What Will the Future Bring?

Posted by • September 20th, 2012

Throughout the 200th anniversary year, we’ve been looking back at the most important NEJM articles in history.  Now, we’re looking ahead.  What do you think the major developments of the next decade will be?  We have tried to imagine how medicine and science might lead to changes that today are unimaginable.  The studies described below are entirely fictional, but the goal is to think creatively about studies in areas where the future could well bring some major advances.

A Poly-Pill that Prevents Heart Disease

The poly-pill consists of low-dose aspirin, a thiazide, a statin, and an ACE inhibitor.  In a large, population-based, double-blind trial the poly-pill is shown to drastically reduce the risk of new cardiovascular events, including sudden cardiac deaths. This study marks the first major shift in cardiology from high-technology treatments to inexpensive and highly effective prevention.

A Highly Effective HIV Vaccine

The results of this double-blind randomized study show 98% efficacy over two years in preventing acquisition of new HIV infection.  The study was conducted in subjects at high-risk of HIV in countries with high rates of HIV transmission.

Discovery of the Etiologic Agent of Chronic Fatigue

The newly discovered Baden-Baden virus is proven to be the cause of the chronic fatigue syndrome. The virus are been found to reside in neural tissue of those with the condition and not in controls.  Mice infected with the virus show characteristic signs of the disease.  Badenbadenviridae were initially isolated from patients being treated for severe CFS at a European spa.

An Effective Treatment for Alzheimer’s

This Phase II trial of DRC-076 in the treatment of Alzheimer’s disease shows virtually no progression of the disease over 3 years in elderly patients diagnosed with early disease.  The companion trial shows that this drug reduced the onset of cognitive symptoms by 90 percent over 3 years in older patients with findings on PET scan indicating a high risk of dementia.

Treating Solid Cancers with Targeted Therapies

A research team sequenced the tumors of 1000 consecutive adults with metastatic lung, breast, colon, kidney, ovarian, or prostate cancer, then treated each patient with regimens designed on the basis of the mutations found in the particular tumor.  After five years, all patients were free of cancer progression, although many remained on their personalized therapeutic regimens.

An Effective and Well-Tolerated Weight-Loss Drug

In this one-year, double-blind study, Daltronic resulted in near-normalization of body-mass index in obese and overweight subjects. There were no adverse effects from treatment in this large patient population.  This drug is safe for patients with diabetes and heart disease.

Vote now for the advance you think is most important for human health.

Next month, we’ll have a run off of all of the winners of the monthly voting for the most important article.  Stay tuned to vote, and find out what article wins the title, “the most important article in NEJM history.”

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