The Scan by 2 Minute Medicine®: Leucovorin autism update, Oura Ring FDA scrutiny, Lilly oral GLP-1 trial, and Florida vaccine mandate repeal

Leucovorin and acetaminophen in the autism spotlight

The FDA announced this week that leucovorin calcium will be available for children with cerebral folate deficiency, a rare disorder that interferes with folate transport into the brain and can mimic features of autism. In small studies of about 40 children, clinicians observed gains in speech and social interaction when folate receptor antibodies were present, although findings have yet to be replicated in larger trials. Cerebral folate deficiency itself is thought to affect fewer than one in a thousand children, but the overlap with autism spectrum symptoms has made the treatment noteworthy. At the same time, officials drew attention to observational research suggesting a possible link between acetaminophen use in pregnancy and autism, though these data remain associative and cannot prove causation. More than 65 percent of pregnant women in the United States report using acetaminophen, and clinical guidance continues to recommend its use when needed because untreated fever also poses maternal and fetal risks. These announcements have generated interest because they involve familiar medications now considered in new contexts. They also highlight how preliminary research can shape practice discussions long before definitive trials are complete. For clinicians, the key is interpreting emerging signals with caution while ensuring families receive balanced counseling. These developments show how research, clinical practice, and patient demand intersect in real time. The next section shifts from pharmacology to consumer technology pushing deeper into health care.

Wearables push FDA to redraw the wellness boundary

The wearable health market has evolved rapidly, moving well beyond step counters. The industry was valued at about 40 billion dollars in 2024 and is projected to exceed 140 billion by 2032. Among the most prominent devices is the Oura Ring, now worn by more than 5 million people and marketed for sleep and recovery monitoring. The U.S. Department of Defense has adopted the ring for fatigue tracking, underscoring how consumer devices are entering operational environments where accuracy and oversight matter. Independent studies show strong correlations, often above 0.90, between Oura’s heart rate variability and clinical standards, but limitations remain for arrhythmias and respiratory tracking. The FDA has emphasized that once devices cross into diagnostic claims, regulatory clearance is required. Several companies have already faced warnings for overstating capabilities. For physicians, this means patients may arrive with reams of data that look clinical but have not been validated for diagnosis. These metrics can encourage engagement and self-awareness yet must be interpreted within limits. The challenge is finding a middle ground where wearable insights complement, but do not replace, validated testing. As adoption accelerates, fluency in these tools is becoming part of routine practice. From measurement, we now pivot to a new oral therapy reshaping obesity care.

Lilly’s oral GLP-1 raises the stakes in obesity care

Eli Lilly released phase III results this month for its oral GLP-1 agent orforglipron, and the results stand out. In a trial of more than 3,000 non-diabetic adults, those on the highest dose lost 12.4 percent of their baseline weight over 72 weeks, compared with just 2.1 percent in the placebo arm. Intermediate doses produced weight loss between 7.8 and 9.3 percent. Injectable GLP-1s such as semaglutide and tirzepatide often deliver losses above 15 percent, but the pill format may appeal to patients reluctant to inject. Gastrointestinal side effects were common and led to discontinuation in about 10 percent of participants, similar to other GLP-1s. The obesity therapeutics market, valued at 25 billion dollars in 2024, is projected to triple by 2030 as oral agents expand access. At the same time, Lilly discontinued development of bimagrumab, a muscle-preserving drug, despite encouraging early findings in body composition. The contrasting decisions reflect the commercial and scientific complexity of obesity therapeutics. Orforglipron may soon be another option, particularly for patients hesitant about injectables. Adherence, payer coverage, and real-world durability will shape its eventual role in practice. From obesity care, the final story moves to population-level prevention and shifting vaccine policy.

Florida dismantles school vaccine mandates

Florida’s health department announced plans to repeal school vaccine mandates, starting with hepatitis B and varicella. Eliminating requirements for measles, polio, or pertussis would require legislative action. The move comes as vaccination rates are already slipping nationwide. In the 2024–2025 school year, CDC data show kindergarten coverage fell to 93 percent, while exemption rates rose to 3.6 percent, the highest in more than two decades. MMR coverage has now dipped below the 95 percent threshold needed to prevent measles outbreaks. CDC reports that 1,514 measles cases and 40 outbreaks have already been confirmed in 2025, spanning 39 states. Pertussis remains a concern as well, with surveillance data showing elevated case counts compared with the past decade. The risks are well documented: unvaccinated children are 13 times more likely to contract pertussis, and maternal vaccination reduces infant hospitalization by more than 90 percent. Even a modest 5 percent drop in measles coverage can be enough to trigger community outbreaks. These policy changes may increase counseling demands and require closer monitoring for resurgence of preventable illnesses. The decision underscores how state policy can influence public health risk far beyond its borders.

Image: PD