Integrated care pathway in individuals with Long COVID: STIMULATE-ICP, a cluster-randomized, phase 3 trial

Nature Medicine, Published online: 28 July 2026; doi:10.1038/s41591-026-04552-x

This cluster-randomized phase 3 trial examining the effectiveness of integrated care pathways comparing usual care with the addition of MRI imaging (Coverscan), or a digitally enabled rehabilitation platform app, or both (Coverscan + app), or neither, found specialist Long COVID care improved fatigue response in all arms.

Implementing a Smartphone and Wearable-Based Stress Management Intervention in Women With Coronary Artery Spasms to Reduce Cardiac Symptoms: Multicenter, Single-Arm, 1-Way Crossover Study

Background: Mental stress is a well-known trigger of cardiac symptoms in patients with coronary artery spasms. Hence, stress management is recommended along with medical therapy. However, specific programs for patients with coronary spasms are lacking. We collaborated with patients to develop a smartphone-based app as a tailored solution. The app provides biofeedback based on heart rate variability–driven stress level estimations. Objective: This study aimed to evaluate the effect of a biofeedback-driven smartphone stress management app on cardiac symptoms in women with coronary vasospasms. Methods: We enrolled 117 women aged 18 to 70 years diagnosed with coronary vasospasms, as confirmed by a gold standard coronary function test. A multicenter, single-sequence, 2-period crossover study was conducted, comprising a 4-week control period followed by a 4-week period using the Wavy intervention app. The intervention comprised breathing-based exercises that were prompted when measured stress levels were too high. The primary outcome was the Seattle Angina Questionnaire Summary Score, and the secondary outcomes included the 36-Item Short Form Health Survey and the Perceived Stress Scale-10 items. Additionally, the user experience and the impact of the breathing exercise on heart rate variability were evaluated. Results: A total of 102 patients completed the study, yet no significant improvements were observed in the Seattle Angina Questionnaire following the intervention period, with the control group scores at 50.4 (SD 15.4) and the intervention group scores at 50.9 (SD 15.0; <i>P</i>=.92). Similarly, no differences were found in the 36-Item Short Form Health Survey and the Perceived Stress Score. However, the 1236 breathing relaxation exercises performed during the study led to a significant improvement in heart rate variability, as indicated by a median root mean square of successive differences increase from 18.59 (IQR 8.38-36.58) milliseconds before the exercises to 34.93 (IQR 24.19-50.64) milliseconds after the exercises (<i>z</i>=−13.72; <i>P</i><.001). Furthermore, two-thirds of participants (68/102, 66.7%) indicated that they would use a more refined version of the app in the future. Conclusions: A 4-week intervention using the Wavy app did not significantly alleviate anginal symptoms in female patients with coronary vasospasms. However, the breathing exercises demonstrated a notable improvement in heart rate variability, suggesting a reduction in stress levels. Patient feedback indicated broad support for the app and its wearable-based functionality, emphasizing the need for substantial refinements. Future development should incorporate patient perspectives to optimize the app as a comprehensive lifestyle management tool. Clinical Trial: ClinicalTrials.gov NCT06171893; https://classic.clinicaltrials.gov/ct2/show/NCT06171893

STAT+: Preliminary trial results suggest a path to a safer Alzheimer’s treatment

An interim look at an Alzheimer’s disease clinical trial evaluating an amyloid-targeting treatment from ProMIS Neurosciences showed low rates of brain bleeding and no incidences of brain swelling — results reported Tuesday that suggest the drug could be safer than approved treatments. 

In a blinded analysis that pooled safety data from patients receiving the ProMIS drug and a placebo, the total rate of ARIA was 4.4%, with all cases mild and asymptomatic, the company said. 

None of the patients experienced ARIA-E, which is the more severe side effect that causes brain swelling. All the cases were characterized as ARIA-H, which involves tiny bleeds in the brain. 

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Daily Multivitamin May Help Older Adults Maintain Cardiovascular Function

A daily multivitamin-mineral supplement modestly improved cardiovascular-related functional health in older adults over three years, according to a secondary analysis of the large COSMOS randomized clinical trial. The findings suggest that routine multivitamin use may help preserve day-to-day physical functioning as people age, particularly among those with certain preexisting cardiovascular conditions.

The research was presented July 27 at NUTRITION 2026, the annual meeting of the American Society for Nutrition.

The findings add to a growing body of evidence from the COSMOS trial suggesting that daily multivitamin supplementation may support healthy aging. Previous analyses reported modest improvements in cognitive function and slower biological aging, although multivitamins have not been shown to reduce major cardiovascular events.

The analysis included 16,027 participants from the COcoa Supplement and Multivitamin Outcomes Study (COSMOS), a randomized, double-blind, placebo-controlled trial that enrolled 21,442 U.S. adults without major cardiovascular disease at baseline. Men were at least 60 years old, and women were at least 65 years old when they entered the study.

Investigators evaluated participants’ responses to the Kansas City Cardiomyopathy Questionnaire (KCCQ), a validated patient-reported measure of cardiovascular health status. The questionnaire assesses physical function, symptom burden, and an overall clinical summary score reflecting the combined impact of both.

Participants assigned to receive a daily multivitamin experienced small but statistically significant improvements in symptom burden compared with those receiving placebo. While the supplements did not significantly improve physical ability scores overall, they produced a modest improvement in the overall clinical summary score.

“The results provide new evidence that a daily multivitamin modestly improved cardiovascular-related functional health, with more pronounced benefits in those with existing carotid stenosis,” the investigators concluded.

The largest benefits were seen in participants with carotid stenosis, a narrowing of the carotid arteries that increases the risk of stroke. Among the 122 participants with the condition, multivitamin supplementation produced clinically meaningful improvements in cardiovascular functional health scores, suggesting this subgroup may derive greater benefit than the broader study population.

The researchers noted that maintaining cardiovascular functional health has practical implications for older adults. Improvements in symptom burden may translate into greater ease performing everyday activities such as dressing, bathing, walking, climbing stairs, and completing household chores. Reduced fatigue, shortness of breath, and swelling could also help older adults remain active and independent.

The trial also evaluated cocoa extract supplementation, but it did not improve cardiovascular functional health in the study population overall. However, a subgroup analysis suggested cocoa extract helped preserve symptom burden scores among participants with heart failure, indicating that additional studies may be warranted in patients with established cardiovascular disease.

Unlike many nutrition studies that focus on disease prevention, this analysis examined how supplementation affected participants’ daily functioning and quality of life.

The investigators cautioned that the observed improvements with multivitamin use were modest and should not be viewed as a replacement for established healthy lifestyle measures such as maintaining a nutritious diet and engaging in regular physical activity.

Because this was a secondary analysis, the findings should be considered hypothesis-generating. The authors said future targeted clinical trials are needed to determine whether specific groups of older adults—particularly those with carotid stenosis or other cardiovascular conditions—may experience greater functional benefits from daily multivitamin supplementation.

The post Daily Multivitamin May Help Older Adults Maintain Cardiovascular Function appeared first on Inside Precision Medicine.

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STAT+: Ahead of hearing, FDA questions the efficacy of Capricor’s Duchenne drug

The Food and Drug Administration said Monday that Capricor Therapeutics’ stem cell treatment for Duchenne muscular dystrophy did not meet the objectives of a Phase 3 trial — contrary to the company’s claims last year.

Capricor said in December that the drug, known as deramiocel, met both the primary and secondary endpoints in a large, randomized study. It was a striking result in a fatal, childhood disease that has proven stubbornly difficult to treat, despite immense advances in genetic medicine. 

The data were also notable for coming primarily in teenagers and young men who have already lost the ability to walk, a population with few options. The drug appeared to both preserve their upper-arm function and stave off the heart failure most patients eventually experience, Capricor had said. 

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Randomized Trial Evaluating the Effect of Light Therapy Using Glasses Versus a Sham Device on the Evolution of Self-reported Depressive Disorders in Chronic Hemodialysis Patients

Conditions: End-stage Chronic Kidney Disease Treated With Hemodialysis; Depressive Disorders

Interventions: Other: Light therapy using active glasses; Other: Light therapy using inactive glasses

Sponsors: Centre Hospitalier Annecy Genevois; Direction Générale de la Santé, France; Association France REIN; LUCIMED

Not yet recruiting