This series of brief episodes focuses on the early recognition and clinical management of hepatic encephalopathy (HE). Drs. Arun Jesudian and Nancy Reau examine subtle signs that may indicate minimal or covert HE and offer strategies for timely diagnosis. The discussion covers practical tools for detection, the role of nutrition and pharmacologic therapy, and evidence-based approaches to prevent progression and hospitalization. Emerging therapies and ongoing clinical trials are also discussed to highlight future directions in HE treatment.

Among patients with moderate to severe plaque psoriasis, oral formulations of therapies is often a preferred route of administration, particularly among those with a fear of needles, which can negatively impact patent compliance. However, the currently available oral small-molecule therapies apremilast and deucravacitinib have demonstrated lower levels of skin clearance relative to biologics for the treatment of plaque psoriasis. Investigation into novel oral small-molecule therapies is ongoing, such as next-generation TYK2 inhibitors and the first-in-class investigational targeted oral peptide icotrokinra, which selectively targets IL-23 receptor signaling. These therapies have demonstrated dramatically improved clinical responses versus comparators and may significantly impact the current treatment paradigm for plaque psoriasis.

For patients with heart failure with reduced ejection fraction (HFrEF), optimizing therapy is an important part of treatment and care. But not all patients may be reaching their treatment goals and can continue to face substantial residual risk despite the use of quadruple pharmacologic guideline-directed medical therapy (GDMT) and medical devices. A soluble guanylate cyclase (sGC) stimulator that targets a previously unaddressed pathway in HFrEF and complements other GDMT may provide an incremental benefit to patients to positively impact outcomes.

This case-based discussion follows Maria, a 38-year-old teacher presenting with fluctuating ptosis, diplopia, and fatigue—classic but easily overlooked signs of generalized myasthenia gravis (gMG). Drs. Goyal and Edmundson review diagnostic strategies for gMG, particularly in seronegative or ocular presentations, and examine FcRn antagonists (efgartigimod, rozanolixizumab, and nipocalimab), using clinical trial data to guide therapy selection. They discuss treatment timing, monitoring, and integrating these agents into personalized care, with attention to comorbidities, reproductive status, and quality-of-life factors.

Metabolic dysfunction-associated steatohepatitis (MASH) with compensated cirrhosis is associated with poor prognosis due to a high risk of hepatic decompensation, hepatocellular carcinoma, cardiovascular events, and death. Using noninvasive diagnostic tools like FIB-4, VCTE, and Agile 4, clinicians can accurately identify cirrhosis and clinically significant portal hypertension without the need for biopsy. Management focuses on preventing hepatic decompensation through beta-blocker therapy (particularly carvedilol), nutritional optimization, and hepatocellular carcinoma surveillance. Novel therapies such as efruxifermin and resmetirom may reverse fibrosis. This evidence-driven approach aims to improve outcomes in patients with MASH-related compensated cirrhosis.

This activity will cultivate familiarity with the emerging CELMoD treatment class poised to transform the management of newly-diagnosed and R/R MM. With a higher affinity for cereblon than their predecessors, CELMoDs represent a new, distinct generation of immunomodulatory drugs with the potential to bridge longstanding treatment gaps for patients exhibiting inadequate responses to the conventional medications. This activity will help providers differentiate CELMoDs from newer, alternative agents used in MM, examine the latest clinical trial data supporting the adoption of these drugs, and readily identify the clinical circumstances in which their use would be warranted in clinical practice. By participating, clinicians can additionally examine the utility of emerging combination strategies that maximize the therapeutic synergies of CELMoDs with other newer treatment classes, such as EZH2 inhibitors. In doing so, community hematologist-oncologists can substantially extend patient survival and improve the patient experience through each phase of the MM care continuum.

Approximately 75% to 90% of patients with depression experience insomnia. This means that a very significant portion of individuals struggling with depression also have difficulty sleeping. Join Drs. Michael Thase and Andrew Krystal for this expert discussion to learn about the most recent data presented at the Psych Congress 2025 in San Diego on emerging therapies, such as the selective OX2R antagonists to treat major depressive disorder with insomnia.

Chronic kidney disease (CKD) is a common complication in type 2 diabetes that is closely linked to cardiovascular risk and often diagnosed late. Early detection with UACR and eGFR, plus treatment with therapies such as SGLT2 inhibitors, finerenone, and GLP-1 receptor agonists, has transformed treatment and guideline recommendations. Attention is now shifting to CKD in type 1 diabetes. Ongoing trials, such as FINE-ONE with finerenone, may soon expand therapeutic options and ensure no patient is left behind.

This case-based program explores the missed opportunities in CKD detection and treatment in a patient with type 2 diabetes. Drs. Agarwal and Cos emphasize the role of primary care physicians in annual UACR screening, which can reveal kidney injury long before symptoms occur. With new evidence from the CONFIDENCE and other trials, the discussion highlights the benefits and safety of early combination therapy with finerenone and SGLT2i, and GLP-1 receptor agonists. Practical strategies are shared to support primary care teams in integrating these therapies and reducing long-term cardio-kidney-metabolic risk.

Tardive Dyskinesia (TD) is an involuntary movement disorder that can develop as a side effect of taking antipsychotic and other medications. Currently there are 2 FDA approved VMAT2 inhibitors for treating TD. Join Drs. Cristoph U. Correll and Jonathan M. Meyer for this expert discussion on the most recent data presented at the Psych Congress 2025 in San Diego on VMAT2 inhibitors for the treatment of TD.

This Clinical Countdown addresses key challenges in diagnosing and managing generalized myasthenia gravis (gMG), with a focus on FcRn antagonists. Drs. Edmundson and Goyal review diagnostic challenges in gMG, along with the mechanism of FcRn blockade and how it compares to traditional therapies such as corticosteroids, IVIG, and plasma exchange. The discussion highlights pivotal phase 3 trials (ADAPT, MycarinG, and VIVACITY MG), evaluating differences in efficacy, dosing schedules, and administration routes for agents like efgartigimod, rozanolixizumab, and nipocalimab. Faculty discuss how data from these trials informs individualized treatment planning and facilitates shared decision-making.

This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.

This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.

This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.

This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.

This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.

This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.

This session from WHAV 2025 explores the complex interplay between hormonal changes and migraine pathophysiology in women, from menarche through menopause. Faculty review diagnostic frameworks, including ICHD-3 criteria, and emphasize menstrual migraine subtypes and the role of estrogen withdrawal. Evidence-based strategies for acute and preventive treatment are discussed, including the use of CGRP receptor antagonists, hormonal therapies, and neuromodulation devices. The program also addresses disparities in care and supports shared decision-making tailored to life stage, comorbidities, and patient preferences.

This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.

This series of brief episodes addresses how primary care providers can recognize early and often subtle signs of hepatic encephalopathy to support timely diagnosis and intervention. Drs. Robert Brown and Steven Flamm discuss clinical indicators that may prompt treatment initiation or specialist referral. The discussion focuses on optimizing patient care through early recognition and appropriate management strategies in the primary care setting.