# Current landscape
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**Selective update: October 16, 2026.** Changed entries reflect focused checks; untouched programs retain prior source dates. Complete-topic reviews remain incomplete.
Development stage, evidence strength and U.S. availability vary by program; the linked notes distinguish them. A category is not labeled approved merely because one treatment is available.
## Metabolic health and longevity
| Topic | Current state | Next expected update |
| --- | --- | --- |
| [GLP-1 and related metabolic therapies](topics/03_glp1.md) | Oral VK2735’s SUNRISE program is announced, while registry recruitment remains pending with November starts; maintenance wording is corrected to daily oral dosing. Zenagamtide switching now records an actual start. A monthly-or-less-frequent Pfizer GLP-1 protocol adds early safety research. | November 2026 estimated SUNRISE starts; primary completion July/October 2028. Separate maintenance Part 2 results forecast in 2027. |
| [Broad cardiovascular prevention, lipids and screening](topics/07_cardiovascular.md) | AMBIENCE and plaque-guided prevention studies ask clinical-event and clinical-utility questions. ARO-DIMERPA’s primary-completion estimate moves to July 2027; its early safety and lipid measurements remain separate from cardiovascular benefit. | July 2027 estimated primary/final completion, month precision; no announced readout. |
| [Liver health and noninvasive assessment](topics/13_liver.md) | A new placebo-controlled Kylo-0603 trial will measure MRI liver-fat reduction. Earlier senolytic biopsy signals and larger FGF21/THRβ programs remain distinct from proven reductions in liver complications; complete patient results and harms remain pending. | November 15, 2026 estimated start; August 15, 2027 estimated primary/final completion. |
| [Kidney preservation and earlier detection](topics/17_kidney.md) | FDA accepts the finerenone application for CKD without diabetes, without a disclosed decision date; this is not approval. PYC-003 adds early ADPKD target engagement, not demonstrated kidney-function preservation. | FDA decision under review; no target date disclosed. |
| [Longevity and healthspan trials](topics/05_longevity.md) | A newly disclosed 31-person ELITE combination pilot measures eight-week function and digital signals, with no posted results or lifespan claim. Larger healthspan evidence remains unsettled; the alleged PEARL 24-month follow-up remains unconfirmed. | Full primary publication/results and original preregistration chronology; no promised date. |
## Screening, genetics and cancer
| Topic | Current state | Next expected update |
| --- | --- | --- |
| [Whole-body MRI](topics/01_whole_body_mri.md) | A new review of heterogeneous screening cohorts estimates pathology-confirmed cancer yield but cannot establish improved patient outcomes. Downstream workups, false positives, overdiagnosis and the benefit of repeated screening remain unresolved. | Prospective controlled outcomes/repeated rounds; no announced publication date. HERCULES live registry access remains a gap. |
| [Galleri and organ-specific cancer screening](topics/02_galleri.md) | SOARA plans to track ovarian blood-screening harms and invasive workups; a separate urine lung-test study validates existing nodules in never-smokers. These registrations add modalities without proving mortality benefit. Galleri's prior primary-endpoint miss and nonbinding FDA vote remain separate. | November 2026 estimated start; May 2028 estimated primary/final completion. |
| [Genetic screening and risk prediction](topics/28_genetic_screening.md) | A small matched study associates genotype-guided chemotherapy dosing with fewer severe toxicities. MLD newborn screening connects diagnosis to early care in a small follow-up cohort; MECP2 findings emphasize penetrance and counseling uncertainty. Broad PRS and embryo-selection outcomes remain unproven. | No announced next readout date. |
| [Cancer treatment, vaccines and recurrence prevention](topics/14_cancer_vaccines.md) | FDA’s October 8 action adds atezolizumab with chemotherapy after resection of stage III dMMR colon cancer, supported by ATOMIC disease-free survival and substantial treatment toxicity. Formulation-specific ages and weight limits differ; overall-survival benefit is not established. New NEONIPIGA follow-up is small, uncontrolled and distinct from randomized recurrence-prevention evidence. | Longer-term overall-survival and access/safety follow-up; no verified release date. |
## Brain, mental health and senses
| Topic | Current state | Next expected update |
| --- | --- | --- |
| [Alzheimer's screening and therapies](topics/08_alzheimers.md) | Banner has announced the first randomization in API-2, testing donanemab, nivagacetor and their combination in the Colombian PSEN1 E280A kindred. The registered primary endpoints concern amyloid removal/maintenance, so this is no demonstration of dementia prevention. It joins a broader pipeline in which biomarker and diagnostic-management findings must remain distinct from cognitive/function outcomes. The prior PLASMAR disclosure study did not test treatment efficacy, and presymptomatic combinations remain investigational. | June 1, 2030 estimated primary/final completion; no announced interim clinical-outcome readout. |
| [Psilocybin and related therapies](topics/09_psychedelics.md) | FDA seeks input on ibogaine trial safeguards through November 20. IBO-CARE proposes an opioid-use-disorder comparison but explicitly awaits funding and authorization; its IND is not filed. Psychedelic efficacy, supervised safety and non-psychedelic treatments remain distinct. | November 20, 2026 public-comment deadline; later protocol/policy dates unannounced. |
| [Mental-health treatments, SSRIs and newer antidepressants](topics/10_ssri_antidepressants.md) | the UK MHRA has strengthened antidepressant patient safety communication, including more prominent suicidal-thought/behavior warnings and explicit PSSD terminology for selected leaflets. This concerns known risks and communication, without a new reliable frequency estimate or a new U.S. label change. The separate supporting leaflet is expected in 2027. Existing antidepressant and broader mental-health programs remain diagnosis-specific; the prior PEACE pilot, BALANSYA formulation and WELTRUZA indication must retain their distinct evidence and geography. | Supporting UK safety leaflet expected in 2027; exact timing and withdrawal-review outcome remain unknown. |
| [Hearing and vision preservation/restoration](topics/18_hearing_vision.md) | BRUNELLO adds year-one vision noninferiority with more proliferative-retinopathy events and adverse-event discontinuations. MCO-010 reports four-year inherited-RP gains, with follow-up denominators and intervals missing; this does not establish acquired-AMD benefit. | BAROLO results and further PDR/safety analyses; exact dates unannounced. |
## Sleep
The October 3 split projects existing verified coverage into five condition topics. Historical source dates and research-check gaps remain unchanged.
| Topic | Current state | Next expected update |
| --- | --- | --- |
| [Insomnia](topics/29_sleep_insomnia.md) | eNightfall adds a randomized test of stepped digital CBT-I with remission and 12-month follow-up in cancer survivors. Existing onset/maintenance drug indications, clinical insomnia outcomes and laboratory sleep-architecture measurements remain separate. | Actual start still unverified; January 1, 2030 primary/April 1, 2030 final estimates. |
| [Obstructive sleep apnea](topics/30_sleep_apnea.md) | AD109 will present symptom, postmenopausal and hypoxic-burden analyses at CHEST on October 20. Other formal programs include IHL-42X, monthly berobenatide and tirzepatide-versus-PAP; trial plans do not show that drugs replace PAP. | October 20 CHEST scheduled analyses/panel; FDA goal February 28, 2027 remains conditional. |
| [Narcolepsy & excessive sleepiness](topics/31_sleep_hypersomnolence.md) | Orexin agonists and established wake-promoting treatments remain diagnosis-specific. A newly public 20-person ofatumumab NT1 protocol explores an immune approach without a comparator; one-month symptoms and one-week safety cannot establish durable benefit. | June 30, 2027 primary/December 31, 2027 final estimates; public results date unannounced. |
| [Circadian rhythm disorders](topics/32_sleep_circadian.md) | Recovered September 29 sponsor data report a 37.1-minute earlier sleep onset versus placebo with tasimelteon in delayed-phase disorder. The small 28-day analysis lacks confidence intervals and detailed harms; registry results and any new indication remain pending. | Full analysis/safety tables and planned FDA submission; no verified filing or decision date. |
| [Restless legs syndrome](topics/33_sleep_restless_legs.md) | Newly recovered IV-iron and extended-duration TOMAC programs target refractory RLS and awakenings. An uncontrolled venous-ablation association does not establish a general RLS cure or causal benefit. | October2026 estimated start; April2029 primary completion. |
## Physical function and immune therapies
| Topic | Current state | Next expected update |
| --- | --- | --- |
| [Muscle building and preservation](topics/04_muscle.md) | COURAGE’s one-year trevogrumab body-composition results remain distinct from strength or fewer falls. A new placebo-controlled forazapadin trial in inherited FSHD will measure muscle force; it has not begun recruiting and does not establish muscle preservation during weight loss. | December 15, 2026 estimated start; December 30, 2028 primary / June 30, 2029 final completion. |
| [Bone health, joint preservation and cartilage repair](topics/11_joint_preservation.md) | AGILI-C adds a European commercial launch for selected cartilage defects; its five-year randomized paper is April evidence, not a new October result. Bone-density studies remain separate from fracture prevention, and structural cartilage repair remains separate from pain, function and avoided joint replacement. | No dependable public results date verified. |
| [Non-opioid pain treatments](topics/16_pain.md) | SL1002 completes pivotal knee-OA pain enrollment, with Q2 2027 results forecast. Suzetrigine adds a randomized knee-replacement opioid-sparing trial and closes its uncontrolled diabetic-neuropathy extension enrollment; chronic-pain approval and comparative benefit remain unproven. | Q2 2027 BEACON topline, sponsor forecast. |
| [Autoimmune disease and immune reset](topics/15_autoimmune.md) | Immune-reset research includes a newly registered in-vivo CD19 CAR-T study, without confirmed dosing or results. Two distinct Chinese CAR-T protocols are withdrawn with zero participants. A completed rap-cel lupus record does not establish lifting of the wider autoimmune-program hold; remission, durable benefit and safety remain separate questions. | October 30, 2026 estimated start; primary completion October 20, 2032 and final January 31, 2033. |
| [Allergy and airway disease](topics/26_allergy_airway.md) | New COPD registry tables add detailed efficacy and harms to older AERIFY-1 and ALIENTO results; companion pivotal trials were negative, and itepekimab remains discontinued. Ensifentrine’s ENHANCE-3 registers a larger exacerbation study, separate from its existing U.S. maintenance approval. Food allergy, asthma and sinus programs retain distinct indications and endpoints. | October 23, 2026 estimated start; April 29, 2029 estimated primary/final completion. |
| [Infectious-disease prevention and treatment](topics/27_infectious_disease.md) | A large randomized shingles-vaccine trial will directly measure cardiovascular events. Travelan’s new full challenge-study report retains a nonsignificant diarrhea endpoint and wide uncertainty; newer antibiotics, phages and transplant-vaccine programs remain distinct. | November 30, 2026 estimated start; November 25, 2032 primary/final completion. |
## Aesthetics & Dental
| Topic | Current state | Next expected update |
| --- | --- | --- |
| [Localized fat removal and cellulite](topics/06_localized_fat.md) | SCULPT registers a ten-person within-patient topical thigh study using circumference as its primary endpoint. It does not establish local fat-volume reduction or cellulite smoothing; CBL-514, other injectable programs and visceral-fat evidence retain their own development and safety limits. | January 15, 2027 estimated start; July 15, 2027 estimated primary/final completion. Verify actual initiation and complete endpoint protocol. |
| [Hair loss, restoration and graying](topics/19_hair_loss.md) | Adult BRAVE-AA follow-up adds four-year response maintenance among selected prior responders and safety follow-up up to five years. For pattern hair loss, PP405 now has sponsor-confirmed first dosing in Phase 2/3 AWAKEN and a separate women's Phase 2 study forecast by end-2026; RLS-1496 remains a planned program without verified patient efficacy. Alopecia areata and pattern hair loss remain separate. | Separate women's Phase 2 initiation by end of 2026 (sponsor forecast); AWAKEN primary December 2027 / final June 2028 (registry estimates). |
| [Skin aging, laxity and regeneration](topics/20_skin_aging.md) | A new décolletage-wrinkle publication reports a randomized SB-NASHA benefit at 12 weeks, with common injection-site reactions. The safety population is broader than the randomized efficacy cohort. Wrinkle response remains distinct from generalized skin regeneration, durable lifting or volume restoration. | Further comparative/rare-harm evidence and a verified U.S. regulatory milestone: no announced date verified. |
| [Scar prevention, treatment and stretch marks](topics/21_scars.md) | New comparative scar reports retain substantial attrition and a nonsignificant total-score comparison. Neither demonstrates reliable eradication of established scars, durable functional improvement or stretch-mark efficacy. | Full numerical and safety report, independent replication; undated. |
| [Facial volume restoration and contour](topics/22_facial_volume.md) | Recovered U.S. Belotero launch dates are sponsor forecasts: October 14 for Volume and December 1 for Intense. Earlier indication-specific approvals remain distinct from actual local inventory and comparative cosmetic benefit. | October 14, 2026 Volume and December 1, 2026 Intense U.S. commercial availability, September 14 sponsor forecasts; verify actual launch. |
| [Pigmentation and uneven skin tone](topics/23_pigmentation.md) | Newly posted toner-adjunct results show no clear descriptive advantage alongside hydroquinone and sunscreen. The formulation and comparative statistics are missing; vitiligo programs retain their separate development status. | Formulation disclosure and complete controlled analysis; undated |
| [Acne and rosacea](topics/24_acne_rosacea.md) | The matched U.S. AURORA denifanstat protocol is now public and recruiting, moving beyond the earlier unmatched trial plan; actual first dosing remains unverified. | Actual first enrollment/dosing, unverified; August 2027 primary and April 2028 final completion are registry estimates. |
| [Dental alignment, regeneration and repair](topics/25_dental.md) | A new P11-4 protocol tests repeated versus single application for early enamel lesions. The primary endpoint and completion timing differ between the paper and registry; no clinical results are yet reported. | October 31, 2027 primary/December 14, 2027 final registry estimates; conflicting July 2027 paper forecast |
An announced meeting is scheduled; a sponsor window is a forecast; a registry completion date is not a promised publication date. Unconfirmed timing stays labeled. See the [date-ordered calendar](MILESTONES.md) and [evidence rules](HOW_THIS_WORKS.md).