Accelerated 5×5 rTMS Matches Standard Protocols in TRD, With Andrew Leuchter, MD

New data showed accelerated repetitive transcranial magnetic stimulation (rTMS) may offer a time-efficient alternative to conventional protocols for 

 delivering treatment in as little as 1 week rather than the standard 6-week course.

“We know enough to know that accelerated treatment works very well,” investigator 

Andrew Leuchter, MD, a professor and director of the neuromodulation division at UCLA TMS Clinical and Research Service, told 

. “I think the major thing that's holding us back from doing accelerated treatment more is just the fact that insurance companies will not reimburse for it. Medicare will pay for up to 2 sessions per day, but no more. What we need is for insurance companies to step up and allow us to be reimbursed for between 5 and 10 sessions per day, and I think that once the reimbursement is in place, you'll see accelerated treatment move up the list of treatment options.

In a retrospective analysis of 175 patients with major depressive disorder (MDD), investigators compared an accelerated “5 × 5” approach (n = 40), consisting of 5 sessions per day over 5 consecutive days, with a conventional once-daily rTMS protocol (n = 135). Both groups experienced clinically meaningful reductions in depressive symptoms, with no statistically significant difference in overall improvement between protocols (

Mean Patient Health Questionnaire-9 (PHQ-9) scores declined from 17.68 to 10.98 in the accelerated group and from 17.83 to 8.97 in the conventional group by the end of treatment. Response rates were 37.5% in the accelerated cohort and 58.5% in the conventional group, whereas remission rates were comparable at 22.5% and 24%, respectively.

The analysis identified variability in response timing. While some patients experienced early improvement during the 5-day accelerated protocol, others demonstrated delayed benefit. Among initial non-responders in the accelerated group, depressive symptoms improved by 36% at 2 to 4 weeks post-treatment (

 =.001), highlighting the importance of follow-up when assessing treatment efficacy.

In his interview, Leuchter emphasized that predicting response to rTMS remains a key clinical challenge. Commonly considered factors, such as illness severity, duration of disease, and prior treatment failures, have not reliably differentiated early from delayed responders. As a result, clinicians currently lack robust tools to guide patient selection or set expectations regarding treatment trajectory.

The study also contributes to ongoing efforts to optimize stimulation parameters. Investigators evaluated prolonged intermittent theta burst stimulation (piTBS), increasing pulse delivery from the standard 600 pulses to 1800 pulses per session. Leuchter noted that this higher-dose approach may enhance therapeutic benefit while maintaining brief treatment sessions of approximately 9 minutes.

“What we really need to do is to compare different kinds of stimulation in head-to-head studies and to identify what is going to be the most effective form of stimulation,” Leuchter said. “Right now, this prolonged intermittent theta burst, where we have a little bit longer session, looks like it's very effective. When I say a little bit longer, it's still only a 9-minute treatment session, so it really doesn't take that long, but it can be tremendously effective.”

Leuchter’s reported disclosure includes Abbott Laboratories.

Apostol MR, Valles TE, Corlier J, et al. Efficacy of 5 × 5 accelerated versus conventional repetitive transcranial magnetic stimulation (rTMS) for treatment-resistant depression. J Affect Disord. 2026;403:121345

Derman C. Accelerated Deep TMS Matches Standard Outcomes in TRD in 6 Days. HCPLive. Published March 18, 2026. Accessed on March 18, 2026. 

https://www.hcplive.com/view/accelerated-deep-tms-matches-standard-outcomes-trd-6-days

Videos

Accelerated rTMS shows comparable efficacy to standard care, with delayed response in some patients and no clear predictors of early benefit.

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Skin of Color Savvy: The Art and Science of Treating Patients of Color

Skin of Color Savvy: Tackling Colorism in Dermatology, With Seemal Desai, MD, and Pearl Grimes, MD

, Seemal Desai, MD, past president of SOCS, is joined by Pearl Grimes, MD, a globally recognized expert in vitiligo and pigmentary disorders and founder of the Vitiligo and Pigmentation Institute of Southern California. Together, they engage in a nuanced discussion on colorism, its historical roots, and its intersection with the clinical management of pigmentary disorders.

The conversation begins with an exploration of colorism as a global phenomenon, emphasizing its presence across regions including the United States, Africa, Asia, and Europe. Grimes highlights the complex historical and sociocultural factors underlying colorism, including colonialism, class structures, and longstanding societal preferences for lighter skin tones. These influences, the experts note, extend beyond aesthetics, impacting socioeconomic mobility, professional opportunities, and interpersonal relationships.

Desai and Grimes then transition to the clinical implications of colorism, particularly in dermatology practices focused on treating hyperpigmentation. They discuss how patient motivations for seeking treatment may reflect a combination of medical concerns and deeper sociocultural influences. Conditions such as melasma, post-inflammatory hyperpigmentation, and lichen planus pigmentosus are frequently treated in clinical settings, but patient expectations may extend beyond restoring even skin tone to a desire for overall skin lightening. The speakers emphasize the importance of distinguishing between appropriate medical treatment and requests influenced by colorism-driven preferences.

A significant portion of the discussion centers on the ethical and clinical challenges dermatologists face in navigating these blurred boundaries. Both experts underscore the importance of patient-centered communication, advocating for approaches that validate patient concerns while reinforcing the goal of restoring natural skin tone rather than altering inherent pigmentation. They stress the need for dermatologists to address the psychological and emotional dimensions of pigmentary disorders, particularly as they relate to self-perception and societal pressures.

The episode also highlights the widespread use of unregulated skin-lightening products and the associated health risks. Desai and Grimes discuss the global prevalence of over-the-counter products containing harmful agents such as high-potency topical steroids, mercury, and arsenic, often marketed as cosmetic or “brightening” treatments. They further address emerging trends, including intravenous and oral glutathione use for skin lightening, noting documented risks such as severe adverse reactions and potential links to disease exacerbation. These examples underscore the critical need for clinicians to conduct thorough patient histories and proactively inquire about all skincare products and treatments.

Education and advocacy emerge as central themes throughout the latter portion of the discussion. The speakers emphasize the role of dermatologists in educating patients about safe and evidence-based treatments, as well as the broader responsibility to engage in public health messaging. They also highlight the importance of regulatory efforts to limit the availability of harmful products and the need for continued collaboration with organizations such as the Skin of Color Society and other global advocacy groups.

The episode concludes with a call to action for dermatologists to approach pigmentary disorders with both clinical rigor and cultural awareness. By addressing the medical, psychological, and societal dimensions of colorism, clinicians can better support patients while promoting safe practices and advancing equitable dermatologic care.

To learn more about SOCS’s programs and initiatives, visit 

Editor’s note: This summary was edited with the help of AI tools.

Podcasts

In this episode of the Skin of Color Savvy podcast, 2 leaders in dermatology discuss the complexities of colorism and its impact on pigmentary disorders.

Hosted by Skin of Color Society and produced by HCPLive, 

 delves into the latest research, clinical insights, and culturally intelligent care practices in dermatology with leading experts. 

Whether it’s groundbreaking research, practice-changing insights, or highlights from the SOCS community, this twice-monthly program provides dermatologists and care providers with expert perspectives on treating patients with skin of color.

Dermatology

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

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

Akl Fahed, MD, MPH, Interventional Cardiologist at Massachusetts General Hospital and Instructor in Medicine at Harvard Medical School.

When DNA Meets BMI: A New Way to Predict Metabolic Disease Earlier, With Akl Fahed, MD, MPH

A biologically enriched metabolic polygenic risk score built from 20 traits and > 8.5 million individuals outperformed existing disease-prediction models and predicted downstream morbidity and clinical interventions for obesity and type 2 diabetes (T2D).

According to study investigators, the score effectively identifies individuals at high risk for metabolic multimorbidity, including predicting GLP-1 receptor agonist initiation, and should be used alongside body mass index (BMI) rather than as a replacement.

"This new score is not looking to replace body mass index at all…" Akl Fahed, MD, MPH, Interventional Cardiologist at Massachusetts General Hospital and Instructor in Medicine at Harvard Medical School, said in an interview. "The power of a DNA-based assessment such as this one is being able to detect risk of disease way earlier than the body mass index, and also to complement it."

Study investigators developed the metabolic PRS with one version optimized for obesity (O-MetPRS) and another for T2D (D-MetPRS), incorporating genes associated with 20 different traits related to metabolic function, including fat distribution measures such as visceral and subcutaneous adipose tissue, as well as insulin and glucose control. Using genome-wide association studies from worldwide datasets, with a particular focus on non-European populations, investigators reported obesity and T2D risk scores outperforming prior PRS models across six ancestries, including African, East Asian, and South Asian individuals.

"One of the limitations in the field of genomics, really for the past 10 years, has been what we call a Eurocentric bias, which means most of the genetic data in the world has come from individuals of European ancestry," Fahed explained. "That field is really shifting pretty quickly now, through 2 ways: accumulating a lot of genomic data on individuals of non-European ancestry, but also improvement in our methods."

The model was trained and tested in the UK Biobank before being externally validated in 3 multi-ethnic cohorts comprising up to 300,000 participants. According to investigators, the risk scores identified individuals at high risk for clinical outcomes such as cardiovascular disease and stroke. In a median 5.5 years follow-up, even individuals with a high PRS who were healthy at baseline were approximately 2 times as likely, specifically, those in the top decile compared to the middle quintile, to eventually receive GLP-1 agonist medications or bariatric surgery.

Investigators say the PRS represents a potential shift in how metabolic disease risk is assessed, offering clinicians an earlier, more biologically comprehensive view of a patient's trajectory before traditional markers like BMI signal concern.

Editor’s Note: Fahed reports relevant disclosures with Goodpath, MyOme, HeartFlow, and Foresite Labs.

Kim MS, Chen Q, Sui Y, et al. Metabolic polygenic risk scores for prediction of obesity, type 2 diabetes, and related morbidities. 

https://doi.org/10.1016/j.cmet.2026.02.009

New genetic risk score better predicts diabetes, obesity and downstream complications. EurekAlert! Published March 16, 2026. Accessed March 24, 2026. 

https://www.eurekalert.org/news-releases/1119751

A metabolic polygenic risk score built from 20 traits and more than 8.5 million individuals outperformed existing disease-prediction models.

Endocrinology

The HCPLive endocrinology page is a comprehensive resource for clinical news and insights on endocrine system conditions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for diabetes, hormonal disease, and more.

Obesity Management

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Hosts Drs. Bunick and Ackerman preview the 2026 American Academy of Dermatology Annual Meeting.

ABCs in Dermatology: Previewing the 2026 AAD Annual Meeting

The 2026 American Academy of Dermatology (AAD) Annual Meeting convenes in Denver with a scientific agenda promising to showcase the latest advances and breakthroughs in dermatologic care. 

, hosts Chris Bunick, MD, PhD, of Yale School of Medicine, and Lindsay Ackerman, MD, of US Dermatology Partners, survey the landscape ahead of the meeting and walk through the sessions each will be presenting on-site.

Bunick reframes antibiotics in acne as anti-inflammatory agents rather than antimicrobials—a distinction he argues is clinically meaningful for patient adherence and prescribing confidence. The talk addresses antibiotic stewardship, the role of narrow-spectrum agents such as sarecycline in preserving gut microbiome integrity while retaining full anti-inflammatory efficacy, and the understudied pathophysiologic distinctions between teenage and adult female acne. Sarecycline's inability to cross the blood-brain barrier, minimal vestibular disturbance, and lowest resistance profile among tetracyclines are highlighted as precision-medicine advances entering the acne space.

Mechanism of Action, Safety & Systemic Inflammation in JAK Inhibition


Bunick presents a comprehensive reappraisal of JAK inhibitor safety and systemic inflammation, anchored in what he describes as a widespread misreading of the ORAL Surveillance study. Because the trial used an active comparator only—with no placebo arm—it cannot support conclusions about absolute cardiovascular risk for either tofacitinib or TNF-alpha inhibitors. The session will present transcriptomic evidence linking psoriasis and atopic dermatitis to shared atherosclerotic risk pathways, introduce his "diaper to diaper" hypothesis tracing systemic inflammation from growth stunting in pediatric AD to cardiovascular disease in adults, and close with a five-year comparative analysis of JAK inhibitor and IL-13-targeted safety data.

Maintenance of IHS4 Response to Upadacitinib in Moderate-to-Severe Hidradenitis Suppurativa

Ackerman presents maintenance-of-response data for upadacitinib in moderate-to-severe HS using the IHS4 severity scoring system—extending previously published week-12 results to week 40 across patients achieving IHS4 55, 75, and 90 response thresholds. Durability is framed as the defining clinical imperative in HS: even patients without active lesions carry substantial anticipatory psychological burden between flares. Ackerman positions JAK1 inhibition as mechanistically well-suited to HS given its broad reach across the disease's heterogeneous cytokine architecture, and signals optimism for the emerging oral and adjuvant JAK inhibitor pipeline—including abrocitinib and povorcitinib—as the field moves beyond its current injectable-only approved options.

Chris Bunick, MD, PhD, and Lindsay Ackerman, MD, preview the 2026 American Academy of Dermatology Annual Meeting.

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.

Hidradenitis Suppurativa

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ABCs in Dermatology

Welcome to ABC’s in Dermatology, HCPLive’s newest dermatology podcast, hosted by a pair of the field’s leading minds in Lindsay Ackerman, MD, and Chris Bunick, MD, PhD.

Created by the same team behind The Medical Sisterhood and Skin of Color Savvy, ABCs in Dermatology is a monthly podcast designed to deliver candid conversations, clinical insight, and forward-looking perspectives from the voices shaping dermatology today.

Alex Hajduczok, MD, is an advanced heart failure and pulmonary hypertension specialist at Oklahoma Heart Institute. 

Inaugural episode of Moving the Needle in Medicine hosted by Alex Hajduczok, MD, featuring guest Martha Gulati, MD, MS

Moving the Needle in Medicine: Blazing a Trail in Cardiology, with Martha Gulati, MD, MS

A physician's career path is rarely linear and the influences shaping it are seldom predictable. In the inaugural episode of 

, host Alex Hajduczok, MD, a cardiologist and heart failure specialist at Oklahoma Heart Institute, sits down with Martha Gulati, MD, MS, FACC, FAHA, director of the Davis Women's Heart Center at Houston Methodist and one of the most recognized voices in women's cardiovascular health. 

The conversation spans 5 decades of professional formation, from a childhood in Ontario marked by early loss to a career defined by landmark research, guideline leadership, and an enduring commitment to a population long underserved by cardiology. Gulati traces her interest in medicine to her mother, a physicist who was once steered away from medicine because it was considered a male field, and to the early death of a parent under a physician's missed diagnosis. 

Her path toward cardiology solidified in medical school at the University of Toronto, where a mentor's invitation into the catheterization laboratory proved decisive. That same thread of mentorship runs throughout the conversation: Gulati credits a series of physicians, including the late Morton Arnsdorf at the University of Chicago and Len Sternberg in Toronto, with not only opening professional doors but shaping how she thinks about sponsorship, advocacy, and the responsibility of those in senior roles to invest in the careers of others.

The episode's most substantive clinical territory covers the origins of Gulati's expertise in women's cardiovascular disease. A lecture by Nanette Wenger, MD, delivered when Gulati was a medical student crystallized the field's foundational failure: women had been systematically excluded from the studies informing cardiovascular care. Rather than accepting this as background knowledge, Gulati made it the organizing principle of her career. She pursued epidemiological training at the University of Chicago, earned a master's degree in health sciences, and published foundational work on exercise capacity in women using the Woman's Take Heart dataset, work appearing first in Circulation and subsequently in the New England Journal of Medicine. 

That body of research established both her scientific identity and a clinical platform she has continued to build across appointments at Ohio State University, Cedars-Sinai Medical Center, and now Houston Methodist. Gulati also discusses her experience leading the 2021 ACC/AHA Chest Pain Guidelines the first such guideline ever developed, as chair of the writing committee, a role she accepted without prior guideline experience. 

She describes the political complexity inherent in evidence synthesis when imaging specialties have competing stakes, the iterative nature of responding to thousands of reviewer comments, and the personal satisfaction of successfully incorporating guidance on ischemia with non-obstructive coronary arteries (INOCA) into the final document. The conversation closes with a frank exchange on GLP-1 receptor agonists and their implications for preventive cardiology, physician wellness, and the structural barriers keeping high-cost medications from patients who need them most.

Hear Martha Gulati, MD, MS, reveal how mentorship and have shaped her career in women’s heart care.

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...

Heart Failure

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Women's Health

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Moving the Needle in Medicine

Moving the Needle in Medicine is a monthly podcast from HCPLive Cardiology exploring the backstories and nuanced career paths that led the field’s movers and shakers to where they are today. Hosted by Alex Hajduczok, MD, the show will offer listeners insight into the biggest names in cardiology and beyond. 

This podcast is available via video on YouTube and on the HCPLive Cardiology podcast platforms on popular audio players.

Tim Smith joined the MJH Life Sciences team in 2022 and is currently an associate editor for HCPLive. He is also the executive producer of two podcasts: Skin of Color Savvy and The Medical Sisterhood. Previously, he was the producer of the Lungcast podcast. He graduated from UC Berkeley and worked in multimedia journalism as a staff writer prior to joining MJH. You can contact him at tsmith@mjhlifesciences.com.

Articles

This release by Apogee Therapeutics highlights findings from the phase 2 APEX trial on zumilokibart (APG777) in adults with moderate to severe atopic dermatitis.

Atopic Dermatitis

Atopic Dermatitis condition center page, audiences can find a variety of coverage mediums for medical news and updates, including articles, video interviews, podcasts, and breaking news on dermatitis research, treatment, and drug development.

APEX: Zumilokibart Shows Durable Response at 52 Weeks in Atopic Dermatitis

David Fleischer, MD, professor of pediatrics at Children’s Hospital Colorado.

In this Q&A, Fleischer discusses clinically meaningful gains in peanut allergy desensitization, strong response rates, and the path toward FDA submission for VP250.


Allergy

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Food Allergy

VIASKIN Peanut Patch Shows Strong Phase 3 VITESSE Results, With David Fleischer, MD

Victoria Johnson joined MJH Life Sciences in 2020 and has written for NeurologyLive, CGTLive, and is now an assistant managing editor for HCPLive and RheumatologyLive. She doesn’t have enough time for her numerous hobbies. You can reach her at vjohnson@mjhlifesciences.com.

Phase 3b ENCORE shows inhaled ARIKAYCE boosts culture conversion and symptoms in antibiotic‑naïve MAC lung disease, paving way for 2026 label expansion.

Pulmonology

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ENCORE: ARIKAYCE Meets End Points, Improves Respiration in MAC Lung Disease

Pamela B. Morris, MD, is a professor of medicine in Cardiology and the Paul V. Palmer Chair of Cardiovascular Disease Preventionat the Medical University of South Carolina. 

New dyslipidemia guidance sharpens risk with CAC, checks lipoprotein(a), and targets LDL goals using expanded therapies for prevention.

Dyslipidemia

Atherosclerotic Cardiovascular Disease

Video Series

Behind the Guidelines: Top Clinical Takeaways From the 2026 Dyslipidemia Guidelines

New dyslipidemia guidance sets LDL targets for FH, urges genetic testing, and highlights evinacumab and APOC3 drugs for severe triglycerides.

Expert Insights: Recommendations on FH, Triglycerides in 2026 Dyslipidemia Guidelines

Understanding Secondary Prevention Goals, Novel Lipid Therapies from 2026 Dyslipidemia Guidelines

Trials show most heart supplements don’t lower LDL or prevent events; learn why omega‑3s, vitamins and red yeast rice fall short of statins.

Expert Insights: Why Dietary Supplements Do Not Lower Cholesterol

New lipid guidelines sharpen LDL goals for diabetes, HIV, CKD, cancer survivors and seniors, highlighting statins’ power and shared decisions.

Lipid Management in Special Populations from 2026 Dyslipidemia Guidelines

New lipid guidance brings back LDL targets by risk, pairing percent reduction with absolute goals—and explains why lower is better.

Behind the Guidelines: Embracing LDL Goals in Dyslipidemia Management

New US guidance spotlights one-time lipoprotein(a) tests and ApoB targets to uncover hidden heart risk and fine-tune lipid therapy.

Latest News

Accelerated 5×5 rTMS Matches Standard Protocols in TRD, With Andrew Leuchter, MD

Skin of Color Savvy: Tackling Colorism in Dermatology, With Seemal Desai, MD, and Pearl Grimes, MD

When DNA Meets BMI: A New Way to Predict Metabolic Disease Earlier, With Akl Fahed, MD, MPH

ABCs in Dermatology: Previewing the 2026 AAD Annual Meeting

Moving the Needle in Medicine: Blazing a Trail in Cardiology, with Martha Gulati, MD, MS