In Pakistan, 50% of strains of a common milk bacterium, Staphylococcus epidermidis, were multi-drug resistant
Cultured Staphylococcus epidermidis isolates from raw milk samples on MSA. Image credit: Inamullah and colleagues, Abdul Wali Khan University Mardan, Pakistan, CC-BY 4.0
Raw cow and sheep milk is frequently contaminated with antibiotic-resistant bacteria that could pose a threat to human and animal health, reports a new study led by Tahir Usman of Abdul Wali Khan University Mardan, Pakistan, published November 12, 2025 in the open-access journal PLOS One.
In Pakistan, over 95% of milk is consumed in its raw form, which has not been pasteurized to kill off harmful bacteria. Milk can become contaminated by bacteria through improper handing or from infections in the teat, called subclinical mastitis. The overuse of antibiotics to treat subclinical sumastitis has led to the emergence of multidrug-resistant bacterial strains, which could then be transmitted to humans through raw milk.
In the new study, researchers investigated the risk posed by Staphylococcus epidermidis, a subclinical mastitis-causing bacteria that often does not lead to visible symptoms in the cow, but results in contaminated, lower-quality milk. They collected 310 milk samples, about half from cattle and half from ewes, and tested them for subclinical mastitis. They also isolated strains of Staphylococcus epidermidis from the milk samples and screened them for antibiotic resistance. About one quarter of the samples showed evidence of subclinical mastitis and almost 13% (1 in 8) were contaminated with Staphylococcus epidermidis. Strikingly, 95% of Staphylococcus epidermidis bacteria isolated from the milk were resistant to penicillin and erythromycin, and half were resistant to three or more antibiotics.
In humans, Staphylococcus epidermidis is a common, generally harmless inhabitant of the skin, but the researchers point out that multi-drug resistant Staphylococcus epidermis bacteria in raw milk could spread antimicrobial resistance to more harmful pathogens, like Staphylococcus aureus, the MRSA pathogen.
The study’s findings underscore the high rates of subclinical mastitis in cattle and ewes, and indicate that Staphylococcus epidermidis might be an important pathogen impacting both animal health and food safety. The high rates of antibiotic resistance observed in the samples also emphasize the urgent need for improved antibiotic stewardship in agriculture to prevent the rise of multi-drug resistant strains.
The authors add: “The presence of multidrug-resistant Staphylococcus epidermidis in raw milk highlights how on-farm antibiotic use directly shapes public health risks. These findings emphasize the urgent need for responsible antibiotic use and improved hygiene practices in the dairy sector to reduce the risk of antimicrobial resistance transmission through the food chain.”
The South African Medical Technology Industry Association (SAMED) is raising the alarm over the Gauteng Department of Health’s ongoing failure to meet its financial obligations to medical technology suppliers – a crisis that now threatens business survival, jobs, and the stability of healthcare delivery across the province.
The Gauteng Health Department currently owes SAMED member companies more than R700 million. Despite fulfilling their contractual commitments and continuing to supply essential medical products and services, many companies have been forced to carry this debt burden for months without payment. To remain operational, suppliers are relying on costly loans and overdrafts simply to sustain cash flow and pay their employees.
SAMED Chairperson, Scott de Oliveira, notes that a recent member survey revealed several companies are on the brink of closure, with job losses imminent – even as South Africa prepares to host the G20 Summit, a global event intended to showcase Johannesburg and the country’s economic potential.
“As the upcoming G20 Summit demonstrates, our government is capable of decisive action and resource mobilisation when it chooses to,” says de Oliveira. “What is deeply concerning in the medtech payment crisis is the Gauteng Department’s lack of urgency to engage with us.”
Despite repeated formal requests from SAMED to meet with senior Gauteng Department of Health officials – including the Chief Financial Officer, Head of Department, and hospital Chief Executive Officers – no meaningful engagement has taken place. Meetings are frequently missed, and correspondence has gone unanswered.
“This reflects a worrying lack of accountability, urgency, and leadership from decision-makers,” de Oliveira emphasises.
The consequences of this inaction are far-reaching. The mounting financial strain on suppliers threatens not only the sustainability of small- and medium-sized enterprises but also the continuity of international subsidiaries that have invested in South Africa and are vital to the delivery of healthcare services.
“Disruptions in the medical supply chain place patients and healthcare professionals at risk,” warns de Oliveira. “Delays or interruptions in the supply of essential equipment, consumables, and support services could have devastating effects on hospitals across Gauteng.”
Several SAMED members have indicated that, unless the issue is urgently resolved, they will be forced to suspend supply to the Department, a decision that would further endanger patient care.
SAMED calls on provincial and national leadership to take immediate, decisive action to clear the payment backlog and to implement a transparent, sustainable payment framework that ensures future compliance and stability.
“It is irrational for government to champion economic growth and job creation through initiatives such as the MEDTECH Master Plan and the G20 Summit, while simultaneously eroding existing businesses and employment through maladministration,” concludes de Oliveira. “This crisis must be addressed urgently – to protect patients, preserve healthcare delivery, and rebuild trust between the public sector and its suppliers.”
SAMED urges the media, public, and stakeholders to bring attention to this issue and hold the Gauteng Department of Health accountable. Public awareness and pressure are essential to compel action and safeguard the integrity of South Africa’s healthcare system.
Phase III clinical trial by Cedars-Sinai and other institutions shows no significant differences for mortality, stroke or rehospitalisation at seven years post-treatment
People who underwent TAVR, a minimally invasive procedure to have their heart’s aortic valve replaced had similar health outcomes years after treatment as people who had surgery, Cedars-Sinai investigators and colleagues report.
“These results show that seven years after treatment, health outcomes for patients were similar whether they underwent a minimally invasive procedure or open-heart surgery,” said Makkar.
Aortic valve disease affects about 2% of the US population, and risk rises with age, so the disorder is expected to become increasingly common.
The international PARTNER 3 trial involved 1000 patients at 71 healthcare locations. Study participants had a severe form of aortic valve stenosis, a condition in which the heart’s aortic valve becomes so narrow and stiff that it cannot open fully to allow blood to pass through. The condition can cause heart failure or stroke.
Clinical trial participants were randomly chosen to undergo either open-heart surgery or a procedure called a transcatheter aortic valve replacement, also known as TAVR. All participants received a commercially available bioprosthetic valve called the SAPIEN 3 valve.
During TAVR, an interventional cardiologist threads a catheter through an artery to reach the heart and replace the diseased valve. Previous randomised controlled trials, including an earlier version of PARTNER 3, reported similar outcomes with TAVR and surgery five years after treatment in people with low to high risk for surgical complications.
For this study, investigators limited participation to patients considered to be at low surgical risk. Seven years after treatment, composite rates of death, stroke or rehospitalisation related to treatment were 34.6% for TAVR (496 people) and 37.2% for surgery (454 people), a difference that was not statistically significant. The rates of failure for the bioprosthetic valve were similar: 6.9% for TAVR and 7.3% for surgery. In addition, patients in both groups reported comparable quality of life outcomes.
“These rich data exemplify the vital information clinicians need to guide patient treatment,” said Eduardo Marbán, MD, PhD, executive director of the Smidt Heart Institute and the Mark Siegel Family Foundation Distinguished Chair. “We are proud to offer leading-edge clinical care while also advancing the field of cardiology with groundbreaking research.”
The Smidt Heart Institute is a global leader in treating heart valve disease surgically and with transcatheter procedures. Makkar, vice president of Cardiovascular Innovation and Intervention, leads a team of interventional cardiologists who perform almost 800 TAVRs each year.
The investigators next plan to report patient outcomes and valve durability at 10 years posttreatment.
For older people with irregular heart rhythms who are at high risk of stroke and bleeding, standard care (including the use of blood thinners when indicated) was found to be the better choice compared to a promising, catheter-based procedure, according to a preliminary late-breaking science presentation today at the American Heart Association’s Scientific Sessions 2025.
The trial, Left Atrial Appendage CLOSURE in Patients with Atrial Fibrillation at High Risk of Stroke and Bleeding Compared to Medical Therapy (CLOSURE-AF), compared a catheter-based procedure to medical therapy among patients with atrial fibrillation (AFib), an irregular heart rhythm.
While blood thinners can be highly effective at reducing the risk of stroke among people with AFib, the medication may cause severe bleeding in some people. Due to this risk, researchers are exploring alternative treatments including this catheter-based procedure. The procedure, called a left atrial appendage closure, seals a small pouch in the heart called the left atrial appendage, or LAA, where blood clots can form. If these blood clots enter the bloodstream, it increases the risk of stroke. Closing this pouch reduces the risk of stroke. It also can allow people to stop taking blood thinners for clot prevention.
The CLOSURE AF study compared catheter-based left atrial appendage closure with physician-directed standard medical care (including timely anticoagulant blood thinning when eligible) in patients with atrial fibrillation at high risk for stroke and bleeding. The aim of the study was to demonstrate non-inferiority for catheter-based LAA closure regarding risk of stroke, systemic embolism, cardiovascular/unexplained death or major bleeding. However, this was not reached.
“We expected that catheter-based LAA closure would be comparable to physician-directed standard medical care often using blood thinning anticoagulant medications,” said study lead researcher Ulf Landmesser, MD, chairman of the department of cardiology, angiology and intensive care medicine at Deutsche Herzzentrum Charité and professor of cardiology at Charité University Medicine in Berlin. “However, this was not the case in this trial of older patients at very high risk of bleeding and stroke.
“Our findings indicate that standard physician-directed medical care, including blood thinners for eligible patients, remains a valid management option for those older patients with irregular heartbeat who are at very high risk for stroke and bleeding.”
Landmesser said that the results of the procedure are different for lower-risk patients, and studies investigating this are currently underway. Moreover, ongoing studies are comparing LAA closure in addition to blood thinning in very high-risk patients.
Because medical treatments and LAA closure for AFib remain in development the results of this study may not apply to future research, other techniques or procedures.
Study details, background and design:
More than 900 adults with AFib who were at high risk of stroke and major bleeding participated in this study.
Participants’ average age was 78 years, and 39% were women.
They were enrolled at 42 health care sites in Germany from March 2018 to April 2024, and they were followed for a median of 3 years.
Participants were randomly assigned to one of two treatment groups: standard medical care (including anticoagulant blood thinners, if eligible); or LAA closure.
Researchers compared the frequency of stroke, life-threatening blood clots, cardiovascular/unexplained death and major bleeding between the two treatment groups.
Scientists at NYU are developing a zinc-based treatment for tooth decay that combats bacteria, blocks pain, and avoids staining teeth – all without drilling
Photo by Caroline Lm on Unsplash
Tooth decay is the most common health condition worldwide. While it is preventable and treatable, billions of people are living with cavities and the pain that accompanies them.
Given the massive scale of the problem, there’s a growing movement in dentistry to treat cavities without drilling and filling them. One such approach is applying a clear liquid called silver diamine fluoride to the surface of teeth. Silver diamine fluoride is already FDA-approved to treat tooth sensitivity, and recent NYU research shows that the compound’s antimicrobial properties also make it effective at preventing cavities and stopping small cavities from progressing into larger ones. Because it’s inexpensive and easy to administer, it can be given in schools, in rural areas lacking dentists, or to patients who may have difficulty with dental care, including those with disabilities.
But treatment with silver diamine fluoride comes with one notable drawback: when the silver in it interacts with tooth decay, it turns the treated surface black. While this is not a significant issue for molars at the back of the mouth or baby teeth that fall out, it’s not a great option for teeth seen in a smile.
“Once your teeth are treated with silver diamine fluoride, that stain is permanent, which is a barrier for many people wanting to use the product,” explains Marc Walters, professor of chemistry at NYU.
Walters has long studied silver and other elements used in medicine to carry drugs and imaging contrast agents. Several years ago, he was approached by researchers at NYU College of Dentistry seeking to better understand how silver stains teeth in order to avoid that outcome.
From silver to zinc
Walters had an idea. What if another mineral could be used that was also colourless and antimicrobial but didn’t turn teeth black? This question led him to zinc, an important nutrient found in foods like oysters and beef, as well as in over-the-counter products intended to shorten the duration of colds. Zinc is also used in dentistry, including in toothpaste and mouthwash to fight bacteria and bad breath, as well as in some denture adhesives and cementing agents to affix crowns or temporary fillings.
Walters began studying a zinc phosphate compound to see how it interacts with cavities, and crucially, to determine whether it can permeate deep into teeth. In order to address pain and hypersensitivity, the compound would need to reach the tooth’s dentin, the porous material sandwiched between the hard enamel outer layer and the nerves within. Dentin contains an abundance of microscopic, hollow channels – in fact, 40 000 of these tubules are packed into each square millimetre of dentin.
“We had to develop a solution to give dentists that will be taken up in these very small openings and go deep enough in the tubules so that the material will be retained,” Walters explains.
Walters applied phosphate followed by zinc to slices of a human tooth. Under the microscope, he saw deposits of the compound deep inside the dentin tubules. But while the zinc phosphate successfully permeated the teeth, he knew that a simpler approach that didn’t require applying two treatments would be easier for dentists. “Two steps is one too many,” says Walters.
Drawing inspiration from silver diamine fluoride, Walters developed another zinc-based molecule called zinc tetramine difluoride, which forms a colourless zinc oxide deep inside dentin tubules. The agent starts out as a liquid that is sensitive to concentration and pH. When painted onto a tooth and absorbed, the conditions within dentin tubules prompt a chemical change that quickly turns it into a solid, blocking the tubules and slowly releasing the antimicrobial zinc into the tooth.
His team is continuing to develop several related compounds for the treatment of cavities and has applied for patents of these zinc-based materials in several countries.
Fast and slow
Having both fact-acting and long-lasting properties would offer an ideal combination for fighting cavities and tooth sensitivity, given that many current treatments for sensitive teeth require multiple applications and can take days or weeks to work.
“In one of our studies, two minutes after treatment with our agent, we can see using the electron microscope that the zinc forms long cylinders of mineral that occupy the tubules,” says Walters. “Blocking the dentin tubules cuts off access to the nerves that are much deeper in dentin. It’s like putting a cork in place that shuts off the lower portion of the tubule from the outside environment – and this happens within a minute or two.”
Walters shows an image of a tubule under the microscope that was filled with the zinc compound.
In additional tests, Walters found that zinc oxide persisted in tooth samples for at least one to two months. The goal is to develop a product that lasts for months or even years inside of teeth, stopping hypersensitivity and fighting bacteria on an ongoing basis.
“Not only do you have the analgesic result of having tubules blocked, but you also have a very low solubility agent that can slowly release the zinc into the tubule to prevent the growth of Streptococcus mutans and other bacteria,” Walters adds.
The journey from lab to shelves
With a promising zinc nanocrystal agent in hand, Walters sought out other experts at NYU and beyond. His work caught the attention of Southern Dental Industries (SDI), an Australian company that makes restorative dental materials, including silver diamine fluoride. The company purchased the license for the zinc technology and NYU is working with them to develop it.
Closer to home, Walters began collaborating with Deepak Saxena, professor of molecular pathobiology and director of research innovation and entrepreneurship at NYU College of Dentistry.
Saxena and Walters are collaborating on a new NIH grant to further develop the zinc-based treatment.
As a result of bringing together this diverse expertise Saxena and Walters received a award from NYU, and last month, secured a grant from the NIH.
The NIH grant will fund feasibility studies for Walters’s team to further develop the formulation and confirm its ability to block tubules in a range of dentin samples. It will also fund research through Periomics Care in which Saxena’s team will study the agent’s antimicrobial properties. Specifically, they will look to see if the zinc creates a “zone of inhibition” – preventing the growth of decay-causing bacteria in the vicinity of it or even killing bacteria that comes in contact with it.
“The mouth is full of bacteria. A compound needs to have good antimicrobial activity, which can occur from ionic imbalance, the properties of the zinc, or by the fluoride,” Saxena says. “If a compound does not stain, has good antimicrobial activity, plus it blocks the tubules, then it should be successful in stopping tooth decay and be aesthetically accepted.”
Saxena and Walters are already planning for the next phase of their research, which will include additional studies on the compound’s formulation, effectiveness, toxicity, and shelf life. Ultimately, if these studies go well, the researchers and SDI will approach the FDA for permission to do a clinic trial.
One factor working in their favour: because zinc phosphate has long been used as a dental adhesive, it’s known to be safe and the FDA has already approved it in other forms. These existing products may pave the way for faster research and development of a cavity treatment compared to untested elements, which can take many years to develop.
The future of dentistry
A new non-invasive treatment for cavities could be a game-changer in oral health. “We know that there’s a need – and a market – for a product that stops tooth decay that is effective, cheap, easy to use, and non-staining, given the rise in global numbers of untreated cavities,” Saxena says.
Dentists could use it to treat cavities without needing to scrape or drill out the cavity in preparation. Squirmy kids would need less time in the dentist’s chair. Older adults who get cavities near the roots of their teeth as their gums recede could have a new option for stopping sensitivity and decay in difficult-to-treat areas. If safe and effective, perhaps small quantities could even be available on drugstore shelves and sold directly to consumers.
For Walters and Saxena, their goal is a future with less tooth decay and pain – and if their studies of zinc confirm its potential, silver-stained teeth may be a thing of the past.
Researchers tracked 85 young adults over a four-year period, finding that increases in ultra-processed food consumption were linked with elevated blood sugar and early signs of diabetes risk.
Photo by Jonathan Borba
More than half of calories consumed in the United States come from ultra-processed foods (UPFs), items like fast food and packaged snacks that are often high in sodium, sugar and unhealthy fats. In adults, research has clearly linked these foods to type 2 diabetes and other conditions, but few studies have explored their effects among youth.
Now, researchers from the Keck School of Medicine of USC have completed one of the first studies to examine the link between UPF consumption and how the body processes glucose, which is known to predict diabetes risk. By tracking changes over time, they gained insights into how dietary choices may influence key biological processes.
The researchers studied a group of 85 young adults over a four-year period. They found that an increase in UPF intake was associated with a higher risk for prediabetes, or early-stage high blood sugar that can lead to diabetes. Eating more UPFs was also linked to insulin resistance, where the body becomes less effective at using insulin to control blood sugar. The study, funded in part by the National Institutes of Health, was just published in the journal Nutrition and Metabolism.
“Our findings show that even modest increases in ultra-processed food intake can disrupt glucose regulation in young adults at risk for obesity. These results point to diet as a modifiable driver of early metabolic disease, and an urgent target for prevention strategies among young people,” said senior author Vaia Lida Chatzi, MD, PhD, a professor of population and public health sciences and paediatrics and director of the ShARP Center at the Keck School of Medicine.
Early adulthood is a formative stage where people have reached physical maturity and are building habits that can persist for years. Trading packaged or restaurant meals for whole and raw foods like fruits, vegetables, and whole grains can reduce the likelihood of developing type 2 diabetes later in life.
“Young adulthood is a critical window for shaping long-term health,” Chatzi said. “By focusing on young adults, we have an opportunity to intervene early, before prediabetes and other risk factors become lifelong conditions.”
Signs of prediabetes
The research included 85 young adults from the Metabolic and Asthma Incidence Research (Meta-AIR) study, part of the broader Southern California Children’s Health Study. Participants, aged 17–22, provided data at a baseline visit between 2014 and 2018 and a follow-up visit approximately four years later.
At each visit, participants reported everything they had eaten on one recent weekday and one recent weekend day. Researchers classified foods into two categories: UPFs (such as candy, soda, cereal, packaged spreads, flavored yogurts, and many restaurant foods) and foods that were not ultra-processed. They then calculated what percentage of each participant’s daily caloric intake came from UPFs.
The researchers also collected blood samples from participants before and after they consumed a sugary drink to test how effectively their body responded to blood sugar with insulin. They then conducted a statistical analysis to compare dietary changes with signs of prediabetes, adjusting for differences in age, sex, ethnicity and physical activity levels.
From baseline to follow-up, a 10% increase in UPF consumption was associated with a 64% higher risk for prediabetes and a 56% higher risk for problems with glucose regulation. Participants who reported eating more UPFs at their initial visit were also more likely to have elevated insulin levels at follow-up—an early sign of insulin resistance, where the body must produce more insulin to keep blood sugar in a healthy range.
Limiting ultra-processed foods
The study shows that the risks of UPFs extend to young adults, a group often overlooked in previous research.
“These findings indicate that ultra-processed food consumption increases the risk for pre-diabetes and type 2 diabetes among young adults – and that limiting consumption of those foods can help prevent disease,” said the study’s first author, Yiping Li, a doctoral student in quantitative biomedical sciences at Dartmouth College who previously worked as a researcher at the Keck School of Medicine.
Future studies with larger groups and more detailed diet tracking can help clarify which foods pose the greatest risk for young adults, the researchers said. They also plan to continue investigating the biological mechanisms behind these links, including how specific nutrients in UPFs may influence insulin and blood sugar regulation.
A new University of California San Diego study offers compelling evidence that GLP-1 receptor agonists may do more than regulate blood sugar and weight. In an analysis of more than 6800 colon cancer patients across all University of California Health sites, researchers found that those taking glucagon-like peptide-1 (GLP-1) medications were less than half as likely to die within five years compared to those who weren’t on the drugs (15.5% vs 37.1%).
The study, led by Raphael Cuomo, PhD, used real-world clinical data from the University of California Health Data Warehouse to assess outcomes across the state’s academic medical centres. After adjusting for age, body mass index (BMI), disease severity and other health factors, GLP-1 users still showed significantly lower odds of death, suggesting a strong and independent protective effect.
The survival benefit appeared most pronounced in patients with very high BMI (over 35), hinting that GLP-1 drugs may help counteract the inflammatory and metabolic conditions that worsen colon cancer prognosis. Researchers believe several biological mechanisms could explain the link. Beyond regulating blood sugar, GLP-1 receptor agonists reduce systemic inflammation, improve insulin sensitivity and promote weight loss – all factors that can dampen tumour-promoting pathways. Laboratory studies also suggest that GLP-1 drugs may directly prevent cancer cell growth, trigger cancer cell death and reshape the tumour microenvironment. However, the study authors emphasise that more research is needed to confirm these mechanisms and determine whether the survival benefit observed in this real-world analysis represents a direct anti-cancer effect or an indirect result of improved metabolic health.
Cuomo notes that while these results are observational, they underscore an urgent need for clinical trials to test whether GLP-1 drugs can improve cancer survival rates, especially for patients with obesity-related cancers.
New method for the targeted production of specific cells
Figure 1 Schematic overview of the experimental workflow. MSCs (blue) were singly encapsulated using a microfluidic approach within calcium-crosslinked, RGD-functionalized alginate microgels (pink), followed by a secondary APA and calcium coating to enhance stability. Encapsulated cells were cultured for 21 days and subjected to cyclic hydrostatic pressure in regular cell culture media without any growth factors. Source: İyisan et al., Small Science, 2025.
For the first time, researchers at the Technical University of Munich (TUM) have succeeded in using nanorobots to stimulate stem cells with such precision that they are reliably transformed into bone cells. To achieve this, the robots exert external pressure on specific points in the cell wall. The new method offers opportunities for faster treatments in the future.
Prof Berna Özkale Edelmann’s nanorobots consist of tiny gold rods and plastic chains. Several million of them are contained in a gel cushion measuring just 60 micrometres, together with a few human stem cells. Powered and controlled by laser light, the robots, which look like tiny balls, mechanically stimulate the cells by exerting pressure. “We heat the gel locally and use our system to precisely determine the forces with which the nanorobots press on the cell – thereby stimulating it,” explains the professor of nano- and microrobotics at TUM. This mechanical stimulation triggers biochemical processes in the cell. Ion channels change their properties, and proteins are activated, including one that is particularly important for bone formation.
Heart and cartilage cells: finding the correct stress pattern
If stimulation is carried out at the right rhythm and with the right (low) force, a stem cell can be reliably triggered to develop into a bone cell within three days. This process can be completed within three weeks. “The corresponding stress pattern can also be found for cartilage and heart cells,” asserts Berna Özkale Edelman. “It’s almost like at the gym: we train the cells for a particular area of application. Now we just have to find out which stress pattern suits each cell type,” says the head of the Microbiotic Bioengineering Lab at TUM.
Mechanical forces pave the way for transformation into bone cells
The research team produces bone cells using mesenchymal stem cells. These cells are considered to be the body’s ‘repair cells’. They are approximately 10 to 20 micrometres in size and are generally capable of developing into bone, cartilage or muscle cells, for example. The challenge: The transformation into differentiated cells is complex and has been difficult to control until now. “We have developed a technology that allows forces to be applied to the cell very precisely in a three-dimensional environment,” says TUM scientist Özkale Edelmann. “This represents an unprecedented advance in the field.” The researchers believe that this method can even be used to produce cartilage and heart cells from human stem cells.
Automation is the next step
For treatments, doctors will ultimately need far more differentiated cells – around one million. “That’s why the next step is to automate our production process so that we can produce more cells more quickly,” says Prof Özkale Edelmann.
Mass General Brigham researchers used real-world data to conduct a head-to-head study to investigate cardioprotective effects, finding both medications reduced risk.
Pexels Photo by Freestocksorg
A new study from Mass General Brigham provides head-to-head evidence comparing the cardioprotective effects of tirzepatide and semaglutide. The researchers found both medications reduced the risk of heart attack, stroke, and death from any cause. The study is published in Nature Medicine, with results simultaneously presented at the American Heart Association Scientific Sessions 2025.
Previous research shows that semaglutide protects against cardiovascular events like heart attack or stroke. But it wasn’t clear if tirzepatide, also commonly prescribed for type 2 diabetes, has the same cardiovascular benefits.
Researchers used US claims databases to compare the cardiovascular outcomes of nearly one million adults taking tirzepatide, semaglutide, or other medications for type 2 diabetes.
“Randomised controlled trials are often considered the reference standard in the medical evidence generation process. However, not all questions can be answered using this time- and resource-intensive method,” said first author Nils Krüger, MD, a research fellow in the Division of Pharmacoepidemiology and Pharmacoeconomics in the Mass General Brigham Department of Medicine. “Data generated in clinical practice and used secondarily for research allow us to address a wide range of clinically relevant questions time- and resource-effectively – when applied correctly. Moreover, we can study patients who reflect the reality of everyday clinical care, in contrast to the highly selected participants of randomized experiments.”
The study demonstrated a cardiovascular benefit for patients at risk for adverse cardiovascular events who had type 2 diabetes. Compared with sitagliptin, a diabetes drug that has shown neutral effects on cardiovascular outcomes, semaglutide reduced the risk of stroke and heart attack by 18 percent. Treatment with tirzepatide lowered the risk of stroke, heart attack, and death by 13 percent compared to dulaglutide, another GLP-1 receptor agonist that has been available for many years.
“Both drugs show strong cardioprotective effects. Our data also indicate that these benefits occur early, suggesting that their protective mechanisms go beyond weight loss alone,” said Krüger. The exact biological mechanisms underlying these protective effects remain unknown.
Because these medications have only recently become available, studies confirming their cardioprotective mechanisms – particularly those directly comparing the two dominant GLP-1 agents, tirzepatide and semaglutide – are still lacking.
“According to recently presented database analyses by the respective manufacturers, each company’s own drug appears to reduce cardiovascular risk much more effectively than the competitor’s,” said Krüger. “However, our study found only small differences between tirzepatide and semaglutide in cardiovascular protection among populations at risk of adverse events, underscoring that both agents provide protective benefit and could be integrated into clinical cardiovascular practice.”
“We hope that our study will help clinicians better understand how these new medications work in clinical practice. Our transparent and open science practices, including pre-registration of a public protocol and shared analytic code, are designed to support scientific discussion,” said last author Shirley Wang, PhD, an associate epidemiologist in the Division of Pharmacoepidemiology and Pharmacoeconomics in the Mass General Brigham Department of Medicine.
Johannesburg, 11 November 2025:As we approach World Diabetes Day on November 14, civil society organisations warn that the cost of inaction on non-communicable diseases (NCDs) such as diabetes is already being paid for in lives, livelihoods and lost potential. The Healthy Living Alliance (HEALA) is calling on the South African government to increase the Health Promotion Levy (HPL) on sugary drinks from 11% to 20%, to help curb sugary drinks consumption and reduce the financial burden on the health system from rising non-communicable diseases.
“Diabetes is now the second leading cause of death in South Africa,1 yet every year we allow preventable diseases to claim more lives,” says Nzama Mbalati, CEO of HEALA. “Raising the Health Promotion Levy is one of the simplest, most effective steps government can take to protect people’s health, especially children, who are consuming sugar at dangerous levels.”
Since the introduction of the HPL in 2018, beverage companies have reduced the sugar content of their drinks, leading to cuts in average per-capita sugar consumption. But the gains have stalled. HEALA and its partners warn that without further cuts in consumption, the policy’s impact will fade, while rates of diabetes will continue to climb.
South Africa’s obesity rate is already twice the global average, and even one sugary drink a week raises a child’s risk of obesity and diabetes.2,3 One in four diabetes cases in the country is caused by sugary drink consumption.4 These numbers are not just statistics; they represent real people and families forced to navigate lifelong illness and financial hardship.
The economic toll is equally alarming. Treating obesity related conditions such as diabetes already costs South Africa more than R33 billion each year or about 15% of total government health spending.5 Modelling by PRICELESS SA (University of the Witwatersrand) shows that increasing the levy to 20% could save approximately 72 000 lives and prevent 85 000 strokes over two decades while easing the fiscal pressure on a health system already stretched beyond capacity.5
HEALA’s new national campaign, which launched in November, brings this message to the fore in two phases. The first calls for stronger health taxes across sugary drinks, alcohol and tobacco, continuing South Africa’s proven track record of using taxation to advance public health. The second sharpens focus on raising the HPL, calling for its increase as part of a consistent, evidence-based approach to protecting lives.
Through personal stories of South Africans living with diabetes, the campaign reveals the real cost of inaction and unites civil society under the banner #OneVoice, calling on government to put public health before profit.
Alphinah Setumo, a 52-year-old mother from Mathibestad, lost both her legs and her eyesight after years of consuming sugary drinks without understanding the risks. “Back then, drinking two litres of a sugary drink a day was nothing,” she recalls. “If I had known what I know now, my life would be different.”
Mpho Thebe, a maths and science tutor from Kroonstad, tells a similar story. Once a daily consumer of fizzy drinks, he lost his left leg to diabetes at 45. Today, he walks with a prosthetic leg and teaches children about perseverance and prevention. “I thought sugar was harmless,” he says. “Now I know it can take everything from you.”
These stories mirror thousands of others across the country, where diabetes silently devastates families, especially in low-income communities where affordable, healthy food and clean water remain scarce.
The campaign, supported by actress and mother Samela Tyelbooi, urges government to act. “As a parent, I worry about how sugar can make my kids sick,” says Tyelbooi. “We need government to increase the HPL, protect our children’s future, and stop putting profit before people.”
HEALA’s coalition partners, including health advocates, researchers and civil society organisations, are speaking with one voice ahead of the Medium-Term Budget Policy Statement and the 2026 Budget Speech. Their collective message is clear: the HPL is not just another tax, it’s a health tax, like those on alcohol and tobacco, designed to save lives, prevent disease and safeguard South Africa’s future.
“This is not about taking away people’s choices, it’s about giving South Africans the chance to make healthier, more informed choices,” adds Mbalati.
Diabetes and other NCDs already account for over 50% of deaths from preventable diseases in South Africa.5,6 Without decisive fiscal measures, the burden will continue to fall on the households least able to bear it.
Globally, countries from Mexico to the UK have proven that health taxes reduce sugar consumption and improve health outcomes.
HEALA is urging citizens to join the call by signing the petition and demanding that government increase the HPL to 20%.
“We have the evidence, we have the stories, and we have the will,” concludes Tyelbooi. “Now we need action.”
