One-quarter of adults aged 60 and older successfully discontinued thyroid replacement therapy in a prospective cohort study

The issue: Levothyroxine is often continued for life, but many older adults may be taking it without a permanent indication.

Why this matters: In a prospective study of 370 adults aged 60 and older, 25.7% discontinued levothyroxine while maintaining acceptable thyroid function at 1 year.

Primary care relevance: Supports supervised dose reduction in selected patients, particularly those on lower baseline doses.

Once-weekly Awiqli (insulin icodec-abae) is expected in pharmacies in the second half of 2026

The issue: The FDA recently approved the first once-weekly insulin for type 2 diabetes

Why this matters: Once-weekly insulin may appeal to patients who do not like daily injections

Primary care relevance: Providers need to be aware of Awiqli's effects and dosing

Randomized trial finds 15% dose increase when taking levothyroxine with breakfast maintains TSH stability

The issue: Food reduces the absorption of levothyroxine (LT4); therefore, dosing guidelines recommend taking it on an empty stomach, typically 30 to 60 minutes before breakfast. Many patients find this inconvenient.

Why this study matters: It randomized 88 adults with hypothyroidism to fasting LT4 intake or LT4 intake with breakfast with a 15% dose increase. The primary outcome, TSH stability, did not differ significantly between groups.

Primary care relevance: For patients who prefer taking LT4 with food, this study provides guidance on dose adjustment.

The guidelines are thorough, but are they practical?

The issue: Primary aldosteronism is an underdiagnosed cause of hypertension; screening and confirmatory testing vary in practice.

Primary care relevance: Updated guidance helps identify patients with resistant or hypokalemic hypertension who may benefit from screening and targeted treatment.

The SOUL Study is a larger and longer version of a previous Rybelsus trial

The issue: Wegovy has been shown to reduce cardiovascular events in type 2 diabetes; the effects of Rybelsus are unknown.

Why this study matters: The SOUL study evaluated the long-term benefit of Rybelsus in adults with type 2 diabetes and established or high cardiovascular risk.

Primary care relevance: Provides evidence on the benefits of Rybelsus for preventing cardiovascular events in patients with type 2 diabetes and established or high cardiovascular risk.

Study demonstrates effectiveness in reducing fracture risk in postmenopausal women aged 50–60

The issue: Early postmenopausal women at risk for osteoporosis need evidence on when and how to use bisphosphonates.

Why this study matters: This study demonstrated that zoledronate effectively reduced fracture risk in postmenopausal women aged 50 to 60.

Primary care relevance: Provides evidence on the benefits of zoledronate for fracture prevention in early postmenopausal women at risk.

BPROAD found intensive BP control reduced CVD in type 2 diabetes, contradicting ACCORD

The issue: Optimal blood pressure targets in type 2 diabetes have been debated; ACCORD suggested no benefit from intensive control, but newer evidence was needed.

Why this study matters: The BPROAD study found that intensive BP control (systolic <120 mmHg) significantly reduced cardiovascular disease in type 2 diabetes, contradicting the older ACCORD trial.

Primary care relevance: Updated evidence supports consideration of intensive BP targets in some patients with type 2 diabetes; guidelines may evolve.

Cross-sectional study finds secondary hypertension prevalent in 30% of hypertensive adults aged 18–40

The issue: Secondary hypertension is often underdiagnosed; prevalence in young adults was unclear.

Why this study matters: A cross-sectional study found secondary hypertension in about 30% of hypertensive adults aged 18 to 40, highlighting the importance of screening in younger patients.

Primary care relevance: Young adults with hypertension may warrant a higher index of suspicion for secondary causes and appropriate workup.