NEJM This Week covers DOACs in atrial fibrillation, orexin-2 agonist phase 3 trials and gene therapies

NEJM This Week surveys studies across anticoagulation, sleep medicine, cancer immunotherapy, gene therapy, genomics and public health. A Korean randomized trial found DOACs superior to no anticoagulation on a 24-month composite endpoint in atrial fibrillation patients with a single stroke risk factor, though the small sample may overstate the effect. Orexin-2 receptor agonists met endpoints in two phase 3 trials for type 1 narcolepsy, and lentiviral gene therapy for Wiskott-Aldrich syndrome showed 96% overall survival at 5.7 years of follow-up.