Gene Therapy Holds at Two Years, West Nile Surges, and Exercise Rivals Antidepressants
Two-year sickle cell gene therapy data; ECDC flags Mediterranean West Nile surge; finerenone shifts HFpEF care; exercise matches SSRIs.
By Dr. Asher Knippel
The start of August's first full week brings durable results from gene therapy's boldest real-world test, a seasonal public-health alert across Cyprus and the eastern Mediterranean, and two pieces of evidence — one about the heart, one about the mind — that quietly reshape treatment defaults.
West Nile Virus Season Opens Early Across Cyprus, Greece, and Italy
The European Centre for Disease Prevention and Control's latest mosquito-borne disease bulletin records an earlier and broader onset of West Nile virus (WNV) transmission across the Mediterranean basin than in any of the three preceding seasons. Human neuroinvasive cases — the fraction (roughly 1%) in which the virus crosses into the brain and spinal cord — have been confirmed in Cyprus, Greece, mainland Italy, and Serbia since late July; entomological surveillance shows elevated Culex pipiens populations across coastal zones where summer temperatures and stagnant-water breeding sites converge. WNV is transmitted exclusively through the bite of an infected mosquito, not person to person; there is no approved antiviral treatment and no human vaccine commercially available in the EU. People aged 60 and over, organ-transplant recipients, and those living with HIV or receiving chemotherapy face the highest risk of neuroinvasive disease, which can cause encephalitis, meningitis, or acute flaccid paralysis. The Cyprus Ministry of Health has activated its seasonal mosquito-control protocol and urges residents and visitors to use EPA-registered repellents at dusk and dawn, eliminate standing water from garden containers and flowerpot trays, and seek immediate hospital assessment for any unexplained high fever combined with neurological symptoms — confusion, severe headache, or limb weakness — between now and mid-October.
Two-Year Data on Sickle Cell Gene Therapies Confirm Durable Results Outside Trials
Reports presented at the American Society of Hematology mid-year meeting and simultaneously published in Blood provide the first systematic look at outcomes for patients treated outside clinical trials with the two gene therapies approved for sickle cell disease in late 2023: exagamglogene autotemcel (Casgevy, from Vertex Pharmaceuticals and CRISPR Therapeutics) and lovotibeglogene autotemcel (Lyfgenia, from bluebird bio). Across a combined 127 patients with at least 24 months of follow-up, 89% of those who received Casgevy and 82% of those who received Lyfgenia remained free of severe vaso-occlusive crises — painful episodes caused by misshapen red blood cells blocking small vessels, which are the defining feature of severe sickle cell disease and the leading driver of hospitalisation, organ damage, and early death. Both therapies require a one-time, arduous course: bone marrow stem cells are harvested, genetically modified outside the body, and reinfused after myeloablative chemotherapy. The early real-world data show that the remission rates achieved in trials are replicable in routine care centres, a reassuring finding for the patients currently in treatment queues and for health systems — including those in the eastern Mediterranean with sizeable sickle cell carrier populations — now evaluating whether to expand access.
Finerenone Confirms Benefit for the Harder Half of Heart Failure
Heart failure with preserved ejection fraction (HFpEF) — the form in which the heart's pumping function is intact but its chambers stiffen and fail to fill properly — accounts for roughly half of all heart failure cases worldwide and has, until recently, resisted the treatments that work in reduced-ejection-fraction disease. Long-term follow-up data from the FINEARTS-HF trial, published in the European Heart Journal, show that finerenone (a selective mineralocorticoid receptor antagonist) reduces the composite of cardiovascular death or worsening heart failure events by 16% relative to placebo, with the benefit consistent across subgroups including patients aged over 75 and those with concurrent atrial fibrillation — two populations that make up a growing share of HFpEF cases in ageing Mediterranean societies. Finerenone was already approved by the FDA and EMA for chronic kidney disease in patients with type 2 diabetes; the extended HFpEF data are supporting regulatory submissions for a broadened heart failure indication. For cardiologists managing older female patients — who are disproportionately affected by HFpEF, often alongside hypertension and metabolic disease — the trial adds a second mechanism of proven benefit alongside SGLT2 inhibitors and the beginning of a combination treatment strategy.
WHO Europe: One in Three Mediterranean Children Lives with Overweight or Obesity
The WHO Regional Office for Europe's updated Childhood Obesity Surveillance Initiative (COSI) report, covering 36 countries and more than 350,000 primary-school-aged children, confirms that Mediterranean EU member states record the highest childhood overweight and obesity prevalence on the continent: in Cyprus, Greece, Spain, and Italy, between 30% and 42% of children aged 7–9 are above the healthy-weight threshold. The report notes that prevalence has plateaued in Northern and Western Europe since 2020 but continues to rise in southern and eastern regions, driven by reduced physical activity, increased screen time, and dietary shifts toward ultra-processed foods. The publication lands alongside intensifying clinical debate about whether GLP-1 receptor agonists — approved in several markets for adolescents aged 12 and over following semaglutide's STEP TEENS trial data — should be used earlier or more widely in high-prevalence settings; WHO Europe's position remains that first-line management should centre on multicomponent lifestyle programmes delivered through schools and primary care, with pharmacotherapy reserved for adolescents with severe obesity and significant comorbidities. Cyprus's Ministry of Health is co-sponsoring a school-based Mediterranean diet programme set to enrol approximately 8,000 children in the 2026–27 academic year.
Aerobic Exercise Matches SSRIs for Mild-to-Moderate Depression, Meta-Analysis Finds
A pre-registered individual patient data meta-analysis published in JAMA Psychiatry, pooling 54 randomised controlled trials and more than 6,700 participants, found that structured aerobic exercise — at least 150 minutes per week of moderate-intensity activity, sustained for 12 or more weeks — produced reductions in depressive symptom scores statistically equivalent to first-line SSRI therapy in adults with mild-to-moderate major depressive disorder. The superiority of medication emerged in severe depression (PHQ-9 score ≥ 20), but across the majority of participants — those with PHQ-9 scores of 10–19 — the two approaches produced indistinguishable outcomes at 12 and 24 weeks. The analysis cannot yet resolve whether combination therapy is superior to either intervention alone at scale, nor can it address long-term adherence in unsupported community settings. Even so, the findings provide the evidence base for primary care clinicians to present structured exercise as a co-equal first-line option, not merely a supplement, for patients with mild-to-moderate depression — a change with significant implications for health systems under pressure, particularly in countries where access to psychiatrists and psychologists remains constrained.
WHO Mid-Decade Cervical Cancer Review: Vaccination Rising, Screening Still Lags
A WHO progress report on the global strategy to eliminate cervical cancer as a public-health problem — launched in 2020 with targets for 2030 — finds that HPV vaccination coverage among adolescent girls has more than doubled globally since the strategy's adoption: 37 countries now report coverage at or above the 90% target for girls aged 9–14. Screening and treatment coverage, however, remains the strategy's weak link: fewer than 20% of eligible women in lower- and middle-income countries have received cervical screening, against the 70% target for 2030. In Europe, coverage is higher but uneven: EU member states generally achieve strong vaccination rates, yet show wide variation in uptake of the recommended shift from cytology-based (Pap smear) to HPV DNA primary screening, which is both more sensitive and permits longer screening intervals. Cyprus transitioned its national programme to HPV DNA primary screening in 2025, which the WHO report cites as a best-practice example for small island health systems. Reaching all three 2030 targets — 90% vaccinated, 70% screened, 90% of women with detected disease treated — is estimated to avert 74 million new cervical cancer cases and 62 million deaths over the following decades, underscoring that vaccination and screening together, not either alone, are required to reach elimination.
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