New England Journal of Medicine

Gemma Lewis, Ph.D., Louise Marston, Ph.D., Larisa Duffy, B.Sc., Nick Freemantle, Ph.D., Simon Gilbody, Ph.D., Rachael Hunter, M.Sc., Tony Kendrick, M.D., David Kessler, M.D., Dee Mangin, F.R.N.Z.C.G.P., Michael King, Ph.D., Paul Lanham, B.A., Michael Moore, F.R.C.G.P., Irwin Nazareth, Ph.D., Nicola Wiles, Ph.D., Faye Bacon, B.Sc., Molly Bird, M.Sc., Sally Brabyn, M.Sc., Alison Burns, B.Sc., Caroline S. Clarke, Ph.D., Anna Hunt, M.Sc., Jodi Pervin, B.Sc., and Glyn Lewis, Ph.D.

doi : 10.1056/NEJMoa2106356

N Engl J Med 2021; 385:1257-1267

Patients with depression who are treated in primary care practices may receive antidepressants for prolonged periods. Data are limited on the effects of maintaining or discontinuing antidepressant therapy in this setting.

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Trial of Intensive Blood-Pressure Control in Older Patients with Hypertension

Weili Zhang, M.D., Ph.D., Shuyuan Zhang, Ph.D., Yue Deng, Ph.D., Shouling Wu, M.D., Jie Ren, M.D., Gang Sun, M.D., Jinfeng Yang, M.D., Yinong Jiang, M.D., Xinjuan Xu, M.D., Tzung-Dau Wang, M.D., Ph.D., Youren Chen, M.D., Yufeng Li, M.D., Lianchen Yao, M.D., Dianfang Li, M.D., Lixin Wang, M.D., Xiaomei Shen, M.D., Xinhua Yin, M.D., Wei Liu, M.D., Xiaoyang Zhou, M.D., Bingpo Zhu, M.D., Zihong Guo, M.D., Hualing Liu, M.D., Xiaoping Chen, M.D., Yingqing Feng, M.D., Gang Tian, M.D., Xiuyin Gao, B.Sc., Kazuomi Kario, M.D., Ph.D., and Jun Cai, M.D., Ph.D. for the STEP Study Group*

doi : 10.1056/NEJMoa2111437

N Engl J Med 2021; 385:1268-1279

The appropriate target for systolic blood pressure to reduce cardiovascular risk in older patients with hypertension remains unclear.

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Ozanimod as Induction and Maintenance Therapy for Ulcerative Colitis

William J. Sandborn, M.D., Brian G. Feagan, M.D., Geert D’Haens, M.D., Douglas C. Wolf, M.D., Igor Jovanovic, M.D., Stephen B. Hanauer, M.D., Subrata Ghosh, M.D., AnnKatrin Petersen, M.D., Steven Y. Hua, Ph.D., Ji Hwan Lee, M.S., Lorna Charles, M.D., Denesh Chitkara, M.D., Keith Usiskin, M.D., Jean-Frederic Colombel, M.D., Loren Laine, M.D., and Silvio Danese, M.D. for the True North Study Group*

doi : 10.1056/NEJMoa2033617

N Engl J Med 2021; 385:1280-1291

Ozanimod, a selective sphingosine-1-phosphate receptor modulator, is under investigation for the treatment of inflammatory bowel disease.

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A Human Pleiotropic Multiorgan Condition Caused by Deficient Wnt Secretion

Guoliang Chai, Ph.D., Emmanuelle Szenker-Ravi, Ph.D., Changuk Chung, Ph.D., Zhen Li, Ph.D., Lu Wang, Ph.D., Muznah Khatoo, B.S., Trevor Marshall, B.S., Nan Jiang, Ph.D., Xiaoxu Yang, Ph.D., Jennifer McEvoy-Venneri, B.S., Valentina Stanley, B.S., Paula Anzenberg, B.S., Nhi Lang, B.S., Vanessa Wazny, B.S., Jia Yu, Ph.D., David M. Virshup, M.D., Rie Nygaard, Ph.D., Filippo Mancia, Ph.D., Rijad Merdzanic, M.D., Maria B.P. Toralles, M.D., Paula M.L. Pitanga, M.Sc., Ratna D. Puri, M.D., Rebecca Hernan, M.Sc., Wendy K. Chung, M.D., Ph.D., Aida M. Bertoli-Avella, M.D., Ph.D., Nouriya Al-Sannaa, M.D., Maha S. Zaki, M.D., Ph.D., Karl Willert, Ph.D., Bruno Reversade, Ph.D., and Joseph G. Gleeson, M.D.

doi : 10.1056/NEJMoa2033911

N Engl J Med 2021; 385:1292-1301

Structural birth defects occur in approximately 3% of live births; most such defects lack defined genetic or environmental causes. Despite advances in surgical approaches, pharmacologic prevention remains largely out of reach.

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