The best treatment for multiple sclerosis (MS) might be antivirals that target the Epstein-Barr virus. Pharmaceutical companies are now being called on to develop such drugs after researchers studied the immune responses of people with and without the condition.

鈥淭here aren鈥檛 good Epstein-Barr virus drugs currently available, but they can be developed,鈥� says at Harvard Medical School. 鈥淭hat might be the most useful specific therapy for MS in the future.鈥�

MS is caused by an immune attack on myelin, a fatty sleeve that wraps around nerves. The loss of myelin reduces their ability to transmit signals and can cause a wide range of symptoms, including muscle weakness. Drugs that suppress the immune system can slow the progression of the condition.

There is strong evidence that the Epstein-Barr virus (EBV), which causes mononucleosis, or glandular fever, is also the cause of MS. 鈥淚 think most MS researchers now would agree that EBV plays a major role in the development of the disease,鈥� says team member at the Harvard T.H. Chan School of Public Health.

But exactly how remains a mystery. Almost everyone is infected with EBV during their childhood or teen years. It mainly infects immune cells known as B-cells, where it can remain dormant for the rest of a person鈥檚 life. But in some cells, the virus can reactivate.

The big question is why only around 1 in 1000 people develop MS when nearly everyone gets EBV. This suggests there is something different about the immune response to EBV in people who go on to develop MS, says team member at Massachusetts General Hospital. 鈥淥ur question for this study was: in people with MS, what parts of EBV does the immune system respond to? And do those responses look different from people who don鈥檛 have MS?鈥�

The team focused on immune cells known as CD4 T-cells, which circulate in the body. Although these aren鈥檛 the cells that directly attack myelin, there are multiple lines of evidence suggesting they play a role in MS, says Drosu.

The team found that, in 30 people with MS, most of the CD4 T-cells targeting EBV were specifically targeting viral proteins produced when the virus is actively replicating, rather than the proteins associated with its dormant stage. What鈥檚 more, people with MS produced twice as many of these cells, on average, as 30 people without the condition.

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The researchers then looked at CD4 T-cells in 60 people with MS before and after they began drug treatments that reduce their number of B-cells. They found these treatments reduced the T-cell response to EBV almost to the levels seen in people without MS.

In addition, the team found low levels of EBV in the saliva of these people before they were treated to reduce their number of B-cells, which shows that the virus was replicating in their bodies. After treatment, viral levels dropped below detectable levels in most people.

The thinking has been that B-cells help drive the harmful immune response in people with MS, says Levy, and this is why drugs that reduce B-cell levels are effective. But the results suggest these drugs also work by eliminating B-cells infected with EBV, he says, thereby reducing the immune response caused by active viral replication. 鈥淲e鈥檙e thinking that depleting B-cells is also depleting the reservoir of the Epstein-Barr virus.鈥�

If so, targeting EBV directly with antivirals might be just as effective as B-cell-depleting drugs, but without the undesirable side effects of treatments that weaken the immune system, such as an increased risk of infections. 鈥淚 think a lot of patients would prefer a specific drug,鈥� says Bjornevik. 鈥淚f we can show that an antiviral had a similar effect as the most effective MS drugs, I think there will be a big market for that drug.鈥�

Another approach already being trialled for treating MS is using modified immune cells called CAR T-cells. While existing drugs merely reduce B-cell levels, CAR T-cells can temporarily eliminate them altogether. Dozens of people with MS have gone into remission after CAR-T treatment, says Levy.

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But EBV might linger in some other cell types and reinfect B-cells as they slowly recover in the years after the CAR T-cell treatment, he says. 鈥淭hen we would need the antivirals鈥� so we just have to wait and see.鈥� CAR T-cells can also have serious side effects, says Bjornevik, so antivirals could be safer as well.

There are also vaccines against EBV under development. 鈥淚f people don鈥檛 get infected with EBV, their risk of MS would be virtually zero,鈥� says Drosu. 鈥淪o I think vaccines are [a] very promising strategy to eradicate MS.鈥�

But 1000 people would have to be vaccinated to prevent just one case of MS, Levy points out. However, EBV causes many other problems, including a number of cancers, and has also been linked to other autoimmune conditions, such as lupus and rheumatoid arthritis. 聽

A daily pill doubles the survival time of people with pancreatic cancer, one of the most aggressive and difficult-to-treat forms of the condition, even after they have stopped responding to chemotherapy. What鈥檚 more, the convenient pill has fewer side effects than standard chemotherapy.

鈥淚t鈥檚 a transformative treatment,鈥� says at University College London, who wasn鈥檛 involved in the research. 鈥淔or decades, [survival outcomes] haven鈥檛 changed for pancreatic cancer. [The new treatment] gives you double the amount of time to enjoy your life, be with your family and do things that you would like to do.鈥�

About 70 per cent of people with pancreatic cancer . A combination of no routine screening and vague symptoms, like a sore back, means that the condition is usually spotted when it has spread elsewhere. Standard treatment involves chemotherapy, but even then, most people only survive for about , on average. 鈥淭he disease is really aggressive and difficult to treat,鈥� says Acedo.

More than 90 per cent of pancreatic cancers are driven by mutations in the KRAS gene, which encodes for a protein known as K-Ras. When the gene is mutated, K-Ras gets stuck in a state that drives cancer cells to divide uncontrollably.

at Memorial Sloan Kettering Cancer Center in New York and her colleagues wondered if a drug called daraxonrasib, which binds to the protein, could dampen its signals and slow the growth of cancer cells.

So the team recruited 500 people with metastatic pancreatic cancer from the US, Europe and Asia, all of whom had stopped responding to an initial round of chemotherapy. They were assigned to two groups: the first took daraxonrasib every day and the second continued to receive standard chemotherapy infusions.

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The researchers 鈥� who presented at the American Society of Clinical Oncology meeting in Chicago on 31 May 鈥� found that the participants in the daraxonrasib group went on to survive for 13.2 months, on average, compared with 6.7 months in the chemotherapy group. 鈥淚t鈥檚 fantastic news,鈥� says Acedo. The treatment is the first in decades to improve survival outcomes among patients with advanced pancreatic cancer, she says.

What鈥檚 more, only 1 per cent of the participants in the daraxonrasib group stopped taking the drug due to side effects, such as rash, whereas 11 per cent stopped chemotherapy due to adverse events like fatigue. 鈥淎 daily pill is also much easier to take than chemotherapy, which involves frequent hospital visits and is invasive,鈥� says Acedo.

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The team has submitted the findings to the US Food and Drug Administration, and hopes to get the drug approved for use in people with metastatic pancreatic cancer who have had chemotherapy in the coming months, says O鈥橰eilly.

But it is still far from a cure, says Acedo. 鈥淚t鈥檚 a few extra months, which is really promising, but it鈥檚 still not years and they鈥檙e still dying of the disease,鈥� says Acedo. Nevertheless, further studies may reveal that combining daraxonrasib with other experimental drugs or chemotherapy could lead to even better outcomes, she says.

The researchers are exploring this in ongoing trials, says O鈥橰eilly. They are also looking at whether daraxonrasib could be used as a first-line therapy in untreated patients, she says.

Two medical instruments recovered from the 15th-century tomb of a Chinese surgeon carry traces of an anaesthetic compound, the earliest chemical evidence ever found of doctors attempting to reduce the pain of a medical procedure.

The surgical scissors and tweezers were unearthed in 1974 from the tomb of a famous doctor named Xia Quan who lived from 1348 to 1411, in Jiangsu province.

at Northwest University in Xi鈥檃n, China, and his colleagues used lasers to study the composition of residues on the instruments, revealing traces of aconitine. This compound is produced by plants of the Aconitum genus, commonly known as wolfsbane and monkshood. They are frequently listed as ingredients in ancient Chinese medicinal prescriptions.

Aconitine interacts with sodium channels in the cell membranes of neurons. At the right dose, it has an anaesthetic effect, but it is highly toxic and is rarely used today due to the risks of poisoning.

The residues are concentrated on the blades of the scissors and the tips of the tweezers, making it unlikely the presence of aconitine was due to contamination, the researchers say.

at Griffith University in Brisbane, Australia, who was not involved in the research, says there鈥檚 no doubt that this is the earliest direct evidence of the use of anaesthetics.

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The research suggests that early surgeons knew more about reducing pain than they have previously been given credit for, he says. 鈥淣ow we can understand why this surgery may have been present or may have been so prolific and actually manageable in the past,鈥� Matheson says.

Historical texts indicate that Ming dynasty practitioners had developed methods to mitigate the toxicity of aconitine, such as 鈥減reparation with boys鈥� urine, soaking in a black soybean decoction, vinegar-boiling, detoxifying with mung beans and removing the outer skin of the aconite tuber鈥�, Zhao and his colleagues write.

Isolating the aconitine from such a toxic plant and then working out how to apply it without causing harm to the patient would have required a 鈥渢remendous amount of science鈥�, says Matheson.

鈥淭hey have to be able to get it out of the plant without harming themselves,鈥� he says. 鈥淭hen they need to process it so it can be applied to whatever they鈥檙e going to need it for, without killing themselves or hurting people. Then they have to make sure that it actually works.鈥�

The long list of side effects associated with statins is vastly overstated, according to the most rigorous assessment of the evidence to date. This is prompting calls for the drugs鈥� packaging to be updated, over concerns that warnings regarding these reported side effects are putting people off the life-saving medicines.

鈥淲e can now be confident that statins do not cause the vast majority of medical issues listed as potential side effects in statin patient information leaflets,鈥� said at the University of Oxford at a press briefing on 3 February.

Statins, which lower cholesterol levels, are inexpensive drugs that significantly cut the risk of heart attacks and strokes. But there has long been concern surrounding their recorded side effects, namely muscle pain, despite a in 2022 showing that this isn鈥檛 commonly caused by statins.

鈥淯nfortunately, ongoing confusion and concern 鈥� not just in patients, but also many doctors regarding potential statin side effects 鈥� mean that many people are not willing to start statins, or stop [taking] them,鈥� said Reith.

Now, Reith and her colleagues have looked into the side effects that are commonly listed on statin labels, such as dizziness, fatigue, memory loss and headache, which normally end up there following evidence from case reports and observational studies. They didn鈥檛 investigate muscle pain or weakness, or whether there is an increased risk of diabetes, which was flagged as a small risk in a .

The researchers analysed 19 randomised controlled trials, involving 120,000 participants who were followed for 4.5 years, on average, looking into the effects of five of the most commonly prescribed statins relative to a placebo.

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Of the 66 side effects they analysed, they found that statins don鈥檛 seem to be the cause for 62 of them, with similar rates of incidence occurring in the placebo groups. They may arise due to the nocebo effect, where the expectation of harm leads to someone experiencing it, says at New York University Langone Health.

The researchers did find that statins legitimately raise the risk of a few side effects, such as excess protein levels in urine, limb swelling and changes in liver function, but not to the extent that they seem to cause harm. 鈥淭his allows us to be confident in saying that the benefits of statins really do significantly outweigh their risks,鈥� said Reith.

Drug regulators should now update statin labels, says at the University of California, Los Angeles. For instance, labels could make clear which side effects are actually caused by statins and which seem to occur at similar rates among people on a placebo, she says.

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But this is rarely a quick process 鈥� the UK鈥檚 Medicines and Healthcare Products Regulatory Agency only recommended that statin labels update descriptions of muscle weakness and pain as a side effect in January 2026, for instance.

In the meantime, clinicians can use the results to reassure people who are taking statins, or who could benefit from them. 鈥淚t鈥檚 not about telling people that they鈥檙e crazy, that they鈥檙e wrong or you don鈥檛 have a side effect, it鈥檚 about educating them to change their expectations and help them,鈥� says Berger.

Watson hopes the review will settle the debate around statin side effects. 鈥淭he focus of future work should shift away from asking whether statins generally cause these symptoms 鈥� we already have this answer,鈥� she says. Instead, it should focus on uncovering who might actually be susceptible to certain statin-related side effects 鈥� such as people with several health problems 鈥� and why, in real-world settings, she says.