Tag: 28/11/25

Categories : Mental HealthTags : Leave a comment

Largest Study Reveals Best Treatment Options for ADHD

On By ModernMedia
Photo by Towfiqu barbhuiya on Unsplash

The most comprehensive review to date of ADHD treatments has found that medication for children and adults, and cognitive behavioural therapy for adults, remain the most effective approaches, backed by the strongest short-term trial evidence.

Researchers led by the Université Paris Nanterre (France), Institut Robert-Debré du Cerveau de l’Enfant (France), and the University of Southampton (UK) analysed over 200 meta-analyses covering different treatment types, participant groups, and clinical outcomes in a study published in The BMJ.

The research was funded by public and peer-reviewed research grants from Agence Nationale de la Recherche (France), France 2030 program (France), and National Institute for Health and Care Research (UK).

To help people with attention deficit hyperactivity disorder (ADHD) and their clinicians make more informed, shared decisions, the team has created an interactive website that clearly presents the findings and the evidence behind each treatment based on the review (ebiadhd-database.org ).

“We know that people with ADHD and their families are often overwhelmed by conflicting messages about which treatments work,” says Professor Samuele Cortese , an NIHR Research Professor at the University of Southampton and senior lead author on the paper.

“We believe this study and the accompanying website provide the most authoritative, evidence-based, and accessible guidance currently available.

“The Evidence-Based Interventions for ADHD website provides freely available, evidence-based, and continuously updated information in an easy-to-understand way. To the best of our knowledge, this is the first platform in the world to do so based on such a rigorous synthesis of the available evidence.”

Overall, five medications in children and adolescents, and two medications and cognitive behavioural therapy (CBT) in adults were shown to be effective while supported by a relatively robust evidence base. Critically, all this evidence was limited to the short-term, despite long-term treatment being common in clinical practice.

Treatments like acupuncture, mindfulness and exercise showed promise, but the evidence supporting their use was of a low quality due to small numbers of participants and risk of bias. The limitations applied to studies evaluating cognitive behavioural therapy in children and adolescents, as well as research on the long-term effects of mindfulness in adults, although mindfulness was the only intervention to demonstrate large beneficial effects at extended follow-up.

Dr Corentin Gosling, Associate Professor at the Paris Nanterre University and first lead author of the study, says: “Long waiting lists for mental health services are a major issue. Having incorrect information about treatments can make people’s journeys even more difficult, by wasting time and money on non-evidence-based approaches, for example.

“By contrast, taking the time to review all treatment options within a shared decision-making process using the web app we developed can empower people with ADHD, leading to better treatment adherence, improved outcomes, and an overall better patient experience.”

The findings generally complement current international clinical guidelines, not only by providing convenient access to current high-quality evidence, but also by covering interventions not usually mentioned in clinical guidelines.

The team hope this new project will achieve a similar impact in influencing clinical guidelines and practice as their previous project (ebiact-database.com), which looked at treatments for autism.

Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making is published in The BMJ and is available online.

Source: University of Southampton

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Release of Useful Health Statistics: 2015 to 2025

On By ModernMedia
Mycobacterium tuberculosis drug susceptibility test. Photo by CDC on Unsplash

By Marcus Low and Nathan Geffen

The National Health Laboratory Service has provided HIV, TB, syphilis and cholesterol data, which Spotlight and GroundUp obtained through the Promotion of Access to Information Act.

Earlier this year, we made a request for data to the National Health Laboratory Service (NHLS) using the Promotion of Access to Information Act. In October, we were provided with the data we requested (and more).

We are grateful and impressed that the NHLS provided the data without fuss and without the need to go to court. Other state institutions could learn from this.

We used the data to analyse HIV viral load data in light of the withdrawal of US aid. It led to us publishing this article: Withdrawal of US aid has hurt South Africa’s HIV programme.

From the outset, we’ve intended to make the data public. No information on patients is recoverable from this data as the finest detail is at the monthly provincial level. We are therefore publishing this data, as an open document format spreadsheet, today. We are of the view that the data provided is useful for scientists and journalists and we hope the NHLS will regularly publish updates to it.

The spreadsheet contains monthly tallies per province of viral load tests, CD4 counts, TB tests, syphilis tests, full blood counts and cholesterol tests. The period covered is January 2015 to September 2025.

Download the spreadsheet

Much of the data is not straightforward to interpret. For example, after we puzzled over the decline in cholesterol tests, one expert pointed out to us that the decrease is probably due to changes in the standard second-line HIV treatment used in the public sector (some older HIV medicines had potential side effects that made cholesterol tests necessary). Similarly, changes in the number of TB tests conducted will have been impacted by guidelines that expanded eligibility for TB testing.

The NHLS informed us of the following caveats:

  1. All counts reflect the number of tests captured on the NHLS TrakCare (LabTrak) Laboratory Information System (LIS) as at the time the counts were performed (21 October 2025).
  2. A system-generated date from the time a sample was captured onto the LIS was used to total counts per month/year.
  3. There may be anomalies in counts for a few months from July 2024 because of disruptions caused by a cyber-attack.
  4. As test counts were requested, rejected tests and unreviewed results were included.
  5. As test counts were requested, the counts provided reflect the number of tests done, not the number of patients tested, as multiple tests may be performed on one patient sample. For example, for a full blood count, each individual test was counted.
  6. The “Pregnant or postnatal women” group was identified according to the NHLS maternal eGK (electronic gatekeeping) codes.

(We have amended the NHLS spreadsheet by inserting a new sheet with the above caveats and a link to this article. No other material changes have been made to the spreadsheet.)

This article was jointly produced by Spotlight and GroundUp.

Republished from Spotlight under a Creative Commons licence.

Read the original article.

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New Trial Could End Kidney Transplant Recipients’ Need for Lifelong Immunosuppression

On By ModernMedia
Human kidney. Credit: Scientific Animations CC0

When Karina Ledesma’s kidneys failed in high school, she was told she’d need a transplant – and a lifetime of immunosuppressive drugs to keep it working. But thanks to an experimental UCLA clinical trial, she’s now living with a kidney donated by her sister and no longer needs daily medications to protect it. 

“It was such a relief to finally throw all the drugs away,” said Ledesma, 26. “I didn’t need to keep them here. I didn’t need to see them every day as a reminder. Tossing them all out was just a really great feeling.”

For nearly a year after her transplant, and before enrolling in the trial, Ledesma experienced troubling side effects from the immunosuppressive medications – insomnia, burning sensations in her fingers and toes and the constant need to plan her day around taking pills at 8am and 8pm. 

Now she’s finally free from those burdens. Ledesma has been off her medications for just over a month, and her sister Rosa Rivera, 28, who donated the kidney, supported her through every step of the journey. 

More patients may soon have the same opportunity. UCLA’s Dr. Jeffrey Veale has received a $6.7 million grant from the California Institute for Regenerative Medicine to expand the clinical trial that helped Ledesma.

His study explores delayed immune tolerance, which involves infusing donor-derived blood stem cells months or even years after a kidney transplant to retrain the recipient’s immune system with the aim of eliminating the need for lifelong immunosuppressive drugs currently required to prevent organ rejection.

Veale and his team have already demonstrated early success with this approach, focusing solely on patients with a close-sibling match who had their transplant within the last five years. Starting in January 2026, the clinical trial will open to patients who have had kidney transplants up to 20 years ago.

Veale’s method works like this: After infusion, the donor stem cells integrate into the recipient’s bone marrow and immune system, creating a mixed population of donor and recipient immune cells — a state known as chimerism. This helps the recipient’s immune system recognize the transplanted kidney as “self,” reducing the risk of rejection and eliminating the need for ongoing immunosuppressive medications.

Of the six patients treated in the phase 1/2 trial to date, three are completely off immunosuppressive drugs, and the others are on a lower dose or successfully tapering. 

“This could be the difference between managing end-stage renal disease as a chronic condition and actually curing it,” said Veale, professor of urology at the David Geffen School of Medicine at UCLA and a member of the UCLA Broad Stem Cell Research Center. “A kidney transplant takes recipients most of the way there, but patients say being able to get off immunosuppressive drugs feels like truly being cured.”

Expanding the trial 

The new grant will fund the enrollment of 10 additional patients in the trial and support research into the science behind immune tolerance, helping Veale and his team identify the biological mechanisms that make tolerance possible and uncover biomarkers that could predict which patients are most likely to benefit. 

The clinical trial is currently only open to patients who have received a kidney donation from a well-matched sibling. Veale hopes that by understanding how tolerance occurs, he and others can pinpoint ways to make it possible in a broader range of donor-recipient types — and in more kinds of organ transplant cases.

“Right now, only a select group of patients qualify for this therapy,” said Veale, who is also director of the UCLA Kidney Exchange Program. “But if we can understand why tolerance works at the cellular level, we may be able to offer it to patients with less well-matched donors – or even extend it to liver and other transplants. That’s what makes this research so exciting. It’s not just about improving outcomes – it’s about unlocking immune tolerance for many more patients.”

Freeing more patients from the burden of immune suppression

Immunosuppressive medications, while essential for transplant success, come with serious — and sometimes life-threatening — side effects including infections, cardiovascular disease, diabetes and cancer. Ironically, they can also cause damage to the very organ they’re meant to protect.

“These immunosuppressive drugs have not changed in decades,” Veale said. “They’re expensive, impair the recipient’s quality of life and decrease graft survival. Once patients start taking them, it’s just a matter of time until they’ll need another transplant.” 

Approximately half of all kidney transplants fail within 15 years and many of the 90,000 people currently waiting for a kidney in the U.S. are heading for their second, third or fourth transplant.

Delayed tolerance could help turn the tide. Unlike earlier protocols that required simultaneous kidney and stem cell transplants, Veale’s method opens up immune tolerance for patients who received a kidney transplant years ago. 

This not only makes it possible to treat patients who received their kidney transplant elsewhere but also enables the stem cell infusion to take place on an outpatient basis, without placing strain on hospital beds and resources.

Importantly, the delayed protocol opens the door for tolerance beyond kidney transplant, where the recipient can recover from their major surgery prior to receiving conditioning treatment and donor stem cell infusion.

“The beauty of doing it in a delayed fashion is that it takes all the pressure off the hospital,” said Veale. “The transplant has already occurred, whether it was done at UCLA or in another part of the world. Now the patient just comes in for an outpatient conditioning regimen and stem cell infusion. They get their treatment in the morning and are out and about in the afternoon. That’s what makes it so scalable.”

Understanding why tolerance works

Still, more research is needed to fully understand why delayed tolerance works and which patients are most likely to benefit. 

Veale’s team will use the CIRM funding to analyse blood and tissue samples from trial participants to look for clues: changes in immune cell populations, cytokine profiles or signs of donor cells persisting in the organ itself. These insights could help researchers predict who will respond best to the protocol and guide the design of future trials involving mismatched pairs.

“With this funding, we can find out why tolerance works. We really don’t fully understand the immunology behind it,” Veale said. “For example, we’ve seen patients lose all signs of donor stem cells over time and yet remain tolerant and off their medications. That tells us something deeper is happening – maybe the donor stem cells re-educate the recipient’s immune system and leave a footprint we can’t yet detect. This grant gives us a chance to finally study what’s going on and learn how to replicate it in more patients.”

Ultimately, Veale hopes the research will help shift the transplant field’s focus from preserving organ function to preventing long-term harm – not just keeping donated kidneys working, but keeping recipients healthy and medication-free. 

Source: University of California – Los Angeles

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Many Men May Not Need Long-term Hormone Therapy for Prostate Cancer

On By ModernMedia
cancer 1
Wild type human prostate cells from an organoid. Credit: National Cancer Institute, National Institutes of Health

A study co-led by investigators at the UCLA Health Jonsson Comprehensive Cancer Center found that most of the benefits of androgen deprivation therapy (ADT) for prostate cancer occur within the first 9 to 12 months. Extending therapy beyond that provides only a small additional protection and increases the risk of other health problems, such as heart or metabolic issues. Results show that the ideal length of ADT depends on cancer risk:

  • Low-risk patients may not need ADT.
  • Intermediate-risk patients benefit most from 6 to 12 months.
  • High-risk patients may benefit from up to 12 months, while very high-risk patients may require longer therapy.

The study was published in the journal JAMA Oncology. 

ADT is a type of hormone therapy that is commonly given alongside radiation to slow the growth of prostate cancer by lowering testosterone. While effective at controlling the disease, long-term ADT can cause side effects, including bone loss, muscle loss and cardiovascular problems. Current treatment guidelines generally recommend 4 to 6 months of ADT for intermediate-risk patients and 18 to 36 months for high-risk patients, but the optimal duration has been unclear.

Researchers conducted a Meta-Analysis of Randomized Trials in Cancer of the Prostate (MARCAP) Consortium using data from 10 266 men across 13 international clinical trials. They assessed outcomes including overall survival, cancer-specific survival and deaths from other causes, comparing different ADT durations. 

The findings highlight the importance of personalised treatment plans for men with prostate cancer. Shorter courses of hormone therapy may be sufficient for many patients, reducing side effects while maintaining effectiveness. Physicians can now use patient-specific factors, including cancer risk, overall health, age and preferences, to make more informed decisions about ADT duration, improving both safety and quality of life.

Source: University of California – Los Angeles