Pfizer was poised to seal a takeover of Metsera on Saturday after its improved offer won over the biotechnology startup’s board and Danish challenger Novo Nordisk called a halt to a back-and-forth bidding war.

Metsera, a US firm specializing in obesity treatments, has been the subject of escalating offers from US pharma giant Pfizer and Novo Nordisk, which makes the weight-loss drug Wegovy and the antidiabetic medication Ozempic.

In a press release Friday, Metsera said Pfizer had made an improved offer to acquire it for up to $86.25 per share, in a deal worth around $10 billion.

Metsera said its board “unanimously recommends that… stockholders approve the adoption of the amended Pfizer merger agreement and approve the merger.”

It added that it expected to close the deal “promptly” after a shareholder meeting on November 13.

Pfizer’s latest offer would double its valuation compared to an initial deal the companies struck in September, which triggered a counteroffer from Novo Nordisk that spiraled into a price war.

The Danish firm said Saturday that it “does not intend to make an increased offer to acquire Metsera.”

The company “will continue to assess opportunities for business development and acquisitions that… further its strategic objectives,” it said.

The Novo Nordisk sale had drawn scrutiny over potential antitrust implications.

Metsera said the US Federal Trade Commission had called it to discuss “potential risks from proceeding with the proposed Novo Nordisk structure under US antitrust laws.”

The call strengthened the board’s conclusion that the Novo Nordisk deal “presents unacceptably high legal and regulatory risks… compared to the proposed merger with Pfizer.”

Novo Nordisk said it believed that its prospective deal was “compliant with antitrust laws.”

The World Health Organization says more than one billion people worldwide lived with obesity, and more than 800 million lived with diabetes as of 2022.

© 2025 AFP

The cost of emergency dialysis is estimated to be eight times that of in-center dialysis. A new study reveals that a transitional dialysis program piloted in Travis County (Austin, Texas) resulted in a significant decrease in emergency department visits and hospital admissions for emergency dialysis by providing a pathway for outpatient dialysis in uninsured patients.

The findings were presented at ASN Kidney Week 2025, held November 5–9.

Central Health, an organization that provides health and wellness services for uninsured patients in Travis County, piloted the transitional dialysis program in November 2022. The goal was to provide in-center/outpatient dialysis for Travis County residents who lacked insurance coverage.

When investigators reviewed data from November 2022 to December 2024 on the 101 patients who enrolled in the program, they observed that there was a significant decline in the number of days patients utilized emergency dialysis in the hospital prior to finding an outpatient facility. Additionally, within one year of starting dialysis, most patients were able to obtain permanent dialysis access with either an arteriovenous fistula or a peritoneal dialysis catheter.

Once accepted into the program, Central Health provided an insurance plan to cover outpatient dialysis and transplantation. To date, 18 patients have been listed for kidney transplantation, and two have received living donor transplants.

“The program has successfully facilitated dialysis access placement and transplant evaluation,” said corresponding author Michelle Lubetzky, MD, of The University of Texas, Austin.

“Since Texas has no safety-net plan for patients who do not qualify for Medicare or Medicaid, the program has the potential to provide a cost-effective solution and decrease in utilization of health care resources for those without medical coverage who develop kidney failure. It can be a model for other states and cities that also lack safety net plans.”

Metformin-associated lactic acidosis (MALA) is a rare but serious adverse effect of the diabetes drug metformin in which the body accumulates too much lactic acid. Investigators developed and tested a protocol for diagnosis and treatment of MALA. Their work will be presented at ASN Kidney Week 2025 from November 5–9.

The protocol, which included immediate initiation of dialysis using either intermittent hemodialysis, continuous kidney replacement therapy, or peritonealdialysis as treatment, was implemented at Maharat Nakhonratchasima hospital (MNRH), in Thailand. Another hospital, Burirum Hospital (BH), did not implement the protocol. A total of 347 cases were included over 5 years (70 in MNRH pre-intervention, 129 in MNRH intervention, and 148 in BH).

In MNRH, the 30-day mortality rate was reduced from 25.7% to 13.9% after implementing the protocol, whereas in BH the 30-day mortality rate was not reduced during the same period (27.2% and 30%). The trend of mortality rate in MNRH during the intervention period decreased by -2.08% per quarter. The average door-to-dialysis time—the interval between a patient’s hospital admission and the initiation of dialysis—was reduced from 870 minutes to 690 minutes, and MALA awareness increased from 38.5% to 89.9% after implementation.

“A standardized MALA protocol covering diagnosis, access, and treatment shortened door-to-dialysis time, increased awareness, and reduced care variation,” said corresponding author Watanyu Parapiboon, MD, of Maharat Nakhon Ratchasima Hospital, in Thailand. “Fast-track dialysis pathways should be adopted for time-sensitive conditions like MALA. Availability of all dialysis modalities ensures flexibility and enables timely treatment initiation.”

Federal and state health officials are investigating 13 cases in 10 states of infant botulism linked to baby formula that was being recalled, authorities said Saturday.

ByHeart Inc. agreed to begin recalling two lots of the company’s Whole Nutrition Infant Formula, the Food and Drug Administration said in a statement.

All 13 infants were hospitalized after consuming formula from two lots: 206VABP/251261P2 and 206VABP/251131P2.

The cases occurred in Arizona, California, Illinois, Minnesota, New Jersey, Oregon, Pennsylvania, Rhode Island, Texas and Washington.

No deaths were reported. The FDA said it was investigating how the contamination happened and whether it affected any other products.

Available online and through major retailers, the product accounted for an estimated 1% of national formula sales, according to the Centers for Disease Control and Prevention.

People who bought the recalled formula should record the lot number if possible before throwing it out or returning it to where it was purchased, the CDC said in a statement.

They should use a dishwasher or hot, soapy water to clean items and surfaces that touched the formula. And they should seek medical care right away if an infant has consumed recalled formula and then had poor feeding, loss of head control, difficulty swallowing or decreased facial expression.

Infant botulism is caused by a bacterium that produces toxins in the large intestine.

Symptoms can take weeks to develop, so parents should keep vigilant, the CDC said.

A ByHeart spokesperson did not immediately respond to an email seeking comment Saturday.

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It can be challenging to identify which patients with advanced chronic kidney disease (CKD) will most benefit from conservative care rather than initiating dialysis.

Researchers have recently developed and validated a prediction model to estimate individualized survival probabilities with conservative non-dialytic management versus dialysis in patients with advanced CKD from the national Veterans Affairs and OptumLabs DataWarehouse databases. The work will be presented at ASN Kidney Week 2025 from November 5–9.

Investigators found that among veterans with advanced CKD who received dialytic versus non-dialytic management, certain factors were linked to higher mortality risk, including older age; higher baseline and more rapid decline in estimated glomerular filtration rate; higher albuminuria levels; worse frailty indexes; lower serum albumin and lower body mass index; recent hospitalization; underlying heart disease, sepsis, or tobacco use; and dialysis transition.

“This new risk prediction tool was developed to estimate the individualized probability of survival with conservative non-dialytic management versus dialysis transition, which demonstrated moderate discrimination (the ability to accurately differentiate between those at higher versus lower risk) and acceptable calibration performance (the degree of agreement between the predicted mortality risk probability and the actual observed probability of death) in two national cohorts of patients with advanced CKD,” said corresponding author Connie Rhee, MD, MSc, of the University of California Los Angeles and the Veterans Affairs Greater Los Angeles Healthcare System.

“This study was conducted as part of the ‘Defining Optimal Transitions of Care in Advanced Kidney Disease: Conservative Management vs. Dialysis Approaches (OPTIMAL)’ study, in which our objective is to establish a stronger evidence base for conservative non-dialytic management in the advanced CKD population.

“By rigorously studying the comparative effectiveness of conservative management versus dialysis transition, findings from our and others’ research have the potential to expand viable, patient-centric treatment options for CKD. We aim for this tool and other approaches to support and enhance the shared decision-making process regarding conservative management versus dialysis initiation among patients, care partners, and health care providers.”

A five-year study has revealed a stability in global acute kidney injury (AKI)–related mortality rates with differing patterns that indicate a rising concentration of mortality in older populations and higher socioeconomic countries. The findings will be presented at ASN Kidney Week 2025 held in Houston from November 5 to 9. The study is titled “Temporal trends in AKI-related mortality across 43 countries, 1996–2021, with projections up to 2050: A global time series analysis and modeling study.”

When investigators at the Kyung Hee University Hospital in Seoul assessed AKI-related mortality trends in 43 countries from 1996 to 2021 using the WHO Mortality Database, they found that high-income countries showed an upward trend, while low- and middle-income countries experienced a decline. Older adults, especially females, in high socioeconomic settings demonstrated increasing mortality trends, and future projections indicated a gradual rise in global AKI-related mortality through 2050.

More detailed analyses revealed that although high-income countries have lower AKI-related mortality rates, they have experienced gradual increases largely attributable to population aging and higher comorbidity burden, while in low- and middle-income countries, declining mortality has been associated with younger populations and improvements in infection control and health care access.

“Our study provides the first global long-term analysis and projections of AKI-related mortality, offering critical insights for policymakers and health systems,” said lead author Hyeon Seok Hwang, MD, Ph.D.

“These findings underscore the need for tailored, region-, age-, and sex-specific strategies to mitigate the future burden of AKI,” added co-author Soo-Young Yoon, MD, Ph.D.

“Additional studies are needed to continue monitoring AKI-related mortality and the effectiveness of different strategies to prevent it,” said co-author Jeong-Yeun Lee, MD.