1: A New Player in Stroke Prevention

A phase 3 double-blind RCT called OCEANIC-STROKE is turning heads in secondary stroke prevention. Researchers found that asundexian, a factor XI inhibitor, reduced the risk of recurrent ischemic events in patients following a noncardioembolic stroke, with no significant increase in major bleeding compared to placebo. For a population where balancing clot prevention against bleeding risk is always a tightrope walk, a drug that may offer both could be a meaningful step forward.

2: A Potential Game-Changer for Pancreatic Cancer

A phase 2 RCT published in Nature Medicine found that elraglusib, a new experimental drug, doubled 1-year survival rates in metastatic pancreatic cancer when added to standard chemotherapy, and reduced the risk of death by 38%. Pancreatic cancer remains one of the hardest cancers to treat, with most patients surviving less than a year after diagnosis. Phase 3 trials are next, but researchers are cautiously optimistic.

3: A New Oral Contender for Relapsing MS

Phase 3 results from the FENhance trials may signal a shift in MS management. Fenebrutinib, an investigational oral BTK inhibitor, significantly outperformed teriflunomide in reducing relapse rates, bringing them down to roughly 1 every 17 years. It's the first BTK inhibitor to show superiority over a standard first-line MS therapy, and unlike many current options, it's designed to cross the blood-brain barrier to target both acute inflammation and the chronic damage driving long-term disability.

Phenytoin (Dilantin): Supply remains tight for both sodium capsules and chewable formats used in seizure control.

Can the weather determine when your patients get pregnant?

What happened: A new study analyzed sperm samples from around 16,000 men across 2 very different climates, Florida and Denmark, to see if environmental variables like temperature and sunlight translate into measurable biological changes. The researchers discovered a consistent seasonal pattern: the concentration of "rapidly progressive" sperm was significantly higher in July and August and reached its lowest point during the winter months.

Despite the difference in latitude, the results were remarkably similar. Denmark saw a 29% increase in sperm speed during the summer, while Florida saw a 12% increase.

The pharmacist’s take: Patients often visit the pharmacy looking for ways to optimize fertility, asking about everything from specific antioxidants to avoiding external heat sources like hot tubs, saunas, or even hot laptops. While this study confirms that heat and seasonality do affect sperm motility, it also provides a necessary reality check: faster sperm does not equate to more babies. Despite the significant seasonal speed boost, the data showed no increase in reported pregnancies 9 months later. This helps debunk the outdated "race to the egg" theory, which suggested that the strongest and fastest sperm held all the power in conception.

Bottom Line: Motility is just one piece of the puzzle, and a "faster" sample doesn't actually move the needle on clinical outcomes. While patients might obsess over lifestyle tweaks to boost sperm speed, the reality is that the "race to the egg" is a myth that oversimplifies the actual mechanics of conception.

1: 🇨🇦 Canada's spring economic statement landed this week with a deficit of $66.9 billion, $11.5 billion better than forecast. Over 12 million Canadians will see their grocery benefit jump 25% starting June 5, CPP contributions drop next January saving average earners about $133 a year, and a new sovereign wealth fund will let everyday Canadians invest directly in nation-building projects. The backdrop is less cheerful: global recession risk is climbing, food and energy prices are expected to stay elevated, and youth unemployment sits at 13.8%. Better than expected, but the fine print is earning its keep.

2: 💉 Dealing with COVID is dropping down Canadians’ to-do lists, but it’s not dropping in hospitals. According to new data, only 26% of adults reported getting vaccinated in 2024, and respiratory hospitalizations remain more than double pre-pandemic levels. Flu and RSV are back in force, but COVID still accounts for more than 40% of those admissions. And inside the hospital, it continues to stand apart: data from Norway show SARS-CoV-2 carries a higher risk of acute respiratory failure than flu, RSV, or parainfluenza.

3: 🏃 A new BMJ Medicine study tracking more than 100,000 people for over 30 years suggests the secret to longevity isn’t just more exercise, it may be more variety. Participants who mixed up their physical activity had a 19% lower risk of death from all causes, even after accounting for total exercise volume. Walking showed one of the strongest effects, while overall benefits appeared to plateau around 20 MET hours per week. For time-pressed physicians, swapping 1 weekly run for tennis, weights, or another modality may beat simply adding kilometres.

4: 🚭 A smoke-free generation in Canada? Health Minister Marjorie Michel confirmed this week the federal government is looking into legislation that would permanently ban the sale of tobacco to anyone born after 2008. The move mirrors the UK’s historic “Tobacco and Vapes Bill” passed last week, which creates a sliding age scale to ensure today's 17-year-olds can never legally buy a cigarette. While the Minister says she's still consulting with partners, a Health Canada-linked study suggests the policy could save $2.3 billion in healthcare costs over 50 years.

📚 Read: this new CMAJ case report on the 61-year-old whose carnivore diet sent his triglycerides to 30 times the upper limit of normal and landed him in the ER with acute pancreatitis.

🧑‍🍳 Make: this pineapple and raspberry pavlova with lemon curd from Canadian pastry legend Anna Olson. It’s crisp outside, marshmallow inside, and fancy enough to make your colleagues think you have it together.

🤑 Save: on tools, outdoor gear, and everything your garage has been missing at the Canadian Tire spring sale.

🎧 Listen: to this episode of Pharm So Hard on single-dose aminoglycosides for resistant UTIs. It’s a practical deep dive for anyone navigating the growing challenge of antibiotic resistance at the counter.

✈️ Visit: Lisbon, which was just named the most colourful city in the world with over 2.6 million unique colours identified across its pastel buildings, patterned tiles, and iconic yellow trams.

😂 Laugh: at the eternal optimism of the patient who thinks "after 4" is a suggestion.

First clue:

Need a rematch? We’ve got you covered. Check out our Crossword Archive to find every puzzle we’ve ever made, all in one place.

Think you crushed it? Challenge your pharmacist friends to beat your time.