Signals
24Adolescent depression care widens past SSRI defaults
Esketamine adolescent indication consideration, ECT and TMS adolescent access, structured measurement-based care, and integrated school-and-medical models are reshaping adolescent depression care.
Pulmonary embolism management restructures around catheter-directed therapy and risk stratification
DOAC first-line maturity, catheter-directed thrombolysis and mechanical thrombectomy growth, and structured pulmonary embolism response team (PERT) infrastructure are reshaping pulmonary embolism care.
Hyperemesis gravidarum therapy options widen past doxylamine-pyridoxine
Doxylamine-pyridoxine and ondansetron maturity, structured outpatient infusion pathways, and emerging GDF15-targeted programs are reshaping hyperemesis gravidarum management.
Lung cancer screening pathway integration matures
Low-dose CT screening adoption growth, AI-assisted nodule management, blood-based biomarker integration, and primary-care pathway formalisation are restructuring lung cancer screening.
Severe asthma management in pregnancy formalises around biologic continuation
Real-world evidence on biologic therapy continuation in pregnancy, structured high-risk pregnancy pulmonology integration, and updated guidelines are reshaping severe asthma in pregnancy.
Thyroid disease in pregnancy management formalises around structured monitoring
Pregnancy-specific TSH targets, structured pre-conception thyroid management, and integrated maternal-fetal medicine and endocrinology pathways are reshaping thyroid disease in pregnancy.
Treatment-resistant schizophrenia care formalises around clozapine integration
Clozapine pathway formalisation, KarXT muscarinic mechanism integration, and emerging mechanism-targeted programs are reshaping treatment-resistant schizophrenia.
Dementia with Lewy bodies care formalises around alpha-synuclein-aware management
Cholinesterase inhibitor optimisation, antipsychotic-avoidance protocols, RBD recognition pathways, and emerging alpha-synuclein-targeted programs are reshaping DLB care.
Autism spectrum disorder pharmacotherapy options widen past irritability indications
Risperidone and aripiprazole maturity for ASD-associated irritability, emerging mechanism-targeted programs for core symptoms, and integrated multidisciplinary care models are reshaping ASD pharmacotherapy.
Pelvic floor disorder therapy options widen past Kegel-and-surgery defaults
Pelvic floor physiotherapy formalisation, vibegron and emerging beta-3 agonist programs in overactive bladder, and integrated multidisciplinary care models are reshaping pelvic floor disorders.
Post-stroke spasticity therapy options widen past oral baclofen
Botulinum toxin maturity, intrathecal baclofen pump access, and emerging novel mechanism programs are reshaping post-stroke spasticity management.
Breast cancer survivorship care widens past tamoxifen and aromatase inhibitor side-effect management
Vasomotor symptom therapy in breast cancer survivors, bone-health management with aromatase inhibitors, and structured survivorship programs are reshaping breast cancer survivorship care.
Tobacco use disorder pharmacotherapy widens past nicotine replacement and varenicline
Cytisine availability, novel nicotine receptor pharmacotherapy, and integrated behavioural-and-pharmacological care delivery are reshaping tobacco use disorder management.
Insomnia comorbid with mental health conditions acquires structured therapy options
Daridorexant maturity, cognitive-behavioural therapy for insomnia (CBT-I) digital expansion, and integrated mental-health-and-insomnia treatment models are reshaping comorbid insomnia care.
Dementia behavioural symptoms acquire approved pharmacotherapy
Brexpiprazole approval for agitation in Alzheimer's dementia and follow-on programs are reshaping dementia behavioural symptom management.
Obsessive-compulsive disorder modern options mature
Deep brain stimulation maturity, novel glutamate-modulator programs, and refined transcranial magnetic stimulation protocols are reshaping refractory OCD management.
Concussion and TBI biomarker tools mature
Plasma GFAP and UCH-L1 assays for concussion and traumatic brain injury are establishing routine emergency-department use.
ARIA monitoring infrastructure is the rate-limit on anti-amyloid uptake
Centres prescribing lecanemab and donanemab consistently report that MRI surveillance capacity, not patient demand or insurance approval, is the bottleneck on how many patients they can treat in 2026.
ATTR amyloidosis silencer therapy uptake is transforming a previously underdiagnosed condition
Transthyretin amyloid cardiomyopathy (ATTR-CM) was historically underdiagnosed and undertreated. Approved silencer therapies (siRNA, ASO) and TTR stabilisers have moved the field rapidly, and the diagnostic-pathway access remains the rate-limit on commercial uptake.
Sickle cell disease curative therapy uptake exposes the conditioning-regimen access gap
Approved curative therapies for sickle cell disease (lentiviral gene therapy and CRISPR-edited autologous stem-cell therapy) are facing real-world uptake constrained by the conditioning regimen requirements and the specialist-centre infrastructure for autologous cell therapy.
AAV gene-therapy manufacturing capacity remains the rate-limit on commercial uptake
The AAV gene-therapy class continues to face manufacturing-capacity constraints that limit commercial scale, particularly for high-dose indications. Investment in capacity is happening, but the lead times are long and the implications for commercial uptake are persisting longer than the field expected.
Plasma-biomarker rollout is concentrated at academic centers
Adoption of plasma p-tau217 testing remains concentrated at academic medical centers and large specialty practices, with community uptake meaningfully behind.
Lecanemab uptake constrained by infusion infrastructure, not demand
Real-world rollout of lecanemab is gated by infusion-chair capacity and MRI monitoring schedules - not by patient interest or prescriber willingness.
ARIA surveillance is becoming the rate-limiting step in anti-amyloid care
Amyloid-related imaging abnormalities require protocol-defined MRI at multiple intervals, and managing positive findings demands neurologist judgment that is in short supply.
Snapshots
9Achondroplasia therapy reference (2026)
Reference snapshot of achondroplasia care across supportive, surgical, and disease-modifying tiers.
Treatment-resistant schizophrenia therapy reference (2026)
Reference snapshot of TRS therapy across clozapine, augmentation, and emerging mechanism tiers.
Systemic sclerosis therapy reference (2026)
Reference snapshot of systemic sclerosis therapy across organ-domain-specific and emerging disease-modifying tiers.
Nausea and vomiting in pregnancy therapy reference (2026)
Reference snapshot of nausea and vomiting in pregnancy therapy from mild morning sickness through hyperemesis gravidarum.
Autism spectrum disorder care reference (2026)
Reference snapshot of ASD care across behavioural therapy, educational support, pharmacotherapy for associated symptoms, and emerging core-symptom programs.
Spasticity therapy reference (2026)
Reference snapshot of spasticity therapy across post-stroke, multiple sclerosis, cerebral palsy, and spinal cord injury populations.
Tobacco use disorder therapy reference (2026)
Reference snapshot of tobacco use disorder therapy across pharmacotherapy, behavioural support, and integrated care models.
OCD therapy reference (2026)
Reference snapshot of OCD therapy across pharmacotherapy, psychotherapy, and procedural-and-emerging tiers.
Acute ischemic stroke therapy reference (2026)
Reference snapshot of acute ischemic stroke therapy across thrombolysis and mechanical thrombectomy.
Explained
5What is treatment-resistant schizophrenia?
Plain-language primer on treatment-resistant schizophrenia, why clozapine matters, and what comprehensive care looks like.
How natural history studies are being co-designed with sponsors
Natural history studies in rare disease are increasingly being designed jointly between patient organisations, academic networks, and sponsors with assets in development. The co-design model has implications for evidence quality, regulatory acceptability, and the commercial use of the resulting data.
How ophthalmic drug delivery has moved from formulation chemistry to device engineering
Ophthalmic drug delivery has shifted in the past decade from a primarily formulation-chemistry exercise (eye drops, conventional intravitreal injection) into a device-engineering one (sustained-release implants, port-delivery systems, microneedle and suprachoroidal delivery). The methodology and the implications for commercial planning are worth understanding.
Patient registries are now critical infrastructure, not nice-to-have evidence
Patient registries in rare disease have moved from research-grade data sources to operational infrastructure underpinning regulatory submissions, HTA decisions, post-marketing evidence, and patient-finding models. The framing has shifted; the funding model is still catching up.
What is a subcutaneous anti-amyloid antibody, and why does it matter for access?
Subcutaneous formulations of the anti-amyloid antibodies are reformulations that allow the same active drug to be given as a small under-the-skin injection rather than an intravenous infusion. The biology is the same. The delivery is dramatically simpler. The access implications are real but partial - subcutaneous administration removes the infusion-chair constraint, but does not change the MRI surveillance requirement.