AT THIS year’s International Society of Gynaecological Endocrinology (ISGE) Congress 2026, held in Rome, Italy, Vitaly F. Bezhenar, Head of the Department of Obstetrics, Gynaecology, and Neonatology at First Pavlov State Medical University of St. Petersburg, Russia, reviewed the current approach to the management of endometriosis-associated pain. He explored the recommended two-step treatment strategy, compared different postoperative hormonal therapies, and discussed the role of long-term medical management in reducing recurrence and improving quality of life in women with endometriosis.
During this symposium at the International Society for Gynecological Endocrinology (ISGE) Annual Congress, leading experts in women’s health and members of the Women’s Health Academy explored the spectrum of menopause symptoms and highlighted the need for an individualised and woman-focused approach to menopause care in clinical practice. The Women’s Health Academy is a multidisciplinary expert group that aims to improve women’s healthcare by advancing education, expanding access to evidence-based resources, and putting women at the centre of care. Rossella Nappi, Professor at the University of Pavia in Italy, began the session by underscoring the impact of menopause on women’s overall health and quality of life, and the importance of integrated symptom recognition that includes vasomotor symptoms (VMS), sleep, mood, and cognitive function. The expert panel, including Andrea Genazzani, Professor at the University of Pisa, Italy; Claudio Soares, Professor from Queen’s University School of Medicine in Kingston, Canada; and Michelle Jacobson, Assistant Professor from the University of Toronto, Canada, then discussed a selection of fictional patient cases. These cases illustrate the need for consultations centred on women’s goals, expectations, and needs to determine the best path to symptom relief and long-term health outcomes. For clinical practice, the experts recommended adopting a simple three-step approach to menopause counselling: 1) identify key symptoms and concerns; 2) focus on symptom relief; and 3) tailor the approach to the individual patient.
Atopic dermatitis (AD) involving sensitive and/or visible hard-to-treat areas, including the head and neck, face, hands, feet, and genital regions, is associated with a significant psychosocial and clinical burden. AD involving these high-burden areas is commonly associated with diminished patient quality of life and a range of management challenges for patients and clinicians. There is a notable lack of epidemiological evidence investigating these regions, with experts highlighting that high-burden areas are poorly defined and under-studied. Evidence to inform clinical practice often comes from sub-analyses, and there is a clear need for more directed research into optimal treatment of high-burden regions. Advancing knowledge of AD pathophysiology has enabled a better understanding of the burden of disease and, along with it, a new generation of targeted therapies. Real-world evidence evaluating the safety and effectiveness of these systemic treatments is increasingly crucial for clinicians to understand and apply their impact when making decisions in routine clinical practice for patients with AD in high-burden areas. A panel of seven expert dermatologists convened for a series of virtual roundtable discussions, conducted on 18th February, 27th February, and 5th March 2026. Experts discussed a series of questions in a roundtable discussion based on pre-read literature provided before the discussion, focusing on unmet needs in high-burden AD, and emerging clinical data on biologic treatment. Discussion was moderated by the medical writer. This article presents excerpts from the expert roundtable discussion on high-burden areas in AD, covering understanding high-burden AD and its associated challenges, the current treatment landscape, and ongoing unmet needs. In particular, the expert roundtable discussion highlighted a need for consistent terminology, clear clinical guidance, and robust data on systemic management specific to AD affecting high-burden areas. Patient disease burden, unmet needs, access to systemic treatments, and emerging data informing potential individualised AD management were explored.
Chronic cough is common and often debilitating in patients with idiopathic pulmonary fibrosis (IPF), affecting most people living with the condition. It is typically persistent and difficult to control, and can cause significant physical consequences, including pain, sleep disruption, and fatigue. In severe cases, it can cause vomiting and even rib fractures. Beyond the physical burden, chronic cough has a profound psychosocial impact, contributing to embarrassment, social withdrawal, and reduced quality of life. Despite this, it is frequently overlooked in clinical care. Limited effective treatment options mean it is often deprioritised in favour of more measurable aspects of disease, leaving many patients without adequate support or relief. However, growing scientific understanding is beginning to change this landscape. Chronic cough is increasingly recognised not simply as a consequence of lung disease, but as a neuropathic condition involving dysregulation of peripheral and central nervous system (CNS) pathways. This shift in thinking is helping to identify new therapeutic targets and is driving the development of potentially more effective treatments. As a result, the future of care in IPF may look very different, with the possibility of personalised medicine, multidisciplinary care, and a greater emphasis on recognising and managing the full impact of chronic cough on patients’ lives. This work will discuss the burden and mechanisms of chronic cough, as well as the future of IPF care, with two leading experts in the field and an Ohio grandfather, whose chronic cough forced him to retire from a job he loved.
Point of care ultrasound (POCUS) imaging is a valuable tool in assisting clinicians to assess and manage patients in the acute and elective care environment. In modern rheumatology practice, POCUS has been increasingly used due to its effective role in identifying signs of acute inflammation, particularly with the use of power Doppler signals. There is growing evidence to support the utility of ultrasound (US) in the early and accurate diagnosis of inflammatory arthritis. This can prompt early initiation or escalation of disease-modifying treatment. It can also help to explain non-response to ongoing treatment and rule out other causes of joint symptoms. The role of US in diagnosing giant cell arteritis, particularly with the ‘halo sign’, is well-recognised as the first-line investigation modality due its non-invasive and quick-access features in comparison to temporal artery biopsy. US can also enhance the precision of intra-articular steroid injections. Acknowledging that there can be discrepancies in the use of US in real-life clinical practice, due to reliance on operator dependence and interpretation of findings, the Outcome Measures in Rheumatology (OMERACT) Ultrasound Working Group have agreed on standardised definitions and scoring symptoms for pathophysiological manifestations in rheumatic diseases. Further research is needed to improve understanding of the predictive role of US assessment in treat-to-target strategies and in the follow-up of patients, particularly in psoriatic arthritis. It is the authors’ hope that modern rheumatologists will increasingly integrate POCUS as a complementary diagnostic and interventional tool in clinical practice to improve patient outcomes.
On the 29th May 2025 in Budapest, Hungary, leading experts discussed bradykinin-mediated angioedema (AE-BK). Henriette Farkas, Head of the Hungarian Angioedema Center of Reference and Excellence, Semmelweis University, in Budapest, Hungary; Marc A. Riedl, Clinical Director of the US HAEA Angioedema Center, UC San Diego Health, California, USA; and Danny M. Cohn, Medical Specialist in Vascular Medicine at the Amsterdam University Medical Center, the Netherlands, elucidated the mechanisms underlying the bradykinin (BK) signalling cascade, associated pathways, and the role of BK in both AE-BK and broader inflammatory disorders. The role of BK B2 receptor (B2R) was discussed, as well as the consequences of B2R antagonism, exploring whether this antagonism might have an impact on pathophysiological processes. A key focus was on the unmet needs in AE-BK, notably for on-demand (ODT) and long-term prophylactic (LTP) treatment approaches to address needs in multiple types of AE-BK. For treatments to address individual patient expectations and needs, they should be effective, well-tolerated, and have a low treatment burden regarding portability, handling, and administration. The value of standardised guidelines to aid the classification of recurrent angioedema (AE) was also discussed. Additionally, the value of reliable and accurate biomarker-based testing aiding diagnosis was emphasised. Ongoing research aims to address these gaps by investigating novel biomarker testing approaches and exploring additional therapeutic approaches.
Leiomyosarcoma (LMS) of the inferior vena cava (IVC), although rare, is the most common primary tumour of the IVC. Due to a vague, non-specific clinical presentation, radiological investigations play an important role in diagnosis. The tumours are classified based on the segment of the IVC involved and the growth pattern. The authors report a case of a 41-year-old man who presented with complaints of pain in the right hypochondrium, abdominal distension, and occasional episodes of fever for 1 month. Imaging features showed a well-defined, lobulated, heterogeneous lesion in the retroperitoneum invading the IVC, causing its expansion. There was an extension into the right atrium. Histopathological findings confirmed the diagnosis of an LMS. Surgery is the mainstay of treatment for such tumours. This case highlights the imaging features of a retroperitoneal LMS involving the IVC, causing its expansion and extension into the right atrium.
Psoriasis affects 60 million people globally. It is an inflammatory skin condition that can significantly impact quality of life. Furthermore, comorbidities including psoriatic arthritis and cardiovascular disease are common, indicating wider immune system involvement. In recent years, the IL-23/Type 17 T cells (T17) axis of inflammation has been shown to play a key role in psoriasis pathogenesis, leading to the development and licensing of biologics that target IL-23- and IL-17-mediated inflammatory pathways. These advanced medications effectively disrupt the inflammatory cycle, resulting in sustained improvements in clinical disease. This article reviews newly available data that provide the latest insights into the molecular interactions and mode of action of IL-23 antagonists. It outlines evidence to demonstrate that IL-23 blockade with risankizumab selectively inhibits pathogenic T17 cell subsets in psoriasis skin lesions, while non-pathogenic or regulatory T17 subsets remain intact, as well as the potential clinical benefits. It also evaluates the alternative binding to CD64 and concludes that it is unlikely to affect the clinical efficacy or safety of licensed IL-23 antibodies. These new data provide clinically relevant insights into the durable efficacy and safety of anti-IL-23 biologics.
