New England Journal of Medicine

Mark G. Lebwohl, M.D., Linda Stein Gold, M.D., Bruce Strober, M.D., Ph.D, Kim A. Papp, M.D., Ph.D., April W. Armstrong, M.D., Jerry Bagel, M.D., Leon Kircik, M.D., Benjamin Ehst, M.D., Ph.D., H. Chih-ho Hong, M.D., Jennifer Soung, M.D., Jeff Fromowitz, M.D., Scott Guenthner, M.D., Stephen C. Piscitelli, Pharm.D., David S. Rubenstein, M.D., Ph.D., Philip M. Brown, M.D., J.D., Anna M. Tallman, Pharm.D., and Robert Bissonnette, M.D.

doi : 10.1056/NEJMoa2103629

N Engl J Med 2021; 385:2219-2229

Tapinarof cream is a topical aryl hydrocarbon receptor–modulating agent under investigation for the treatment of psoriasis. Tapinarof modulates the expression of interleukin-17 and the skin-barrier proteins filaggrin and loricrin.

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Dupilumab in Children with Uncontrolled Moderate-to-Severe Asthma

Leonard B. Bacharier, M.D., Jorge F. Maspero, M.D., Constance H. Katelaris, M.D., Alessandro G. Fiocchi, M.D., Remi Gagnon, M.D., Ines de Mir, M.D., Neal Jain, M.D., Lawrence D. Sher, M.D., Xuezhou Mao, Ph.D., Dongfang Liu, M.S., Yi Zhang, Ph.D., M.P.H., Asif H. Khan, M.B., B.S., M.P.H., Upender Kapoor, M.D., Faisal A. Khokhar, M.D., Paul J. Rowe, M.D., Yamo Deniz, M.D., Marcella Ruddy, M.D., Elizabeth Laws, Ph.D., Naimish Patel, M.D., David M. Weinreich, M.D., George D. Yancopoulos, M.D., Ph.D., Nikhil Amin, M.D., Leda P. Mannent, M.D., David J. Lederer, M.D., and Megan Hardin, M.D., M.P.H. for the Liberty Asthma VOYAGE Investigators*

doi : 10.1056/NEJMoa2106567

N Engl J Med 2021; 385:2230-2240

Children with moderate-to-severe asthma continue to have disease complications despite the receipt of standard-of-care therapy. The monoclonal antibody dupilumab has been approved for the treatment of adults and adolescents with asthma as well as with other type 2 inflammatory diseases.

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Evaluation of mRNA-1273 SARS-CoV-2 Vaccine in Adolescents

Kashif Ali, M.D., Gary Berman, M.D., Honghong Zhou, Ph.D., Weiping Deng, Ph.D., Veronica Faughnan, B.S., Maria Coronado-Voges, M.S., Baoyu Ding, M.S., Jacqueline Dooley, B.A., Bethany Girard, Ph.D., William Hillebrand, M.S., Rolando Pajon, Ph.D., Jacqueline M. Miller, M.D., Brett Leav, M.D., and Roderick McPhee, M.D., Ph.D.

doi : 10.1056/NEJMoa2109522

N Engl J Med 2021; 385:2241-2251

The incidence of coronavirus disease 2019 (Covid-19) among adolescents between 12 and 17 years of age was approximately 900 per 100,000 population from April 1 through June 11, 2021. The safety, immunogenicity, and efficacy of the mRNA-1273 vaccine in adolescents are unknown.

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Cardiovascular Events with Finerenone in Kidney Disease and Type 2 Diabetes

Bertram Pitt, M.D., Gerasimos Filippatos, M.D., Rajiv Agarwal, M.D., Stefan D. Anker, M.D., Ph.D., George L. Bakris, M.D., Peter Rossing, M.D., Amer Joseph, M.B., B.S., Peter Kolkhof, Ph.D., Christina Nowack, M.D., Patrick Schloemer, Ph.D., and Luis M. Ruilope, M.D. for the FIGARO-DKD Investigators*

doi : 10.1056/NEJMoa2110956

N Engl J Med 2021; 385:2252-2263

Finerenone, a selective nonsteroidal mineralocorticoid receptor antagonist, has favorable effects on cardiorenal outcomes in patients with predominantly stage 3 or 4 chronic kidney disease (CKD) with severely elevated albuminuria and type 2 diabetes. The use of finerenone in patients with type 2 diabetes and a wider range of CKD is unclear.

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Transgenic Epidermal Cultures for Junctional Epidermolysis Bullosa — 5-Year Outcomes

Maximilian Kueckelhaus, M.D., Tobias Rothoeft, M.D., Laura De Rosa, Ph.D., Burcu Yeni, B.Sc., Tobias Ohmann, Ph.D., Christoph Maier, M.D., Lynn Eitner, M.D., Dieter Metze, M.D., Lorena Losi, M.D., Ph.D., Alessia Secone Seconetti, Ph.D., Michele De Luca, M.D., and Tobias Hirsch, M.D.

doi : 10.1056/NEJMoa2108544

N Engl J Med 2021; 385:2264-2270

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Waning of BNT162b2 Vaccine Protection against SARS-CoV-2 Infection in Qatar

Hiam Chemaitelly, M.Sc., Patrick Tang, M.D., Ph.D., Mohammad R. Hasan, Ph.D., Sawsan AlMukdad, M.Sc., Hadi M. Yassine, Ph.D., Fatiha M. Benslimane, Ph.D., Hebah A. Al Khatib, Ph.D., Peter Coyle, M.D., Houssein H. Ayoub, Ph.D., Zaina Al Kanaani, Ph.D., Einas Al Kuwari, M.D., Andrew Jeremijenko, M.D., Anvar H. Kaleeckal, M.Sc., Ali N. Latif, M.D., Riyazuddin M. Shaik, M.Sc., Hanan F. Abdul Rahim, Ph.D., Gheyath K. Nasrallah, Ph.D., Mohamed G. Al Kuwari, M.D., Hamad E. Al Romaihi, M.D., Adeel A. Butt, M.B., B.S., Mohamed H. Al-Thani, M.D., Abdullatif Al Khal, M.D., Roberto Bertollini, M.D., M.P.H., and Laith J. Abu-Raddad, Ph.D.

doi : 10.1056/NEJMoa2114114

N Engl J Med 2021; 385:e83

Waning of vaccine protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or coronavirus disease 2019 (Covid-19) is a concern. The persistence of BNT162b2 (Pfizer–BioNTech) vaccine effectiveness against infection and disease in Qatar, where the B.1.351 (or beta) and B.1.617.2 (or delta) variants have dominated incidence and polymerase-chain-reaction testing is done on a mass scale, is unclear.

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Waning Immune Humoral Response to BNT162b2 Covid-19 Vaccine over 6 Months

Einav G. Levin, M.D., Yaniv Lustig, Ph.D., Carmit Cohen, Ph.D., Ronen Fluss, M.Sc., Victoria Indenbaum, Ph.D., Sharon Amit, M.D., Ram Doolman, Ph.D., Keren Asraf, Ph.D., Ella Mendelson, Ph.D., Arnona Ziv, M.Sc., Carmit Rubin, M.Sc., Laurence Freedman, Ph.D., Yitshak Kreiss, M.D., and Gili Regev-Yochay, M.D.

doi : 10.1056/NEJMoa2114583

N Engl J Med 2021; 385:e84

Despite high vaccine coverage and effectiveness, the incidence of symptomatic infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been increasing in Israel. Whether the increasing incidence of infection is due to waning immunity after the receipt of two doses of the BNT162b2 vaccine is unclear.

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Waning Immunity after the BNT162b2 Vaccine in Israel

Yair Goldberg, Ph.D., Micha Mandel, Ph.D., Yinon M. Bar-On, M.Sc., Omri Bodenheimer, M.Sc., Laurence Freedman, Ph.D., Eric J. Haas, M.D., Ron Milo, Ph.D., Sharon Alroy-Preis, M.D., Nachman Ash, M.D., and Amit Huppert, Ph.D.

doi : 10.1056/NEJMoa2114228

N Engl J Med 2021; 385:e85

In December 2020, Israel began a mass vaccination campaign against coronavirus disease 2019 (Covid-19) by administering the BNT162b2 vaccine, which led to a sharp curtailing of the outbreak. After a period with almost no cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, a resurgent Covid-19 outbreak began in mid-June 2021. Possible reasons for the resurgence were reduced vaccine effectiveness against the delta (B.1.617.2) variant and waning immunity. The extent of waning immunity of the vaccine against the delta variant in Israel is unclear.

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