A blockbuster MS drug undergoes FDA re-evaluation. We explore the story of Ocrelizumab, a treatment for primary progressive multiple sclerosis, following a patient petition that highlighted internal disagreements among agency reviewers regarding its efficacy. We look to Sweden, where new research involving sibling pairs separated by adoption investigates how early-life environments shape long-term health and social outcomes. Finally, we revisit the dominant medical narrative on Alzheimer’s disease. Why is it so difficult to move towards comprehensive treatments? Has the focus on amyloid plaques hindered our understanding of other critical factors like vascular health and social inequality? Peter Doshi is a senior editor at The BMJ and an associate professor of pharmaceutical health services research at the University of Maryland. Erik Peterson is an associate professor at the Karolinska Institute in Stockholm, specializing in psychiatric epidemiology and adoption studies. Carol Brayne is a professor emerita of public health medicine at the University of Cambridge and a leading expert in the epidemiology of dementia. Reading List: Multiple sclerosis: Could Roche's bestselling drug Ocrevus be doing more harm than good in women with primary progressive MS? Home environment conditions during childhood and psychosocial outcomes across three generations in Sweden: population based adoption-discordant sibling comparison study

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