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Welcome to the official Bluesky account for the New England Journal of Medicine. Follow for high-quality, peer-reviewed research and clinical content from the world’s leading medical journal, online at NEJM.org.

Follow @ai.nejm.org for medical AI content.
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A 75-year-old woman with a history of infiltrating ductal carcinoma of the breast (previously treated with bilateral radical mastectomy and ongoing adjuvant hormonal therapy) presented to the dermatology clinic with a 1-year history of rash on the chest. 1/2

#MedSky #DermSky
Image Challenge What is the diagnosis? Left: Photo of the rash on the chest Right: Histopathology of a skin-biopsy sample from the left chest-wall scar
November 14, 2025 at 8:20 PM
nejm.org
Case Record of the MGH: A 79-year-old man was admitted to a hospital in Guangzhou, China, with progressive dyspnea and edema. Echocardiography and computed tomography revealed a mass in the right atrium. A diagnosis was made. Read the full case details: nej.md/4i6o3tN

#MedSky
Case Records of the Massachusetts General Hospital A 79-Year-Old Man with Dyspnea, Edema, and Pacemaker-Lead Displacement Imaging of the right atrial mass
November 14, 2025 at 2:08 PM
nejm.org
What is the appropriate antithrombotic regimen for patients with chronic coronary syndrome who are at high atherothrombotic risk and receiving long-term oral anticoagulation?

View the full results of the AQUATIC trial: nej.md/45AU4Wp

#MedSky #CardioSky
November 13, 2025 at 8:02 PM
nejm.org
In the latest episode of the Not Otherwise Specified podcast, host Lisa Rosenbaum, MD, and her guests examine the value system of American medicine and the systematic denigration of primary care that creates a dangerous vicious cycle.
Not Otherwise Specified Episode 3.5 Undervalued
November 13, 2025 at 5:27 PM
nejm.org
New in the November 13, 2025, issue of NEJM:

Deferring Arterial Catheterization in Shock (EVERDAC trial) nej.md/3LmOO0D 

Beta-Blockers after MI without Reduced EF (REBOOT trial) nej.md/45QYbws

#MedSky
Images and descriptions of what's new on NEJM.org this week
November 13, 2025 at 2:02 PM
nejm.org
A new review updates the pathophysiology and disease course of acromegaly, focusing on the general clinician’s key role in early diagnosis and management.

Read the Review Article “Acromegaly” by Andrea Giustina, MD, and Annamaria Colao, MD, PhD: nej.md/3JPVdBg

#MedSky
Review Article Acromegaly Andrea Giustina, M.D., and Annamaria Colao, M.D., Ph.D. Panel A: An artist’s rendering of the facial features of acromegaly. Panel B: Radiographic orofacial findings in a representative patient with acromegaly.
November 12, 2025 at 11:00 PM
nejm.org
Personalized therapies hold tremendous promise but challenge traditional models of drug and biologic development. The @fda.gov outlines a path to market entry for products where a randomized trial is not feasible. Learn more: nej.md/4nUQdcl
Sounding Board "Nearly 30 years after the sequencing of the human genome, bespoke therapies are close to reality. The FDA will work as a partner and guide in ushering these therapies to market, and our regulatory strategies will evolve to match the pace of scientific advances." "FDA’s New Plausible Mechanism Pathway Vinay" by Prasad, M.D., M.P.H., and Martin A. Makary, M.D., M.P.H.
November 12, 2025 at 10:40 PM
nejm.org
The authors of a new review provide practical suggestions for clinical educators to reinvigorate the teaching and practice of bedside clinical skills in the modern health care environment. Learn more: nej.md/4nUirnP

#MedSky #MedEd
Key Points from the Review Article "Strategies to Reinvigorate the Bedside Clinical Encounter"
November 12, 2025 at 10:10 PM
nejm.org
What is the biggest frustration for medical trainees? Ben Davis, MD, director of the Swedish First Hill Family Medicine Residency program in Seattle, addresses that question in this video clip.

#MedSky #MedEd
November 12, 2025 at 8:05 PM
nejm.org
The benefit of chest-wall irradiation after mastectomy in intermediate-risk breast cancer has been uncertain. Research findings from the SUPREMO phase 3 trial are summarized in a new Quick Take video. nej.md/4om4ik6

#MedSky #Oncology
A visual representation of the the SUPREMO phase 3 trial, which evaluated whether chest-wall irradiation improves survival in patients with intermediate-risk early breast cancer treated with mastectomy.
November 12, 2025 at 5:30 PM
nejm.org
In a phase 1 trial in the United States and Liberia, a replication-competent recombinant vesicular stomatitis virus–vectored vaccine against Lassa fever had acceptable safety and was immunogenic over a wide dose range. Full trial results and Research Summary: nej.md/47pstZ9

#MedSky
The New England Journal of Medicine Safety and Immunogenicity of an rVSV Lassa Fever Vaccine Candidate A Research Summary based on Malkin E et al. | 10.1056/NEJMoa2501073 | Published on November 6, 2025 Visual representations of the patients in the trial and the treatments they were assigned. Read the full Research Summary at NEJM.org.
November 12, 2025 at 2:09 PM
nejm.org
Despite their frequent use, opioids have limited benefits in managing noncancer pain. Avoiding long-term opioid use, reducing the opioid dose, or replacing opioids with nonopioid alternatives may reduce the risk of opioid-related harm. Learn more: nej.md/4oL3fu2

#MedSky #NeuroSky
Key points from the Clinical Practice article "Opioid Deprescribing in Patients with Noncancer Pain"
November 11, 2025 at 8:03 PM
nejm.org
Lassa fever has pandemic potential. However, no vaccines are approved. An rVSV Lassa fever vaccine has been developed, but data on its safety and immunogenicity are limited. Research findings are summarized in a new Quick Take video. nej.md/4nzCYO7

#MedSky #IDSky
A visual representation of a new trial, which evaluated the safety and immunogenicity of a Lassa virus vaccine.
November 11, 2025 at 5:02 PM
nejm.org
In the ATTAIN-1 phase 3, randomized trial, the use of orforglipron, an oral glucagon-like peptide-1 receptor agonist, led to significant mean body-weight reductions in patients with #obesity, as compared with placebo. Full trial results and Research Summary: nej.md/4n1nSl2

#MedSky #EndoSky
The New England Journal of Medicine Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist for Obesity A Research Summary based on Wharton S et al. | 10.1056/NEJMoa2511774 | Published on September 16, 2025 Visual representations of the patients in the trial and the treatments they were assigned. Read the full Research Summary at NEJM.org.
November 11, 2025 at 2:02 PM
nejm.org
For a woman with symptomatic carotid-artery stenosis, would you recommend surgical carotid endarterectomy or percutaneous carotid-artery stenting? Read the case vignette, treatment options, and vote: nej.md/43fbIxg

#MedSky #MedEd
November 10, 2025 at 8:08 PM
nejm.org
A follow-up report showed that the overall benefit of machine perfusion over cold storage in kidney graft survival remained present 10 years after transplantation. Read the full report: nej.md/4hDQNK4

#MedSky #Nephrology #Surgery
A figure showing graft survival in 818 patients who received kidney transplants and were included in the combined data for all kidneys obtained from donors after brain death and after circulatory death.
November 10, 2025 at 6:31 PM
nejm.org
For moderate-to-severe plaque psoriasis, biologic therapies are highly effective but are available only by injection, and current oral therapies are often less effective. Research findings from the ATTAIN-1 phase 3 trial are summarized in a new Quick Take video. nej.md/47Upat0

#MedSky #EndoSky
A visual representation of the ATTAIN-1 phase 3 trial, which examined the efficacy and safety of an oral GLP-1 receptor agonist for obesity.
November 10, 2025 at 5:02 PM
nejm.org
In moderate-to-severe plaque psoriasis, oral icotrokinra led to a skin-clearance response in 50%–65% of patients at week 16, as compared with 4%–8% with placebo. The incidence of adverse events was similar in the two groups. Full ICONIC-LEAD trial results & Research Summary: nej.md/3WDM6qg
The New England Journal of Medicine Oral Icotrokinra for Plaque Psoriasis in Adults and Adolescents A Research Summary based on Bissonnette R et al. | 10.1056/NEJMoa2504187 | Published on November 6, 2025 Visual representations of the patients in the trial and the treatments they were assigned. Read the full Research Summary at NEJM.org.
November 10, 2025 at 2:49 PM
nejm.org
Tobevibart plus elebsiran and tobevibart alone both lowered HDV RNA and ALT levels. The combination resulted in a high incidence of undetectable HDV RNA and an HBsAg level below 10 IU/ml at week 48. Full SOLSTICE phase 2 trial results: nej.md/4qIXpuM

@aasldnews.bsky.social | #TLM25
American Association for the Study of Liver Diseases Meeting 2025 Original Article | Nov 9, 2025 | NEJM.org A Phase 2 Trial of Tobevibart plus Elebsiran in Hepatitis D Figure 2A. HDV RNA Responses. The NEJM identity sits at the bottom.
November 9, 2025 at 11:05 PM
nejm.org
A 1-week-old full-term baby boy was brought to the hospital for evaluation of discharge from his navel. A growth of pink tissue at the umbilicus that seeped yellow liquid was noted. Read the full case details: nej.md/4hLNwIQ

#MedSky #Neonatology @chugrenoblealpes.bsky.social
Images in Clinical Medicine Patent Persistent Omphalomesenteric Duct Panel A: A photo of the growth of pink tissue at the umbilicus that seeped yellow liquid. Panel B: A photo of the duct and involved loop of bowel.
November 9, 2025 at 6:30 PM
nejm.org
In a meta-analysis of 17,801 patients with myocardial infarction and preserved LVEF (≥50%), beta-blockers did not reduce death, MI, or heart failure over a median 3.6 years of follow-up. Full results: nej.md/43U5Ppo

#AHA25
Kaplan–Meier curves of the cumulative incidence of death from any cause, myocardial infarction, or heart failure (the composite primary end point).
November 9, 2025 at 4:14 PM
nejm.org
A previously healthy 8-year-old boy was brought to clinic with a 7-day history of an itchy rash on his cheeks and a lacy rash on his chest and arms. He reported no recent fever, runny nose, or malaise. What is the most likely etiology of the rash? nej.md/IC11062025
November 9, 2025 at 3:22 PM
nejm.org
In patients with atrial fibrillation after successful ablation, rivaroxaban therapy did not lead to a significantly lower incidence of a composite of stroke, systemic embolism, or new covert embolic stroke than aspirin therapy. Full OCEAN trial results: nej.md/3LsRJ86

#AHA25
American Heart Association Scientific Sessions 2025 Original Article | Nov 8, 2025 | NEJM.org Antithrombotic Therapy after Successful Catheter Ablation for Atrial Fibrillation Figure 2. Cumulative Incidence of Stroke or Systemic Embolism. The NEJM identity sits at the bottom.
November 8, 2025 at 8:20 PM
nejm.org
ADAPT AF-DES trial: In patients with atrial fibrillation and a drug-eluting stent placed at least 1 year earlier, monotherapy with a non–vitamin K antagonist oral anticoagulant was noninferior to combination therapy with clopidogrel for net adverse clinical events. nej.md/4nH8DgK

#AHA25
American Heart Association Scientific Sessions 2025 Original Article | Nov 8, 2025 | NEJM.org Therapy for Atrial Fibrillation in Patients with Drug-Eluting Stents Figure 2A. Net Adverse Clinical Events The NEJM identity sits at the bottom.
November 8, 2025 at 7:35 PM
nejm.org
In an interim analysis, sibeprenlimab, a humanized IgG2 monoclonal antibody that inhibits the proliferation-inducing ligand APRIL (a key driver of IgA nephropathy), reduced proteinuria as compared with placebo. nej.md/493Xtza

@asnkidney.bsky.social | #KidneyWk
A line plot of the least-squares geometric mean change in spot UPCR from baseline
November 8, 2025 at 4:35 PM