk is making waves with its triple-G candidate in China, which has shown positive mid-phase trial results. This success could position Novo Nordisk as a formidable player in diabetes treatment, even as it faces competition from Eli Lilly. The development not only strengthens Novo Nordisk's global market position but also exemplifies the growing importance of international collaborations and localized clinical trials in accessing emerging markets.Sarepta Therapeutics' investment in Arrowhead Pharmaceuticals' siRNA assets is beginning to show promise with preliminary data from two siRNA candidates. This indicates a significant shift towards RNA-based therapies in addressing untreatable genetic conditions, emphasizing an innovative pivot towards precision medicine and personalized treatment approaches.Maze Therapeutics has released promising phase 2 data for its lead kidney disease candidate, described by analysts as having "best-in-class potential." Despite this clinical promise, the market's negative reaction resulted in a significant drop in Maze's stock value, highlighting the volatile nature of biotech investments where scientific potential often clashes with financial realities.In obesity treatment research, BrightGene's early-stage data shows an 8% weight loss at eight weeks with its oral dual agonist. This adds to evidence supporting multi-target therapies for complex metabolic disorders like obesity. Meanwhile, Takeda's plan to realize $1.3 billion in cost savings through restructuring aims to streamline operations and fund late-stage drug development, reflecting an industry-wide focus on operational efficiency.The partnership between ICON and Advarra seeks to optimize clinical trial efficiency through a network of connected sites, aligning with broader industry efforts to leverage technology and improve drug development timelines.Turning to UCB's substantial $2 billion investment in a biologics manufacturing facility near its US headquarters in Atlanta, Georgia, this move marks UCB's first major manufacturing footprint in the United States, underscoring its commitment to expanding biologics production capabilities. Biologics are increasingly important due to their potential for treating chronic and genetic conditions, highlighting why UCB's investment is pivotal as it strengthens its position in the US market.Biogen's collaboration with Alteogen involves a $20 million investment to utilize Alteogen's subcutaneous delivery technology for two unnamed biologics. Subcutaneous administration offers improved patient convenience and potentially better therapeutic outcomes compared to traditional intravenous methods.On the regulatory front, ImmunityBio received an FDA warning over promotional claims for Anktiva, their cancer drug. This underscores the critical need for accurate communication in drug marketing. Additionally, CSL updated its Flucelvax label at the FDA's request to include a febrile seizure warning, reflecting ongoing vigilance in post-marketing surveillance.The integration of AI into pharmaceutical operations is accelSupport the show

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world.The pharmaceutical and biotech sectors are navigating a period of profound transformation, marked by significant scientific developments, regulatory challenges, and strategic realignments. In 2025, several major pharmaceutical companies collectively reduced their workforce by over 22,000 employees. This was a strategic response to the looming $300 billion patent cliff, which is expected to significantly impact the sector as numerous high-revenue-generating drugs lose patent protection. Such workforce reductions highlight the industry's need to innovate rapidly to offset potential revenue losses.In a pivotal legal development, a massive class action lawsuit seeking RICO penalties against Takeda and Eli Lilly has been allowed to proceed by the Supreme Court. This decision underscores the increasing legal scrutiny pharmaceutical companies face over their business practices. Should the prosecution succeed, substantial financial penalties could be imposed on these companies, potentially reshaping corporate governance and compliance frameworks across the industry.In terms of drug development and acquisitions, Gilead Sciences' $2.2 billion acquisition of Ouro marks a strategic pivot towards autoimmune therapeutics. This acquisition enriches Gilead's portfolio with a promising autoimmune T-cell engager and revitalizes its partnership with Galapagos, a Belgian biotech firm. Such deals are crucial as companies seek to bolster their pipelines with innovative therapies addressing unmet medical needs.Karyopharm's recent mixed results from its Phase 3 trial of Expovio in combination with Jakafi for treating myelofibrosis illustrate the complexities and challenges inherent in oncology drug development. The company plans to engage with the FDA to discuss these outcomes, indicating a cautious yet hopeful approach toward potential approval. This scenario underscores the high-stakes environment of clinical trials where mixed results can significantly influence regulatory decisions and market strategies.Meanwhile, Eli Lilly's decision to withdraw certain insulin products from European markets by 2027 reflects shifts in strategic priorities amidst regulatory pressures and market dynamics in Europe. This move may indicate a broader trend of pharmaceutical companies reassessing product portfolios in response to evolving healthcare policies and market demands.The year also saw WuXi Biologics expanding its project portfolio significantly with U.S. clients, despite geopolitical uncertainties. This trend highlights the increasing globalization of drug development and manufacturing processes, driven by a growing demand for contract research, development, and manufacturing services.On the technology front, artificial intelligence continues to reshape various facets of the life sciences industry. AI-driven platforms are not only optimizing engagement strategies but also enhancing operational efficiencies within life sciences teams. These tools offer flexibility that allows organizations to adapt workflows according to specific needs rather than being confined by rigid systems.However, challenges remain as evidenced by Aardvark's decision to halt trials for its obesity candidate due to cardiac concerns. This pause reflects ongoing safety challenges in drug development that necessitate robust risk management strategies.In financial developments, Wilmington PharmaTech's commitment of $50 million towards expanding its API production capacity in Delaware signals confidence in future demand for complex custom APIs. However, NIH grant cuts disproportionately affecting women and early-career scientists raise concerns about diversity and sustainability within the scientific workforce.The strategic investments continue as Novartis announces a substantial commitmeSupport the show

iuscan.org.   --> not for profit discussed in this podcast episode.    Title: Intestinal Ultrasound for Diagnosis and Management of Inflammatory Bowel Disease Target Audience This activity is directed to physicians, medical students, nurse practitioners, nurses, and physician assistants. Objectives: Upon completion of this activity, participants should be able to: Review how Inflammatory Bowel Disease (IBD) is traditionally diagnosed and managed.  Review how intestinal ultrasound works and how it has been used to diagnose and manage IBD and review the data.  Review the benefits and limitations of intestinal ultrasound for IBD management and diagnosis.  Course Directors: Tony R. Tarchichi MD — Associate Professor, Department of Pediatrics, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center (UPMC.) Paul C. Gaffney Division of Pediatric Hospital Medicine. No relationships with industry relevant to the content of this educational activity have been disclosed. Michael Dolinger MD - Assistant Professor, Department of Pediatrics, NYU Grossman School of Medicine Dr. Dolinger disclosed he is a consultant for Abbvie, Pfizer, Johnson & Johnson, Celltrion, Takeda, Sanofi and Samsung Corp. Conflict of Interest Disclosure: No other planners, members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships to disclose.   Accreditation Statement: In support of improving patient care, the University of Pittsburgh is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. The University of Pittsburgh School of Medicine designates this enduring material activity for a maximum of 0.5 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity. Other health care professionals will receive a certificate of attendance confirming the number of contact hours commensurate with the extent of participation in this activity. Disclaimer Statement: The information presented at this activity represents the views and opinions of the individual presenters, and does not constitute the opinion or endorsement of, or promotion by, the UPMC Center for Continuing Education in the Health Sciences, UPMC / University of Pittsburgh Medical Center or Affiliates and University of Pittsburgh School of Medicine. Reasonable efforts have been taken intending for educational subject matter to be presented in a balanced, unbiased fashion and in compliance with regulatory requirements. However, each program attendee must always use his/her own personal and professional judgment when considering further application of this information, particularly as it may relate to patient diagnostic or treatment decisions including, without limitation, FDA-approved uses and any off-label uses. Released 3/23/26, Expires 3/23/28 The direct link to the course is provided below: Coming soon!

In this episode of Let's ComBinate, Subhi Saadeh sits down with Joseph Luminiello, CEO and Co-Founder of RCG Intel, to break down how competitive intelligence is actually used in biopharma and why most companies get it wrong.Joe introduces a practical framework built on three pillars: data (scientific publications and congresses), signal intelligence (press releases and filings), and human intelligence, which provides the context needed to interpret what those signals actually mean. While data and AI tools are becoming more accessible, Joe explains why interpretation and real-world insight remain the true differentiators in strategic decision-making.The conversation covers real-world applications across pharma strategy, including evaluating low-cost API suppliers, make-versus-buy decisions, competitor assessments, and forecasting. Subhi and Joe also discuss how cultural incentives and assumptions often shape forecasts more than data, and why even well-built models can miss significantly.Timestamps00:00 Introduction00:51 What is competitive intelligence02:57 Human intelligence in practice05:37 How insights are sourced07:59 Validating and triangulating data12:37 Forecasting and key assumptions18:01 Common client blind spots20:31 Speed of change in pharma23:56 Why context matters more than raw data27:27 Tools, congress strategy, and wrap-upLinksRCG Intel:https://rcgintel.com/Joseph Luminiello on LinkedIn:https://www.linkedin.com/in/joeluminiello/Joseph Luminiello is the CEO and Co-Founder of RCG Intel, a boutique competitive intelligence consultancy serving the pharmaceutical and biotech sector. With more than 40 years of experience across healthcare, biopharma, and strategic intelligence, Joe has built his career around what he calls prescience, the ability to synthesize disparate data points and anticipate how they will shape the future. Before launching RCG Intel, Joe served as CEO of multiple biopharma companies, including AVM Biotechnology and Third Coast Therapeutics, where he raised capital and advanced drug development programs. As Founder and CEO of SmartHealth Catalyzer, he built a 150-member senior executive operations team and sourced over 130 intellectual property projects from Midwest universities. Earlier in his career, he spent six years at Takeda Pharmaceuticals, where he rose to Vice President of Business Development, contributed to diligence for Takeda's acquisition of Nycomed, and helped launch Takeda Canada as its second employee.Subhi Saadeh is the Founder and Principal at Let's ComBinate BioWorks. He is a Certified Quality Auditor and ISO 13485 Certified Lead Auditor with leadership experience at Baxter, Pfizer, and Gilead Sciences. Subhi has extensive experience across drug-device combination products, including supplier quality, development quality, design controls, purchasing controls, audits, and management of contract manufacturers and external partners. Through Let's Combinate, he is focused on bridging the gap between pharma and devices by creating educational content, participating in industry groups, and providing consulting support to align development, quality, and regulatory expectations.

Dr. Monty Pal and Dr. Vamsi Velcheti discuss the evolving treatment landscape in EGFR-mutated non-small cell lung cancer, including landmark trials like FLAURA2, novel drug therapies, and the growing importance of ctDNA and MRD testing. TRANSCRIPT Dr. Monty Pal: Hello, and welcome to the ASCO Daily News Podcast. I'm your host, Dr. Monty Pal. I'm a medical oncologist and professor and vice chair of academic affairs at the City of Hope Comprehensive Cancer Center in Los Angeles. Today, I'm truly delighted to introduce Dr. Vamsi Velcheti, who's a professor of medicine and the chief of hematology-oncology at the Mayo Clinic in Jacksonville, Florida. We'll be discussing the expanding treatment landscape in EGFR-positive lung cancer and how to navigate the challenges of balancing treatment efficacy, toxicity, and patient quality of life in the EGFR-positive space.  Just FYI, our full disclosures are available in the transcript of this episode.  Vamsi, it's so great to have you on the podcast. Thank you so much for being here. Dr. Vamsi Velcheti: Thank you, Monty. It's a pleasure to be here with you. It's a really exciting topic and there are a lot of updates in the EGFR space. Dr. Monty Pal: So, I'm going to need your help with this because I'll be honest with you, I see very little lung cancer, if any, in my practice. I'm pretty much exclusively kidney cancer these days. I'm coming on 20 years at City of Hope now, and I still remember when trials like ECOG 1599 were presented with, you know, platinum doublets. And, of course, the field has changed a lot since then. But tell us a little bit about the first-line landscape, and I think just for the sake of time, we're going to stick with EGFR-positive disease here. What does it look like these days? Dr. Vamsi Velcheti: Monty, the foundation of care remains the third-generation EGFR inhibitors. These are selective EGFR inhibitors, like osimertinib. We've had an evolution of the development of these TKIs. Like, you know, we had the first-generation, second-generation, not-so-selective EGFR inhibitors. Now we have mutant-selective EGFR inhibitors in the clinic, and they're doing a really good job. And these are quite effective in patients who have classical activating mutations. But the reality is that these have not been transformative. These agents have fundamentally changed the response patterns, excellent CNS penetration, and very good tolerability profile. However, we don't see a lot of durability in terms of the response. So, what's different today is now there have been several trials in combination with these third-generation EGFR inhibitors that have really laid the foundation of how we kind of think about EGFR-positive disease. At the high level, there are a lot of challenges to selecting the patients for these combination-based modalities. I'm assuming we'll be talking more about these different trials and different approaches. Some of these combination-based strategies have really moved the needle in terms of improving overall survival and really improving long-term outcomes and durability in our patients. Dr. Monty Pal: And we are going to get into the weeds on this in just a moment. But I did kick off this podcast talking about chemotherapy, ECOG 1599. It does seem as though chemotherapy is still a component of management in advanced non-small cell lung cancer. So, can you tell us about, perhaps first, you mentioned osimertinib, you know, some of these next-generation EGFR inhibitors. Tell us about the role of chemo plus osimertinib. Dr. Vamsi Velcheti: That's exactly where I was going with the combination-based strategies. You know, we first started off with our earlier trials in the EGFR space evaluating the question of, are targeted therapies, are these highly effective, third-generation, EGFR-selective inhibitors, superior to platinum-doublet chemotherapy? And we've had multiple trials demonstrating that, like the FLAURA trial and in the past with second-generation EGFR inhibitors like erlotinib and gefitinib and afatinib. So, we know that these TKIs actually perform better than platinum-doublet chemotherapy. Now, we have a large, global, phase 3 trial data from the FLAURA2 trial, which looks at the question, "Hey, you know, osimertinib is better than chemotherapy, platinum-doublet chemotherapy. Can we do even better by combining osimertinib with platinum-doublet chemotherapy?" So, FLAURA2 answered that question. This is a large, phase 3 trial, and it's a positive trial with improved durability of disease control and improving overall survival with combination with chemotherapy. So, it's a very important and landmark trial, and essentially combining osimertinib with a platinum-based chemotherapy improved responses, deepened responses, and improved overall survival and really changing the disease trajectory. And this strategy is definitely compelling, especially in patients who have certain clinical high-risk features like, you know, patients who have high disease burden or patients who are sometimes having rapid disease progression early on osimertinib, especially with patients who have a lot of visceral disease burden. So, intensifying treatments up front could alter the natural trajectory of the disease. Dr. Monty Pal: So, you sort of alluded to this in that last part there, but is that kind of how you in clinical practice select? Is it based on, you know, visceral involvement? Is it based on rapidity of disease where you think about adding chemotherapy to osimertinib? Maybe you can give us the corollary. Which patients do you just use osimertinib alone in, for instance? Dr. Vamsi Velcheti: Definitely, there are some patients who have low disease burden and they have the classical mutations, like an exon 19 deletion. And these patients, especially if they don't have a lot of disease burden, they don't have CNS involvement, there may be a subset of patients who could just do fine on osimertinib of course, with close monitoring of the disease. I guess we'll get into that later, how do we do that with either ctDNA or like closer imaging or both. So, there may be some opportunity to kind of escalate patients' treatments based on certain clinical characteristics or radiographic characteristics or certain biological characteristics informed by ctDNA or other approaches. Dr. Monty Pal: No, that's interesting. And you're right, we will chat about ctDNA in just a bit. But before we get there, I think one of the big agents that has really sort of come to the fore in advanced non-small cell lung cancer is amivantamab. I've heard a lot about this in the context of even kidney cancer because in certain subsets, I'm interested in MET-directed therapies and so forth, right? So maybe tell us a little bit about the mechanism of amivantamab first, and then maybe tell us about this pivotal MARIPOSA trial where it's combined with lazertinib. Dr. Vamsi Velcheti: So, the MARIPOSA trial compared lazertinib alone with amivantamab plus lazertinib. And this trial demonstrated overall survival advantage, and there were key differences in terms of tolerability and the safety of amivantamab, which is an EGFR and MET bispecific, and there were certain kind of unique toxicity profiles that make it a little different than the intensification approach with chemotherapy through the FLAURA2 trial. So, there's a trade-off in terms of the toxicity profile. It's a different agent and a different management protocol in terms of dermatological toxicity management that clinicians need to be comfortable with. And also, there are certain unique issues in terms of amivantamab; there's a higher rate of infusion-related reactions, there's an increased risk for edema and VTEs because of amivantamab. Certainly a different toxicity profile, different management paradigm there in terms of longitudinal care of these patients requiring dermatological care and like, you know, close monitoring and prophylaxis VTEs. But having said that, definitely it's a different strategy, and it kind of changes the biology and the natural history of the cancers, and we do see some durability of responses that we see with the MARIPOSA. So, it's certainly a great alternative, at least for some patients. Dr. Monty Pal: That was a great overview of MARIPOSA. Now comes the really difficult question, which is, how do you choose between the two? You have these two great options, right, for EGFR-positive patients. You've already highlighted some of the distinctions in terms of toxicity. I think the audience is well aware of the side effects of chemo-doublet, perhaps even the EGFR-based therapies. Amivantamab is quite new. Give us a sense of how you in clinical practice decide between the two potential options here. Dr. Vamsi Velcheti: Yeah, I think that's the big challenge. I think these are two independent strategies that have evolved through the phase 3, and both of them have demonstrated overall survival benefit. So, the way I think about this is in three dimensions, right? Like, the disease biology, the patient priorities, and feasibility of care delivery. So, when I talk about the disease biology, you know, the mechanism is very different, and MET is a very dominant driver of disease in EGFR-altered patients and it's a significant mechanism of resistance, acquired resistance to TKIs. So, certainly I think there's a patient population that could benefit from a MET-directed therapy up front. However, we don't have great data to kind of really demonstrate how using amivantamab in the front line is going to change that. And are there like perhaps like some patients who we could identify who would benefit from such a strategy? Very recently, there have been some approvals in the second-line setting in lung cancer, not in the EGFR space, but like in generally in lung cancer, with the MET ADCs, and those drugs are approved with a companion diagnostic, which requires MET IHC testing. So, what has happened, at least in large academic practices and also I think in the community now, they have been checking for MET IHC expression more routinely in lung cancer. What we have been doing in our institution is we have been doing MET IHC as a reflex for all patients with EGFR, not just EGFR, but all non-small cell lung cancer patients. What that has done is now, like, we have been increasingly testing patients with EGFR for MET. And there's clearly a subset of patients who have de novo MET expression and a high MET expression. And those patients, I've been kind of like preferentially treating them with the MARIPOSA regimen. But again, I have to caution the audience that we still don't have data that MET IHC is going to help us make those decisions, whether it's better than like a FLAURA2 regimen. But however, in the second-line setting in the CHRYSALIS trial, we know that MET is a very powerful predictor of response to amivantamab. We really need more data there, but that's what I have been doing in my practice. But also, there's a lot of patient preference here. Like, there are some patients who don't want chemotherapy, and they want a non-chemotherapy approach. So, certainly there are some patients who prefer to have amivantamab. And now with the amivantamab, the subcutaneous version, the infusion reactions and the logistics of actual administration of amivantamab are more favorable with the subcutaneous approval. So, those are some of the elements that we need to take into account. Dr. Monty Pal: Well, I want to hone in on that because this subcutaneous administration route has been a big debate that I've seen on social media. Tell us, how much easier does it actually make the amivantamab experience? Does it cut down on the rash? Is it just infusion reactions? What's been your clinical experience? Vamsi Velcheti, MD: So, the subcutaneous administration of amivantamab has definitely improved the infusion reaction issue. Very rarely patients have infusion reaction now with the subcutaneous injections. And also, the infusion time is much, much shorter. Like we don't need a lot of infusion time, which is sometimes a challenge in busy infusion clinics. We need to take that into account. As far as the impact of the subcutaneous formulation on dermatological toxicity, we haven't really seen significant difference in terms of the intensity or rates of dermatological toxicity with subcutaneous. The benefits are really with the infusion reaction, the ease of administration. And interestingly, in the PALOMA trial, it also seems to be, even though this was not the primary endpoint of the study, there seems to be some suggestion that the subcutaneous amivantamab seems to have improved OS compared to the IV amivantamab. We don't really understand why, but that's a finding from the trial that's very intriguing. Dr. Monty Pal: That is really fascinating. I'm kind of curious to see how that's going to pan out. I'm going to shift gears a little bit here. And, you know, as we sort of close, I wanted to talk a little bit about biomarkers. I mean, this is obviously not a lung cancer-specific issue. It's something we think about across the board. But what I will say is that there are certain commonalities, and in bladder cancer, we think a lot now about ctDNA. But you've been way ahead of the game in lung cancer. Tell us how you guys use ctDNA, maybe both from the standpoint of monitoring for mutational status, but if you can, maybe offer some insights into some of these new MRD tests that are available too. Dr. Vamsi Velcheti: Yeah, it's rapidly evolving. Certainly, I think in the lung cancer space, you know, this has really kicked off in the lung cancer space with incorporating ctDNA into the workflow. Of course, you know, like baseline evaluation, we still kind of heavily rely on tissue genomic sequencing. But as you know, with targeted therapy, a lot of these patients have disease that evolves over time, and changes in terms of mutational pattern driving acquired resistance is a major issue across different molecular subtypes. And especially so in EGFR, when there are certain actionable opportunities associated with that transformation. So, we need to kind of have like a longitudinal snapshot of how we monitor these patients. So, the ctDNA has come to be like a tool that has now come to the forefront of clinical workflow, and almost all my patients who are having disease progression have ctDNA for kind of evaluating for resistance and informing treatment decisions, especially in EGFR. But having said that, there are a lot of challenges in terms of using ctDNA as a tool for monitoring. There are a lot of different types of assays and different platforms, and being able to use this as a quantitative tool that would be used along with the CT scans that we routinely use in clinical practice has been a challenge. And I think I would love to hear your perspectives as well, Monty, about how you're thinking about that in bladder and other disease contexts. But having said that, I think there's a lot of opportunity to incorporate ctDNA and MRD assays into clinical decision-making. Right now, in terms of clinical trials and clinical development, there have been some very interesting trials that are currently ongoing, especially in the EGFR space. We know that patients who clear ctDNA, based on some retrospective data and also like some retrospective-prospective data from trials that have already read out, that patients who clear ctDNA early with target therapy tend to do much better. They have a longer durability of response. There may be a subset of patients who have, even though they're having radiographic response, they have persistent ctDNA after a certain time point of initiation of targeted therapy. Those patients may require escalation of therapy. We don't yet know. I can't recommend that as a standard right now because we don't have clinical evidence to support that. But however, some of the clinical trials, like the ELIOS trial that's being done right now, that's actually completed enrollment, we'll hopefully see the results very soon. So, there is an emerging thought that instead of intensifying treatment for all patients with EGFR, there may be a population that may be just fine with frontline osimertinib monotherapy and introducing the intensification strategy at the time of emergence of MRD or progression on ctDNA before radiographic progression. So, there are a lot of adaptive molecular response criteria that we are kind of exploring in clinical trials that could inform how the future is going to look like for EGFR and other perhaps targeted therapies as well. So, it's fascinating, and I think there's a lot of opportunity there. Dr. Monty Pal: You know, you asked for my perspective. I actually think that what you highlighted there is the most interesting opportunity for ctDNA: the ability to de-escalate therapy. In terms of drug development, we've done so much to bring new therapies to patients, and now it's a bit of an embarrassment of riches, but the downside is that I feel like we tend to overtreat a lot of patients in the clinic. So, I definitely view MRD, you know, some of these other ctDNA techniques with methylation and so forth that may not be sort of tumor-dependent or bespoke could be incredibly, incredibly helpful. You touched on sort of the future, right, in this last section here with biomarkers. But give us a sense now in terms of novel drug therapies in the EGFR space. What are you most excited about moving forward in 2026 and beyond? Dr. Vamsi Velcheti: Yeah, I think there's a lot going on in this space, and not just this space, but across lung cancer and others as well. Like looking at the next generation of targets for ADCs. And I think a lot of these have to do with…so far in the drug development space, as you know, the improvements in clinical outcomes has been very incremental. So, we really need to make that big leap. And I think the big leap is not going to come from, in my opinion, from the next ADC, but it's going to come from how we tailor treatments and how we monitor disease better and how do we kind of incorporate the next treatment earlier and not wait for the radiographic progression. So, there's a lot of opportunity there to integrate biomarkers and dynamic biomarkers into clinical trial design and incorporating the recent advances in terms of drug design. You know, we have a lot of assets in the EGFR space, the next-generation EGFR inhibitors that are kind of designed with resistance in mind and rational combination, knowing when to introduce those combinations is also equally important. So, there's a lot going on, really exciting times to be in drug development. The one thing that I really hope will come to the forefront in drug development, not just for lung cancer, but all disease groups, is to kind of really be thoughtful about how we incorporate these really cool molecular monitoring tools and creating a composite score with imaging to be able to like really design the next generation of clinical trials. Dr. Monty Pal: You're so spot-on with that. I definitely think that we're getting to this point where, you know, we could think about the next BiTE, the next CAR-T, the next ADC. But, you know, maybe it's time for us to start really honing in on appropriate applications of these drugs, honing in on the right dose and what have you, because I definitely see some issues there.  Vamsi, this has just been terrific. I really want to thank you so much for sharing your fantastic insights with us today on the ASCO Daily News Podcast, and I really appreciate all your efforts to move the field of lung cancer forward. Dr. Vamsi Velcheti: Thanks, Monty. I really enjoyed the conversation. Dr. Monty Pal: Yeah, this was terrific.  And thanks to our listeners as well. If you value the insights that you hear from the ASCO Daily News Podcast, please take a moment to rate, review, and subscribe wherever you get your podcasts. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Follow today's speakers:     Dr. Monty Pal   @montypal  Dr. Vamsi Velcheti @VamsiVelcheti Follow ASCO on social media:          ASCO on X    ASCO on Bluesky         ASCO on Facebook          ASCO on LinkedIn          Disclosures:       Dr. Monty Pal:      Speakers' Bureau: MJH Life Sciences, IntrisiQ, Peerview     Research Funding (Inst.): Exelixis, Merck, Osel, Genentech, Crispr Therapeutics, Adicet Bio, ArsenalBio, Xencor, Miyarsian Pharmaceutical     Travel, Accommodations, Expenses: Crispr Therapeutics, Ipsen, Exelixis   Dr. Vamsi Velcheti:   Honoraria: Galvanize Therapeutics  Consulting or Advisory Role: Bristol-Myers Squibb, Merck, AstraZeneca/MedImmune, GSK, Amgen, Taiho Oncology, Novocure, Regeneron, Takeda, Janssen Oncology, Picture Health Research Funding (Inst.): Genentech, Trovagene, Eisai, OncoPlex Diagnostics, Alkermes, NantOmics, Genoptix, Altor BioScience, Merck, Bristol-Myers Squibb, Atreca, Heat Biologics, Leap Therapeutics, RSIP Vision, GlaxoSmithKline

This Special Episode on Atrial Fibrillation covers: Cardiology this Week: A concise summary of recent studies Atrial fibrillation burden: clinical relevance of a new outcome Pulsed field ablation: game changer? Drug treatment following atrial fibrillation ablation Spotlight: Holiday Heart Syndrome Host: Rick Grobbee Guests: Rick Grobbee, Konstantinos Koskinas, Jason Andrade, Arian Sultan, Michiel Rienstra Want to watch that special episode? Go to: https://esc365.escardio.org/event/2549 Disclaimer: ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode. The ESC is not liable for any translated content of this video. The English language always prevails. Declarations of interests: Stephan Achenbach, Jason Andrade, Yasmina Bououdina, Rick Grobbee and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada.  Michiel Rienstra has declared to have potential conflicts of interest to report: consultancy fees from Bayer (OCEANIC-AF national PI) , InCarda Therapeutics (RESTORE-SR national PI), Novartis to the institution. Speaker fee from Daiichi-Sankyo, Pfizer to the institution. Unrestricted research grant from the Dutch Heart Foundation and is conducted in collaboration with and supported by the Dutch CardioVascular Alliance, 01-002-2022-0118 EmbRACE. Unrestricted research grant from ZonMW and the Dutch Heart Foundation; DECISION project 848090001. Unrestricted research grants from the Netherlands Cardiovascular Research Initiative: an initiative with support of the Dutch Heart Foundation; RACE V (CVON 2014–9), RED-CVD (CVON2017-11). Unrestricted research grant from Top Sector Life Sciences & Health to the Dutch Heart Foundation (PPP Allowance; CVON-AI (2018B017). Unrestricted research grant from the European Union's Horizon 2020 research and innovation programme under grant agreement; EHRA-PATHS (945260). This research is funded by the Dutch Heart Foundation and is conducted in collaboration with and supported by the Dutch CardioVascular Alliance, 01 -002 -2022 -0118 EmbRACE.  Emma Svennberg has declared to have potential conflicts

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we explore the latest news and trends shaping this dynamic industry.Significant strides have been made recently, particularly with the FDA's approval of J&J and Protagonist Therapeutics' novel psoriasis medication, Icotyde. This once-daily oral treatment could disrupt a market dominated by injectable therapies. The convenience of oral administration is likely to improve patient compliance and drive substantial sales, marking a pivotal moment in psoriasis treatment. The Phase 3 ICONIC trial demonstrated substantial efficacy over existing treatments like Bristol Myers Squibb's Sotyktu. This trend towards more patient-friendly options is indicative of a broader industry shift and signifies Protagonist's entry into competitive immunology markets.Turning to biosimilars, Sandoz has expanded its partnership with Samsung Bioepis to commercialize up to five biosimilars, including a version of Takeda's Entyvio. This collaboration highlights the industry's growing reliance on biosimilars as affordable alternatives to branded biologics. Amidst pricing pressures and a global demand for accessible medications, such strategies are becoming increasingly vital.In an ambitious venture, TerraPower Isotopes, backed by the Gates Foundation, is investing $450 million in a plant for producing actinium-225, a rare isotope used in radiopharmaceuticals. This move positions TerraPower as a leader in supplying crucial ingredients for targeted cancer therapies—an area that promises advancements in precision medicine by offering targeted treatments with fewer side effects.Regulatory landscapes are evolving too, with the FDA and NIH committing $150 million towards alternatives to animal testing in drug development. This initiative emphasizes ethical scientific practices and leverages innovative technologies like organ-on-chip systems. Such regulatory support is essential for speeding up drug development while ensuring safety standards remain high.Stem cell therapy also sees promising developments with Aspen Neuroscience's treatment for Parkinson's disease. After one year, all treated patients showed symptom improvement, paving the way for pivotal Phase 3 trials. These results underscore the transformative potential of regenerative medicine in tackling neurodegenerative disorders.As the industry evolves, it faces challenges such as looming patent expirations and intensified competition. These pressures are prompting companies to innovate and reconsider strategies for existing product lines. In response to these challenges, strategic realignments are becoming more common.Meanwhile, Indiana's plan to create 100,000 jobs through a $1 billion strategy highlights regional efforts to establish hubs for life sciences innovation, illustrating the broader economic impact of the biopharma sector.In parallel news, Xaira Therapeutics has raised an impressive $1 billion to leverage AI for drug discovery in inflammatory and immunological research. This underscores growing reliance on AI technologies to accelerate drug development timelines. Crossbow Therapeutics reached a significant milestone by securing $77 million in Series B funding to advance its T-cell engager technology—a promising approach in immuno-oncology that harnesses the immune system against cancer cells.Despite these advancements, economic pressures continue to challenge some companies. Layoffs at Gossamer Bio and Bicycle Therapeutics highlight sector volatility and the need for strategic adaptability. Corporate governance remains under scrutiny as Moderna's CEO compensation package reveals executive priorities amidst revenue shortfalls. Meanwhile, GSK faces criticism over its management practices concerning Flovent, which raises ethical concerns about pricing strategies.In cardiovascular care, Support the show

For years, Samantha adapted quietly. She chewed longer, sipped water with every bite, avoided certain foods, and assumed the discomfort was just reflux. It wasn't. In this patient voice episode, Samantha shares the moment she realized something more serious was happening — and how that journey led to a diagnosis of eosinophilic esophagitis (EoE). She opens up about the subtle symptoms many people overlook, the daily adjustments she made without realizing it, and what finally pushed her to seek answers. If swallowing sometimes feels harder than it should, this story may sound familiar. This podcast is for educational purposes only and is not a substitute for medical advice. Always consult your healthcare provider regarding your symptoms or condition. This educational initiative was developed with support from Takeda.  

Enterprises are operationalizing artificial intelligence at scale, moving from experimentation to accountability. Gabriele Ricci of Takeda and Board Director Karenann Terrell discuss how leaders can embed AI into core operations, address unfinished digital foundations, and measure success by outcomes—not through pilots.

Die Gendermedizin bekommt in der Wissenschaft immer mehr Aufmerksamkeit. So ist die geschlechterspezifische Medizinforschung eines der Schwerpunktthemen im diesjährigen Wissenschaftsjahr, das unter dem Motto „Medizin der Zukunft“ steht. Nicht zuletzt wird dabei die sogenannte Gender-Data-Gap, also das Fehlen frauenspezifischer Daten zu Physiologie, Pathophysiologie, Epidemiologie, Diagnostik und Therapie, thematisiert. Hören Sie im Podcast, welchen Einfluss diese Datenlücke auf die Diagnose und Therapie gastrointestinaler Erkrankungen hat.

Host: Sabiha Gati Guest: Thomas F. Luescher Want to watch that extended interview on The future of guidelines in an era of Big Data and AI, go to: https://esc365.escardio.org/event/2556?resource=interview Want to watch the full episode? Go to: https://esc365.escardio.org/event/2556 Disclaimer: ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode.  The ESC is not liable for any translated content of this video. The English language always prevails. Declarations of interests: Stephan Achenbach, Yasmina Bououdina, Sabiha Gati, Nicolle Kraenkel and Thomas F. Luescher have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada.  Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

This episode covers: Cardiology this Week: A concise summary of recent studies The future of guidelines in an era of big data and AI Exercise in hypertrophic cardiomyopathy Snapshots Host: Sabiha Gati Guests: Kostas Koskinas, Thomas F. Luescher, Michael Papadakis, Stephan Achenbach Want to watch that episode? Go to: https://esc365.escardio.org/event/2556 Want to watch the extended interview on The future of guidelines in an era of Big Data and AI, go to: https://esc365.escardio.org/event/2556?resource=interview Disclaimer: ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode.  The ESC is not liable for any translated content of this video. The English language always prevails. Declarations of interests: Stephan Achenbach, Yasmina Bououdina, Sabiha Gati, Nicolle Kraenkel and Thomas F. Luescher have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada.  Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Episode 103 features Coach Chijo Takeda! Coach Chijo is a volleyball coach, educator, and content creator known for teaching the fundamentals of indoor volleyball with clarity, articulation, and energy. Through his online platforms, he has built a rapidly growing community of youth athletes and coaches who value skill development, confidence-building, and culture-driven leadership. In addition to coaching on the court, Chijo shares in-depth volleyball insights on YouTube and Instagram, regularly hosting IG Lives to answer questions and support coaches around the world. He also offers an online membership community designed to help coaches grow their knowledge, leadership, and impact. Coach Chijo is passionate about developing not just better players, but better people through the game of volleyball. Coach Chijo's Links: Website: https://coachchijo.com/ Youtube Channel: https://www.youtube.com/@CoachChijo Instagram: https://www.instagram.com/coachchijo/ Tik Tok: https://www.tiktok.com/@coachchijo In this episode we discuss: • Building real confidence in young athletes • Creating a culture that develops leaders • Coaching without ego • The mindset behind elite performance • What the next generation of volleyball truly needs This conversation is for players, coaches, and parents who want more than just skill development, they want growth from the inside out. Coach Chijo shares what it really takes to develop inspired, confident, resilient athletes in today's game. If you're serious about volleyball and personal growth, this episode is for you.

This episode covers: Cardiology This Week: A concise summary of recent studies Atrial septal defects in adults Conservative and invasive management of chronic coronary syndromes Milestones: 4S trial   Host: Rick Grobbee Guests: JP Carpenter, Annemien van den Bosch, Rasha Al-Lamee, Roxana Mehran Want to watch the episode? Go to: https://esc365.escardio.org/event/2552 Want to watch the extended interview on Atrial septal defects in adults, go to: https://esc365.escardio.org/event/2552?resource=interview Disclaimer: ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode. The ESC is not liable for any translated content of this video. The English language always prevails. Declarations of interests: Stephan Achenbach, Yasmina Bououdina, Rick Grobbee, Nicolle Kraenkel and Annemien van den Bosch have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Rasha Al-Lamee has declared to have potential conflicts of interest to report:speaker's fees for Menarini pharmaceuticals, Abbott, Philips, Medtronic, Servier, Shockwave, Elixir. Advisory board: Janssen Pharmaceuticals, Abbott, Philips, Shockwave, CathWorks, Elixir, Astrazeneca. Consulting Fees: Menarini pharmaceuticals, Abbott, Philips, Shockwave, Elixir, IsomAB, VahatiCor, SpectraWave, AstraZeneca, Cathworks, Janssen Pharmaceuticals. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Roxana Mehran has declared to have potential conflicts of interest to report: institutional research payments from Abbott, Alleviant Medical, Chiesi, Concept Medical, Cordis, CPC Clinical Research, Daiichi Sankyo, Duke, Faraday Pharmaceuticals, Idorsia Pharmaceuticals, Janssen, MedAlliance, Medtronic, NewAmsterdam Pharma, Novartis, Novo Nordisk Inc., Population Health Research Institute (PHRI), Protembis GmbH, Radcliffe, RM Global Bioaccess Fund Management, Sanofi US Services, Inc. ; personal fees from: None ; Equity

This episode, we talk about two monumental projects that were started in this reign.  One was the historiographical project that likely led to the creation of the Kojiki and the Nihon Shoki.  And then there was the start of the first permanent capital city:  the Fujiwara Capital. Listen to the episode and find more on our website:  https://sengokudaimyo.com/podcast/episode-143   Rough Transcript   Welcome to Sengoku Daimyo's Chronicles of Japan.  My name is Joshua and this is Episode 143: Temmu's Monumental Projects     Ohoama sat astride his horse and looked out at the land in front of him.   He could still see the image of the rice fields, now long fallow, spreading out on the plain.  To the north, east, and west, he could see the mountains that would frame his vision.  As his ministers started to rattle off information about the next steps of the plan, Ohoama began to smile.  He thought of the reports his embassies to the Great Tang had brought back, about the great walled cities of the continent.  In his mind's eye, Ohoama envisioned something similar, rising up on the plain in front of him. There would be an earth and stone wall, surrounding the great city.  The gates would be grand, much like the temples, but on an even greater scale.  Houses would be packed in tight, each within their own walled compounds.  In the center painted red and white, with green accents, would be a palace to rival any other structure in the archipelago.  The people would stream in, and the city would be bustling with traffic. This was a new center, from which the power of Yamato would be projected across the islands and even to the continent.   Greetings everyone, and welcome back.  This episode we are still focused on the reign of Ohoama, aka Temmu Tennou, between the years 672 and 686. Last episode we talked about the Four Great Temples—or the Four National Temples.  Much of this episode was focused on the rise and spread of Buddhism as we see in the building of these national temples, but also on the changes that occurred as the relationship between Buddhism and the State evolved.  This was part of Ohoama's work to build up the State into something beyond what it had been in the past—or perhaps into something comparable to what they believed it to have been in the past.  After all, based on the size of the tomb mounds in the kofun period, it does seem that there was a peak of prosperity in the 5th century, around the time of Wakatakeru, aka Yuryaku Tennou, and then a decline, to the point that the lineage from Wohodo, aka Keitai Tennou, seemed to have come in during a time when they were rebuilding Yamato power and authority. This episode we are going to talk about two projects that Ohoama kicked off during his reign.  He wouldn't see the completion of either one, since both took multiple decades to complete, but both focused on linking the past and the future.  The first we'll talk about is a new attempt to gather historical documents and records—the last time that was done was in the time of Kashikiya Hime, over 50 years ago.  That was during the height of Soga power.  Since then a lot had changed, and presumably there were even more stories and records that had been written down.  Plus the tide had changed.  So they needed to update—and maybe even correct—the historical record. But beyond that, there was a greater goal: Ohoama and his court also needed to make sure that the past was something that they wanted to go back to, among other things. The other thing we are going to discuss is the start of a project to build a brand new capital city.  And when we talk a bout city, we really mean a city.  This was a massive undertaking, likely unlike anything that we've seen so far.  Sure, there had been monumental building projects, but this was something that was going to take a lot more work - how much more monumental could you get than a new city?  And it would create a physical environment that would be the embodiment of the new centralization of power and authority, and the new state that Ohoama was building, with his administration—and Yamato—at the center.   Let's start with the big ones.  First and foremost, we have the entry from the 17th day of the 3rd month of the 681.  Ohoama gave a decree from the Daigokuden to commit to writing a Chronicle of the sovereigns and various matters of high antiquity.  Bentley translates this as saying that they were to record and confirm the Teiki, which Aston translated as the Chronicle of the Sovereigns, and various accounts of ancient times.  This task was given out to a slew of individuals, including the Royal Princes Kawashima and Osakabe; the Princes Hirose, Takeda, Kuwada, and Mino; as well as Kamitsukenu no Kimi no Michichi, Imbe no Muraji no Kobito, Adzumi no Muraji no Inashiki, Naniwa no Muraji no Ohogata, Nakatomi no Muraji no Ohoshima, and Heguri no Omi no Kobito.  Ohoshima and Kobito were specifically chosen as the scribes for this effort.  We aren't told what work was started at this time.  Aston, in his translation of the Nihon Shoki, assumes that this is the start of the Kojiki.  Bentley notes that this is the first in a variety of records about gathering the various records, including gathering records from the various families, and eventually even records from the various provinces.  And I think we can see why.  Legitimizing a new state and a new way of doing things often means ensuring that you have control of the narrative.  Today, that often means doing what you can to control media and the stories that are in the national consciousness.  In Ohoama's day, I'd argue that narrative was more about the various written sources, and how they were presented.  After all, many of the rituals and evidence that we are looking at would rely on the past to understand the present.  The various family records would not only tell of how those families came to be, but would have important information about what else was going on, and how that was presented could determine whether something was going to be seen as auspicious, or otherwise.  Even without getting rid of those records, it would be important to have the official, State narrative conform to the Truth that the state was attempting to implement. Ultimately, there is no way to know, exactly, how everything happened.  If the Nihon Shoki had a preface, it has been lost.  The Kojiki, for its part, does have a preface, and it points to an origin in the reign of Ohoama—known as the sovereign of Kiyomihara.  In there we are told that the sovereign had a complaint—that the Teiki and Honji, that is the chronicles of the sovereigns and the various other stories and legends, that had been handed down by various houses had come to differ from the truth.  They said they had many falsehoods, which likely meant that they just didn't match the Truth that the State was trying to push.  Thus  they wanted to create a so-called "true" version to pass down. This task was given to 28 year old Hieda no Are.  It says they were intelligent and had an incredible memory.  They studied all of the sources, and the work continued beyond the reign of Ohoama.  Later, in 711 CE, during the reign of Abe, aka Genmei Tennou, Oho no Yasumaro was given the task of writing down everything that Hieda no Are had learned.  The astute amongst you may have noticed that this mentions none of the individuals mentioned in the Nihon Shoki.  Nor does the Nihon Shoki mention anything about Hieda no Are.  So was this a separate effort, or all part of the same thing?  Was Are using the materials collected by  the project? As you may recall, we left the Kojiki behind some time ago, since it formally ends with the reign of Kashikiya hime, aka Suiko Tennou, but realistically it ended with Wohodo, aka Keitai Tennou—after that point there are just lists of the various heirs.  As such, there is some speculation that this was originally built off of earlier histories, perhaps arranged during the Soga era. The general explanation for all of this is that Hieda no Are memorized the poems and stories, and then Yasumaro wrote them down.  Furthermore, though the language in the Kojiki does not express a particular gender, in the Edo period there was a theory that Hieda no Are was a woman, which is still a popular theory. Compare all of that to the Nihon Shoki.  Where the Kojiki was often light on details and ends with Suiko Tennou, the Nihon Shoki often includes different sources, specifically mentions some of them by name, and continues up through the year 697.  Furthermore, textual analysis of the Nihon Shoki suggests that it was a team effort, with multiple Chroniclers, and likely multiple teams of Chroniclers.   I have to admit, that sounds a lot more like the kind of thing that Ohoama was kicking off. We have an entry in the Shoku Nihongi, the work that follows the Nihon Shoki, that suggests 720 for the finished compilation of the Nihon Shoki.  So did it take from 681 to 720 to put together?  That is a really long project, with what were probably several generations of individuals working on it. Or should this be read in a broader sense?  Was this a historiographical project, as Bentley calls it, but one that did not, immediately, know the form it would take?  It isn't the first such project—we have histories of the royal lineage and other stories that were compiled previously—much of that attributed to Shotoku Taishi, but likely part of an earlier attempt by the court.  In fact, given that the Kojiki and Sendai Hongi both functionally end around the time of Kashikiya hime, that is probably because the official histories covered those periods.  Obviously, though, a lot had happened, and some of what was written might not fit the current narrative.  And so we see a project to gather and compile various sources.  While this project likely culminated in the projects of the Kojiki and the Nihon Shoki, I doubt that either work was necessarily part of the original vision.  Rather, it looks like the original vision was to collect what they could and then figure things out. It would have been after they started pulling the accounts together, reading them, and noticing the discrepancies that they would have needed to then edit them in such a way that they could tell a cohesive story.  That there are two separate compilations is definitely interesting.  I do suspect that Oho no Yasumaro was working from the efforts of Hieda no Are, either writing down something that had been largely captured in memory or perhaps finishing a project that Are had never completed.  The Nihon Shoki feels like it was a different set of teams, working together, but likely drawing from many of the same sources. And as to why we don't have the earlier sources?  I once heard it said that for books to be forgotten they didn't need to be banned—they just needed to fall out of circulation and no longer be copied anymore.  As new, presumably more detailed, works arose, it makes sense that older sources would not also be copied, as that information was presumably in the updated texts, and any information that wasn't brought over had been deemed counterfactual.  Even the Nihon Shoki risked falling into oblivion; the smaller and more digestible Kojiki was often more sought after.  The Kojiki generally presents a single story, and often uses characters phonetically, demonstrating how to read names and places.  And it just has a more story-like narrative to it.  The Nihon Shoki, comparatively, is dense, written in an old form of kanbun, often relying more on kanbun than on phonetic interpretations.  It was modeled on continental works, but as such it was never going to be as easy to read.  And so for a long time the Kojiki seems to have held pride of place for all but the most ardent scholars of history. Either way, I think that it is still fair to say that the record of 681 was key to the fact that we have this history, today, even if there was no way for Ohoama, at the time, to know just what form it would take. Another ambitious project that got started under Ohoama was the development of a new and permanent capital city. Up to this point we've talked about the various capitals of Yamato, but really it was more that we were talking about the palace compounds where the sovereign lived.  From the Makimuku Palace, where either Mimaki Iribiko or possibly even Himiko herself once held sway, to the latest palace, that of Kiyomihara, the sovereigns of Yamato were known by their palaces.  This is, in part, because for the longest time each successive sovereign would build a new palace after the previous sovereign passed away.  There are various reasons why this may have been the case, often connected to insular concepts of spiritual pollution brought on by the death of an individual, but also the practical consideration that the buildings, from what we can tell, were largely made of untreated wood.  That made them easier to erect, but also made them vulnerable to the elements, over time, and is probably one of the reasons that certain shrines, like the Shrine at Ise, similarly reconstitute themselves every 20 years or so. Furthermore, we talk about palaces, but we don't really talk about cities.  There were certainly large settlements—even going back to the Wei chronicles we see the mention of some 70 thousand households in the area of Yamateg.  It is likely that the Nara basin was filled with cultivated fields and many households.  Princes and noble households had their own compounds—remember that both Soga no Umako and Prince Umayado had compounds large enough that they could build temples on the compounds and have enough left over for their own palatial residences, as well.  However, these compounds were usually distributed in various areas, where those individuals presumably held some level of local control. It is unclear to me how exactly the early court functioned as far as housing individuals, and how often the court was "in session", as it were, with the noble houses.  Presumably they had local accommodations and weren't constantly traveling back and forth to the palace all the time.  We know that some houses sent individuals, men and women, to be palace attendants, even though they lived some distance away.  This was also likely a constraint on the Yamato court's influence in the early days. We do see the sovereign traveling, and various "temporary" palaces being provided.  I highly doubt that these were all built on the spot, and were likely conversions of existing residences, and similar lodging may have been available for elites when they traveled, though perhaps without such pomp and circumstance. What we don't really see in all of this, are anything resembling cities.  Now, the term "city" doesn't exactly have a single definition, but as I'm using it, I would note that we don't see large, permanent settlements of significant size that demonstrate the kind of larger civil planning that we would expect of such a settlement.  We certainly don't have cities in the way of the large settlements along the Yangzi and Yellow rivers. We talked some time back about the evolution of capital city layouts on the continent.  We mentioned that the early theoretical plan for a capital city was based on a square plan, itself divided into 9 square districts, with the central district constituting the palace.  This design works great on paper, but not so much in practice, especially with other considerations, such as the north-south orientation of most royal buildings.  And then there are geographic considerations.  In a place like Luoyang, this square concept was interrupted by the river and local topography.  Meanwhile, in Chang'an, they were able to attain a much more regular rectangular appearance.  Here, the court and the palace were placed in the center of the northernmost wall.  As such, most of the city was laid out to the south of the palace. In each case, however, these were large, planned cities with a grid of streets that defined the neighborhoods.  On each block were various private compounds, as well as the defined markets, temples, et cetera. The first possible attempt at anything like this may have been with the Toyosaki palace, in Naniwa.  There is some consideration that, given the size of the palace, there may have been streets and avenues that were built alongside it, with the intention of having a similar city layout.  If so, it isn't at all clear that it was ever implemented, and any evidence may have been destroyed by later construction on the site.  Then we have the Ohotsu palace, but that doesn't seem to be at the same scale as the Toyosaki palace—though it is possible that, again, we are missing some key evidence.  Nonetheless, the records don't really give us anything to suggest that these were large cities rather than just palaces. There is also the timeline.  While both the Toyosaki palace and the Ohotsu palace took years to build, they did not take the time and amount of manpower that would be needed to create a true capital city.  We can judge this based on what it took to build the new capital at Nihiki. This project gets kicked off in the 11th month of 676.  We are told that there was an intent to make the capital at Nihiki, so all of the rice-fields and gardens within the precincts, public and private property alike, were left fallow and became totally overgrown. This likely took some time.  The next time we see Nihiki is in the 3rd month of 682, when Prince Mino, a minister of the Household Department, and others, went there to examine the grounds.  At that point they apparently made the final decision to build the capital there.  Ohoama came out to visit later that same month. However, a year later, in the 12th month of 683, we are told that there was a decree for there to be multiple capitals and palaces in multiple sites, and they were going to make the Capital at Naniwa one of those places.  And so public functionaries were to go figure out places for houses.  So it wasn't just that they wanted to build one new, grand capital.  It sounds like they were planning to build two or three, so not just the one at Nihiki.  This is also where I have to wonder if the Toyosaki Palace was still being used as an administrative center, at the very least.  Or was it repurposed, as we saw that the Asuka palaces had been when the court moved to Ohotsu? This is further emphasized a few months later, when Prince Hirose and Ohotomo Yasumaro, at the head of a group of clerks, officials, artisans, and yin yang diviners were sent around the Home Provinces to try and divine sites suitable for a capital.  In addition, Prince Mino, Uneme no Oni no Tsukura, and others were sent to Shinano to see about setting up a capital there as well.  Perhaps this was inspired by the relationship between the two Tang capitals of Chang'an and Luoyang.  Or perhaps it was so that if one didn't work out another one might. Regardless, Nihiki seemed to be the primary target for this project, and in the third lunar month of 684 Ohoama visited the now barren grounds and decided on a place for the new palace.  A month later, Prince Mino and others returned with a map of Shinano, but there is no indication of where they might want to build another capital. After that, we don't hear anything more of Shinano or of a site in the Home Provinces.  We do hear one more thing about Naniwa, which we mentioned a couple of episodes back, and that is that in 686 there was a fire that burned down the palace at Naniwa, after which they seem to have abandoned that as a palace site.  And so we are left with the area of Nihiki. This project would take until the very end of 694 before it was ready.  In total, we are looking at a total of about 18 years—almost two decades, to build a new capital.  Some of this may have been the time spent researching other sites, but there also would have been significant time taken to clear and level.  This wasn't just fields—based on what we know, they were even taking down old kofun; we are later told about how they had to bury the bodies that were uncovered.  There was also probably a pause of some kind during the mourning period when Ohoama passed away.  And on top of it, this really was a big project.  It wasn't just building the palace, it was the roads, the infrastructure, and then all of the other construction—the city gates, the various private compounds, and more.  One can only imagine how much was being invested, especially if they were also looking at other sites and preparing them at the same time.  I suspect that they eventually abandoned the other sites when they realized just how big a project it really was that they were undertaking. Today we know that capital as Fujiwara-kyo, based on the name of the royal palace that was built there, and remarkably, we know where it was.  Excavations have revealed the site of the palace, and have given us an idea of the extent of the city:  It was designed as a square, roughly 5.3 kilometers, or 10 ri, on each side.  The square itself was interrupted by various terrain features, including the three holy mountains.  Based on archaeological evidence, the street grid was the first thing they laid out, and from what we can tell they were using the ideal Confucian layout as first dictated in the Zhouli, or Rites of Zhou.  This meant a square grid, with the palace in the center. Indeed, the palace was centered, due south of Mt. Miminashi, and you can still go and see the palace site, today.  When they went to build the palace, they actually had to effectively erase, or bury, the roads they had laid out.  They did the same thing for Yakushi-ji, or Yakushi-temple, when they built it as part of the city; one of the reasons we know it had to have been built after the roads were laid out.  We will definitely talk about this more when we get to that point of the Chronicles, but for now, know that the Fujiwara palace itself, based on excavations of the site, was massive.  The city itself would surpass both Heijo-kyo, at Nara, and Heian-kyo, in modern Kyoto.  And the palace was like the Toyosaki Naniwa palace on steroids.  It included all of the formal features of the Toyosaki Palace for running the government, but then enclosed that all in a larger compound with various buildings surrounding the court itself.  Overall, the entire site is massive.  This was meant as a capital to last for the ages. And yet, we have evidence that it was never completed.  For one thing, there is no evidence that a wall was ever erected around it—perhaps there was just no need, as relations with the mainland had calmed down, greatly.  But there is also evidence that parts of the palace, even, were not finished at the time that they abandoned it.  Fujiwara-kyo would only be occupied for about 16 years before a new capital was built—Heijo-kyo, in Nara.  There are various reasons as to why they abandoned what was clearly meant to be the first permanent capital city, and even with the move to a new city in Nara it would be clear that it was going to take the court a bit of time before they were ready to permanently settle down—at least a century or so. Based on all the evidence we have, and assuming this was the site of the eventual capital, Nihiki was the area of modern Kashihara just north of Asuka, between—and around—the mountains of Unebi, Miminashi, and Kagu.  If these mountains are familiar, they popped up several times much earlier in the Chronicles--Mostly in the Age of the Gods and in the reign of the mythical Iware-biko, aka Jimmu Tennou.  Yet these three mountains help to set out the boundaries of the capital city that was being built at this time. There is definitely some consideration that they were emphasized in the early parts  of the Chronicles—the mythical sections, which were bolstering the story of Amaterasu and the Heavenly Grandchild, setting up the founding myths for the dynasty.  Even though the Chronicles  were not completed until well after the court had moved out, the Fujiwara capital is the climax of the Nihon Shoki, which ends in 697, three years into life at the new palace.  And so we can assume that much of the early, critical editing of the Kojiki and Nihon Shoki were done with the idea that this would be the new capital, and so it was woven into the histories, and had it continued as the capital, the very landscape would have recalled the stories of the divine origins of the Royal family and the state of Yamato itself.  This was the stage on which Ohoama's state was built.  He, and his successors, didn't just change the future path of the Yamato government.  They rearranged the physical and temporal environment, creating a world that centered them and their government.  I suspect that Ohoama didn't originally consider that these wouldn't be finished during his reign.  That said, he came to power in his 40s, only slightly younger than his brother, who had just died.  He would live to be 56 years old—a respectable age for male sovereigns, around that time.  From a quick glance, Naka no Oe was about 45 or 46 years old, while Karu lived to about 57 or 58.  Tamura only made it to 48.  The female sovereigns seem to have lasted longer, with Ohoama's mother surviving until she was 66 or 67 years old, and Kashikiya Hime made it to the ripe old age of 74.  That said, it is quite likely that he thought he would make it longer.  After all, look at all the merit he was accruing!  Still, he passed away before he could see these projects fully accomplished.  That would have to be left for the next reign—and even that wasn't enough.  The Fujiwara Capital would only be occupied for a short time before being abandoned about two reigns later, and the histories as we know them wouldn't be complete for three more reigns.  So given all of this, let's take another quick look at Ohoama himself and where he stands at this pivotal moment of Yamato history.When we look at how he is portrayed, Ohoama is generally lionized for the work he is said to have accomplished.  I would argue that he is the last of three major figures to whom are attributed most of the changes that resulted in the sinification of the Yamato government.  The first is prince Umayado, aka Shotoku Taishi, who is said to have written the 17 article constitution, the first rank system, and the introduction of Buddhism.  To be fair, these things—which may not have been exactly as recorded in the Chronicles—were likely products of the court as a whole.  Many people attribute more to Kashikiya Hime, aka Suiko Tennou, as well as Soga no Umako.  Of course, Soga no Umako wasn't a sovereign, or even a member of the royal family, and Kashikiya Hime, aka Suiko Tennou, seems to have likewise been discounted, at least later, possibly due to the fact that she is thought to have come to power more as a compromise candidate than anything else—she was the wife of a previous sovereign and niece to Soga no Umako.  Many modern scholars seem to focus more on the agency of Kashikiya Hime and suggest that she had more say than people tend to give her credit for.  That said, Shotoku Taishi seems to have been the legendary figure that was just real enough to ascribe success to.  That he died before he could assume the throne just meant that he didn't have too many problematic decisions of his own to apparently work around. The next major figure seems to be Naka no Oe, aka Tenji Tennou.  Naka no Oe kicks off the period of Great Change, the Taika era, and is credited with a lot of the changes—though I can't help but notice that the formal sovereign, Naka no Oe's uncle, Karu, seems to have stuck with the new vision of the Toyosaki Palace and the administrative state while Naka no Oe and his mother moved back to the traditional capital.  And when Naka no Oe moved the capital to Ohotsu, he once again built a palace more closely aligned to what we see in Asuka than the one in Naniwa, which brings some questions about how the new court was operating.  But many of his reforms clearly were implemented, leveraging the new concepts of continental rulership to solidify the court's hegemony over the rest of the archipelago. Ohoama, as represented in the Chronicles, appears to be the culmination of these three.  He is building on top of what his brother had implemented through the last three reigns.  Some of what he did was consolidate what Naka no Oe had done, but there were also new creations, for which Ohoama is credited, even if most of the work was done outside of Ohoama's reign, but they were attributed to Ohoama, nonetheless.  Much of this was started later in Ohoama's reign, and even today there seem to be some questions about who did what.  Nonetheless, we can at least see how the Chroniclers were putting the story together. There are a lot of scholars that point to the fact that the bulk of the work of these projects would actually be laid out in the following reigns, and who suggest that individuals like the influential Uno no Sarara, who held the control of the government in Ohoama's final days, may have had a good deal more impact on how things turned out, ultimately.  In fact, they might even have been more properly termed her projects—there are some that wonder if some of the attributions to Ohoama were meant to bolster the authority of later decrees, but I don't really see a need for that, and it seems that there is enough evidence to suggest that these projects were begun in this period. All of this makes it somewhat ironic that by the time the narrative was consolidated and published to the court, things were in a much different place—literally.  The Fujiwara capital had been abandoned.  The court, temples, and the aristocracy had picked up stakes and moved north.  Fujiwara no Fuhito had come on the scene, and now his family was really taking off.  This was not the same world that the Chronicles had been designed around. And yet, that is what was produced.  Perhaps there is a reason that they ended where they did. From that point on, though, there were plenty of other projects to record what was happening.  Attempts to control the narrative would need to do a lot more.  We see things like the Sendai Kuji Hongi, with its alternative, and perhaps even subversive, focus on the Mononobe family.  And then later works like the Kogoshui, recording for all time the grievances of the Imbe against their rivals—for all the good that it would do.  With more people learning to write, it was no longer up to the State what did or did not get written down. But that has taken us well beyond the scope of this reign—and this episode, which we should probably be bringing to a close.  There are still some things here and there that I want to discuss about this reign—so the next episode may be more of a miscellany of various records that we haven't otherwise covered, so far.  Until then if you like what we are doing, please tell your friends and feel free to rate us wherever you listen to podcasts.  If you feel the need to do more, and want to help us keep this going, we have information about how you can donate on Patreon or through our KoFi site, ko-fi.com/sengokudaimyo, or find the links over at our main website,  SengokuDaimyo.com/Podcast, where we will have some more discussion on topics from this episode. Also, feel free to reach out to our Sengoku Daimyo Facebook page.  You can also email us at the.sengoku.daimyo@gmail.com.  Thank you, also, to Ellen for their work editing the podcast. And that's all for now.  Thank you again, and I'll see you next episode on Sengoku Daimyo's Chronicles of Japan.  

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