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Crisis Point

Tim Smith joined the MJH Life Sciences team as an assistant editor for HCPLive in August 2022. He graduated from UC Berkeley with a degree in political science, working in multimedia journalism as a staff writer prior to joining MJH. In his spare time, he enjoys reading, watching TV, listening to podcasts, and rock climbing. You can contact him at 

 with biologics, especially interleukin (IL)-17 inhibitors, notably raises their risk of superficial fungal infections, according to recent findings.

These data resulted from an analysis led by such investigators as Heli Liu, from the Department of Dermatology and Venereology at the Third Hospital of Shanxi Medical University in China. Liu and colleagues noted the importance of biologic agents as an option for moderate-to-severe psoriasis, though they added that risk of superficial fungal infections, such as Candida and dermatophytes infections, had still been unclear prior to their research.

“Although some clinical studies have investigated the risk of superficial fungal infections associated with various biologic agents, the available evidence remains limited and fragmented,” Liu and coauthors wrote.

 “Therefore, this study aims to systematically synthesise and quantitatively assess the existing data through a meta-analysis, providing more robust evidence to support clinical decision-making.”

The investigative team identified all of the necessary randomized controlled trials (RCTs) for their analysis published up to December 2024 systematically, specifically implementing comprehensive searches across the Embase, PubMed, the Cochrane Library, and Web of Science (WOS) databases. They implemented terms in English for their searches such as  “biologics,” "psoriasis," “anti-IL-17,” and “anti-TNF."

They also used terms related to fungal infections  such as “onychomycosis,” “Candida,” “dermatophyte infections,” and “tinea pedis." Additionally, the database searches included terms for therapies such as "secukinumab," “etanercept,” “ixekizumab,” “bimekizumab,” “brodalumab," “guselkumab,” “ustekinumab,” "adalimumab," and “tildrakizumab.”

For studies to be eligible for inclusion in Liu et al's research, they needed to meet a specific set of criteria. Specifically, participant groups were required to have comparable baseline characteristics, study designs had to be RCT, patients in studies were required to have had a confirmed diagnosis of moderate-to-severe plaque psoriasis, studies were required to report data on the incidence of superficial fungal infections linked with biologic use, and the control arm needed to include either a conventional systemic treatment, another biologic, or placebo.

Screening of the studies included in Liu and coauthors' analysis was done via 2 independent reviewers who would assess both titles and abstracts for relevance. This was then followed by a full-text review to apply the necessary criteria for inclusion and exclusion. They evaluated quality of RCTs independently through the use of the Cochrane Handbook for Systematic Reviews of Interventions (version 5.1.0). The investigators conducted meta-analyses via RevMan 5.4 and STATA 16.0 software.

There were 29 of the initial pool of 644 records deemed eligibile for inclusion in the meta-analysis. The findings resulting from the study showed that IL-17  inhibitors were substantially linked with an elevated Candida infection risk compared to placebo (odds ratio [OR], 2.39; 95% CI, 1.84–3.11; 

This was compared to a lack of statistically significant differences in Candida risk for IL-12/23 (IL-12/23) inhibitors (OR, 1.11; 95% CI, 0.27–4.63; 

 = .88) or tumor necrosis factor-alpha (TNF-α) inhibitors (OR, 1.75; 95% CI, 0.53–5.82; 

 = .36) when compared to placebo. In comparisons to biologic classes directly, IL-17 inhibitors showed a greater risk of Candida infections versus TNF-α (OR, 2.23; 95% CI, 1.08–4.57; 

 = .03) and IL-12/23 inhibitors (OR, 4.21; 95% CI, 2.71–6.55; 

In their evaluations of dermatophyte infection risk, Liu and colleagues' meta-analysis showed that the utilization of biologics overall showed a link to a significantly increased risk (OR, 1.89; 95% CI, 1.19–3.01; 

 = .007). They further highlighted the far greater risk IL-17 inhibitors posed in terms of dermatophyte infections versus IL-12/23 inhibitors (OR, 2.70; 95% CI, 1.29–5.63; 

 = .008). Collectively, the investigators' analysis pointed to a significantly increased overall risk with biologic therapies in terms of superficial fungal infections compared to placebo (OR, 2.10; 95% CI, 1.73–2.55; 

“Future research should integrate real-world evidence and long-term follow-up data to comprehensively assess the infection risk profiles associated with biologic therapy in psoriasis and to optimise individualised dosing strategies,” the investigators concluded.

H Liu, L Zhou, Z Song, Y Kang, et al. Biologic Therapy and Superficial Fungal Infection Risk in Moderate-to-Severe Psoriasis: A Meta-Analysis. Mycoses 68, no. 6 (2025): e70081, 

D Rigopoulos, R Baran, S Chiheb, et al. Recommendations for the Definition, Evaluation, and Treatment of Nail Psoriasis in Adult Patients With No or Mild Skin Psoriasis: A Dermatologist and Nail Expert Group Consensus. Journal of the American Academy of Dermatology 81, no. 1 (2019): 228–240.

Articles

Recent findings indicate that biologics, particularly IL-17 inhibitors, significantly increase the risk of superficial fungal infections in psoriasis patients. A meta-analysis led by Heli Liu and colleagues systematically reviewed randomized controlled trials to assess this risk. The study found that IL-17 inhibitors are associated with a higher risk of Candida and dermatophyte infections compared to other biologics and placebo. The analysis underscores the need for further research to evaluate long-term infection risks and optimize dosing strategies for biologic therapies in psoriasis management.

This analysis highlights the risk of superficial fungal infections among patients with moderate-to-severe psoriasis given biologics such as IL-17 inhibitors.

Plaque Psoriasis

The HCPLive plaque psoriasis page is a resource for medical news and expert insights on psoriasis. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for psoriatic disease, and more.

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Clinical

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Biologic Use in Psoriasis Raises Risk of Superficial Fungal Infection Among Patients

Arvid Sandforth, MD, physician scientist, Institute of Diabetes Research and Metabolic Diseases, Tübingen, Germany

Targeting Glycemic Control Over Weight Loss for Type 2 Diabetes Prevention, with Arvid Sandforth, MD

New research posits that prediabetes remission based off of achieving glycemic targets should be the primary treatment goal for type 2 diabetes (T2D) prevention, rather than weight loss targets.

These findings were presented by primary investigator Arvid Sandforth, MD, physician scientist, Institute of Diabetes Research and Metabolic Diseases, Tübingen, Germany, at the 

2025 American Diabetes Association (ADA) Scientific Sessions

HCPLive spoke with Sandforth during the meeting to learn more about how prediabetes remission has emerged as an effective target for preventing T2D. Sandforth gave an overview of the pre-diabetes lifestyle intervention study he investigated, which is a multicenter study from the German Center for Diabetes Research. He shared some exciting findings from the study, which found that, across subgroups of weight loss, weight stability, and weight gain, achieving normal glycemia provided the same protective effect against developing T2D. While he stressed that losing weight remains the most effective way to reach pre-diabetes remission, achieving glycemic control seems to be the more important factor even if weight is not lost.

“[This] ties in into the concept of clinical obesity as a general concept that's being put forward more and more. And I think that's very important… it's not overweight or obesity per se. It's the wrong lipids at the wrong place,” Sandforth said. “T2D, that's hyperglycemia, [is] the thing we're trying to prevent. So why not look at glycemia when it comes to prevention? Why not introduce glycemic targets as an add on?”

Sandforth A, Sandforth L, Katzenstein S, et al. Achieving Prediabetes Remission during Lifestyle Intervention Is More Effective Than Weight Loss for Type 2 Diabetes Prevention. Presented at: ADA 2025; June 20-23; Chicago, Illinois. Presentation #163-OR

Videos

Sandforth emphasized the important of achieving prediabetes remission for preventing T2D as seen in his new research.

Type 2 Diabetes

Endocrinology

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 conference coverage page features articles, videos, and expert-led live coverage from major medical meetings throughout the year.

Glycemic Control Trumps Weight Loss for Type 2 Diabetes Prevention, with Arvid Sandforth, MD

Welcome to The HCPFive, your go-to roundup for the latest healthcare news and breakthroughs, curated specifically for busy healthcare professionals.

Each week, we highlight 5 key developments or headlines from healthcare that you need to know—whether it's a cutting-edge treatment, regulatory updates, or innovations shaping the future of medicine. This week's top stories include a pair of US Food and Drug Administration approvals for dupilumab (Dupixent) for the treatment of adult patients living with 

 and lenacapavir (Yeztugo) as pre-exposure prophylaxis (PrEP) to reduce the risk of sexually acquired HIV, new research on the potential dangers of weight cycling, phase 3 data for supporting fecal microbiota transplantation (FMT) for the treatment of primary 

, and findings on the growing global prevalence of 

With The HCPFive, you'll get the essential takeaways to stay informed and ahead of the curve. Here’s your quick dive into the top stories for the week of June 15, 2025—let’s jump in!

FDA Approves Dupilumab (Dupixent) for Bullous Pemphigoid in Adult Patients

On June 20, 2025, the FDA approved dupilumab (Dupixent) for the treatment of adult patients living with bullous pemphigoid based on positive clinical trial findings in the ADEPT trial. The decision marks the first targeted therapy to receive approval from the FDA as well as the 8th indication for dupilumab in a disease with underlying type 2 inflammation.

FDA Approves Lenacapavir, First Twice-Yearly HIV Prevention Option

On June 18, 2025, the FDA approved Gilead’s lenacapavir (Yeztugo), an injectable HIV-1 capsid inhibitor, as PrEP to reduce the risk of sexually acquired HIV in adults and adolescents weighing at least 35kg. The decision makes lenacapavir the first twice-yearly option for preventing HIV and significantly improves the treatment burden on patients compared to current daily oral (Gilead's Truvada and Descovy) or bimonthly injectable (GSK's Apretude) options.

Weight Cycling Increases Risk of MASLD, Other Cardiometabolic Diseases

Recent research highlights the potential dangers of going through cycles of weight loss and subsequent regain, known as weight cycling. In the study, weight cycling was found to increase the risk of several cardiometabolic diseases, including 

metabolic dysfunction-associated steatotic liver disease (MASLD)

Fecal Microbiota Transplantation Shows Promise for First-Line Primary C Diff Treatment

Recently published phase 3 data suggest FMT may be a viable first-line treatment for primary CDI. The randomized, open-label, noninferiority trial was conducted at 20 hospitals in Norway and found clinical cure and no disease recurrence within 60 days without additional treatment was observed in 66.7% of patients with FMT versus 61.2% with vancomycin, demonstrating FMT’s numerical superiority and statistically significant noninferiority to the standard-of-care antibiotic.

Rheumatoid Arthritis Burden Has Surged Over Last 30 Years

Findings from a large AI-powered study suggest the global RA burden has significantly increased worldwide, additionally revealing local hotspots and a growing trend of RA in younger people. Results showed RA incidence rose by 13.2% from 1990 to 2021, in which it affected 17.9 million people globally, with the affected population growing younger and broader. While the age-standardized death rate fell 32.7% from 1980 to 2021, global DALYs nearly doubled from 1990 to 2021.

The latest healthcare updates include FDA approvals for dupilumab (Dupixent) for bullous pemphigoid and lenacapavir (Yeztugo) as a twice-yearly HIV PrEP option. Research indicates weight cycling increases risks for cardiometabolic diseases like MASLD. Phase 3 data supports fecal microbiota transplantation (FMT) as a promising first-line treatment for primary Clostridioides difficile infection. An AI-powered study reveals a significant global increase in rheumatoid arthritis incidence over the past 30 years, with a younger demographic being increasingly affected.

Stay updated with the latest healthcare breakthroughs, including FDA approvals, clinical trial data, and novel research, in this week's essential news roundup.

Gastroenterology

Gastroenterology condition center page is a comprehensive resource for clinical news and insights on digestive and GI conditions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for 

, IBS and IBD, Crohn's disease, and more.

C Difficile Infection

C. difficile condition center page, resources on the topics of medical news and expert insight into Clostridium difficile can be found. Content includes articles, interviews, videos, podcasts, and breaking news on C. diff research, treatment, and drug development.

MASH / MASLD

The HCPLive MASH & MASLD page is a comprehensive resource for clinical news and insights on metabolic dysfunction-associated steatotic liver disease and steatohepatitis. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for fatty liver disease, steatohepatitis, and more.

Hepatology

Rheumatology

Rheumatology condition center page is a comprehensive resource for clinical news and insights on rheumatologic disease. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for arthritis, gout, nr-AxSpA, and more.

The HCPFive: Top News for Healthcare Providers from the Week of 06/15

Timothy Garvey, MD, is a professor of medicine at the Univeristy of Alabama at Birmingham. 

Melanie J. Davies, MD, is a professor of Diabetes Medicine at the University of Leicester and the codirector of the Leicester Diabetes Centre at University Hospitals of Leicester NHS Trust.

Welcome back to Diabetes Dialogue at ADA 2025!

Diabetes Dialogue: REDFINE 1 and REDEFINE 2, with Timothy Garvey, MD, and Melanie Davies, MD

85th Scientific Sessions of the American Diabetes Association (ADA 2025)

, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and co-director of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, take a deep dive into the REDEFINE 1 and REDEFINE 2 trials with trial investigators W. Timothy Garvey, MD, of University of Alabama at Birmingham, and Melanie Davies, MD, of the University of Leicester.

REDEFINE 1 was a 68-week, phase 3a trial enrolling over 3400 adults without diabetes but with obesity or overweight and at least one comorbidity. Participants received once-weekly CagriSema, semaglutide alone, cagrilintide alone, or placebo alongside lifestyle intervention.

Key outcome: CagriSema led to a mean weight loss of 20.4%, vs 3.0% with placebo.

Over 50% of participants on CagriSema reached a non-obese BMI.

Gastrointestinal side effects were common (80%), but mostly mild to moderate.

REDEFINE 2 enrolled 1206 adults with type 2 diabetes and overweight or obesity, randomized to CagriSema or placebo for 68 weeks.

Key outcome: CagriSema led to 13.7% mean weight loss, vs 3.4% with placebo.

73.5% achieved an HbA1c ≤6.5% vs 15.9% on placebo.

Significant improvements were seen across all weight loss and glycemic endpoints.

The speakers also highlight the agent’s favorable side effect profile, flexibility in real-world dosing, and benefits in body composition and physical function. Garvey emphasizes the shift toward complication-centric obesity care, underscoring the need for clinician-guided treatment beyond online prescription models.

The conversation closes with a look ahead to REDEFINE 3—a cardiovascular outcomes trial including patients with and without diabetes—and other ongoing studies in the REDEFINE and REIMAGINE trial programs.

Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others.

Relevant disclosures for Garvey include Boehringer-Ingelheim, Novo Nordisk, Eli Lilly and Company, Merck & Co., Inc., Alnylam Pharmaceuticals, Inc., Fractyl Health, Inc., Inogen, Epitomee, Pfizer Inc., and Neurovalens. Relevant disclosures for Davies include Abbie, Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly and Company, GSK, Novo Nordisk, Pfizer, Regeneron, Roche, Sanofi, and Zealand Pharma.

Garvey WT, Blüher M, Osorto Contreras CK, et al. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity. 

Davies MJ, Bajaj HS, Broholm C. Cagrilintide–Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes. 

Podcasts

Explore groundbreaking findings from the REDEFINE trials on CagriSema's impact on weight loss and diabetes management at ADA 2025.

Obesity Management

Obesity Management condition center page, resources on the topics of medical news and expert insight into clinical weight management can be found. Content includes articles, interviews, videos, podcasts, and breaking news on obesity research, treatment, and drug development.

Switch to Weekly Efsitora Insulin for Type 2 Diabetes Feasible, with Athena Philis-Tsimikas, MD

Once-weekly insulin efsitora alfa was well-tolerated and efficacious in people with type 2 diabetes (T2D) switching from daily basal insulin.

These findings, from the phase 3 QWINT trial in the larger QWINT program evaluating efsitora, were presented by Athea Philis-Tsimikas, MD, corporate vice president of Scripps Whittier Diabetes Institute at Scripps Health in San Diego, California, at the 

, held June 20-23, in Chicago, Illinois. The findings were also simultaneously published in 

 spoke with Philis-Tsimikas during the meeting to learn more the QWINT program evaluating insulin efsitora alfa in differing populations with T2D and about the latest findings from the QWINT-3 trial that demonstrated weekly injections of efsitora as being non-inferior to daily insulin degludec.

Philis-Tsimikas emphasized that switching from daily to weekly insulin can less the treatment burden in people with T2D. She acknowledged that, in the future clinical setting, primary care physicians may have to adapt to a new paradigm, but it is one that will benefit their patients.

“This will be an interesting way for primary care physicians, in particular, to use insulin, because this is a larger dose than you're normally used to giving… allowing physicians to understand how to give that first dose to get [patients] up to steady state, and then give a maintenance dose thereafter, might be a learning curve, but knowing that the patients overall really like this and it leads to good outcomes for their glucose control, make it worthwhile in the long run,” Philis-Tsimikas told 

Philis-Tsimikas's disclosures include Dexcom, Lilly, Medtronic, and Novo Nordisk.

Philis-Tsimikas A, Bergenstal RM, Bailey TS, et al. Once-weekly insulin efsitora alfa versus once-daily insulin degludec in adults with type 2 diabetes currently treated with basal insulin (QWINT-3): a phase 3, randomised, non-inferiority trial. Published online June 22, 2025. DOI: 10.1016/S0140-6736(25)01044-X

Philis-Tsimikas shared the latest findings demonstrating inferiority after switching from daily basal insulin to weekly insulin efsitora.

Once-Weekly Insulin Efsitora a Practical Option for Type 2 Diabetes, with Athena Philis-Tsimikas, MD

Kevin Sayer joins the program to discuss the latest from Dexcom and preview where the business is headed in an evolving diabetes landscape.

Type 1 Diabetes

Diabetes Dialogue

Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives is a monthly podcast hosted by Diana Isaacs, PharmD, and Natalie Bellini, DNP, aimed at providing a regular roundup of the latest clinically applicable insights across diabetes and metabolic diseases, with a focus on leveraging technology to improve care.

podcasts page features a feed of medical news and interview podcast series, including DocTalk, Lungcast, Derm Discussions, and Heart Trials.

Diabetes Dialogue: Updates from Dexcom at ADA 2025, with Kevin Sayer

Patrick Campbell is the editorial director of HCPLive. Patrick has spent years spearheading coverage surrounding cardiometabolic health and rheumatic disease for MJH Life Sciences. Before joining MJH Life Sciences in 2019, he spent time as a beat reporter and/or multimedia specialist with the Pocono Record, Star News Group, and NJ Advance Media. He is the executive producer for multiple HCPLive podcasts, including Diabetes Dialogue, Don't Miss a Beat, Kidney Compass, Medical Ethics Unpacked, The Medical Sisterhood, and Skin of Color Savvy. 


Follow him on Twitter @RealPatCampbell or reach him via email at PCampbell@mjhlifesciences.com.

A new study reveals once-weekly efsitora alfa effectively lowers blood glucose in type 2 diabetes. 

QWINT-1: Weekly Insulin Efsitora Matches Daily Insulin in Type 2 Diabetes

Assistant Professor, Endocrinology, Diabetes and Clinical Pharmacology, University of Kansas Medical Center

Steger discussed findings from a 6-month lifestyle investigating TRE+ER and IER.

Validating Intermittent Fasting for T2D, with Felicia Steger, PhD, RD

A global study reveals that universal access to semaglutide could save 28 million lives and significantly reduce obesity and diabetes worldwide.

Cardiology

Cardiology condition center page is a comprehensive resource for clinical news and insights on cardiovascular and cardiometabolic diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for heart disease and cardiovascular events, as well as associated diabetes, renal failure, and more...

Chronic Kidney Disease

Nephrology

The HCPLive nephrology page is a resource for medical news and expert insights on kidney disease. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments in nephrology, and more.

Universal Semaglutide Access Could Save 28 Million Lives in 5 Years, Study Finds

CagriSema shows weight loss results in recent trials comparable to existing interventions. 

ADA 2025: CagriSema Demonstrates Dual Benefit in Obesity and Type 2 Diabetes

Post-Doctoral Fellow at the Emory Global Diabetes Research Center

Xue discussed her research developing a personalized prediction algorithm for predicting responders to a DPP-style intervention.

Personalized Diabetes Prevention: Insights from 15 Years of the VA MOVE! Program, with Qiaochu Xue, PhD, MPH

A phase 3 trial reveals ecnoglutide significantly reduces body weight in overweight patients, showcasing its potential as a novel obesity treatment.

SLIMMER: Ecnoglutide Demonstrates Weight Loss Potential in Phase 3 Trial

New findings reveal semaglutide significantly enhances walking ability and quality of life for patients with T2D and PAD.

Atherosclerotic Cardiovascular Disease

STRIDE: Semaglutide Reduces Progression of PAD by 54% in Type 2 Diabetes

A new study reveals hybrid closed-loop technology significantly improves glucose control for pregnant women with T1D.

Women's Health

On the HCPLive women's health page, resources on the topics of medical news and expert insight into obstetrics, gynecology, and women's related health can be found. Content includes articles, interviews, videos, podcasts, and breaking news on women's health, and more.

Closed-Loop Therapy Improves Glycemic Control in Pregnant Women with T1D

Clinical Professor, Cumming School of Medicine, and Child Health & Wellness Researcher, Alberta Children's Hospital Research Institute, at University of Calgary

Automated insulin delivery systems enhance blood glucose control for pregnant women with type 1 diabetes, potentially advancing  diabetes care.

Latest News

Biologic Use in Psoriasis Raises Risk of Superficial Fungal Infection Among Patients

Glycemic Control Trumps Weight Loss for Type 2 Diabetes Prevention, with Arvid Sandforth, MD

The HCPFive: Top News for Healthcare Providers from the Week of 06/15

Diabetes Dialogue: REDFINE 1 and REDEFINE 2, with Timothy Garvey, MD, and Melanie Davies, MD

Once-Weekly Insulin Efsitora a Practical Option for Type 2 Diabetes, with Athena Philis-Tsimikas, MD