Five PubMed papers to open first: pediatric leukemia, adolescent HIV, colonoscopy intervals, bone infection, and IUD pain
A ranked 10-minute triage of five papers entered in PubMed from September 15-22, 2026, led by randomized results in pediatric acute lymphoblastic leukemia, adolescent HIV maintenance therapy, colonoscopy surveillance intervals, orthopedic infection, and pain during IUD placement.
This issue covers the papers that entered PubMed between September 15 and September 22, 2026, using each record's PubMed entry date. All five report randomized comparisons in journals at the top of the impact tiers. Their citation counts are still too young to separate them: as of September 22, three of the five had no cited-by works, one had one, and one had two. The order below rests on the strength of the randomized evidence and on how directly each result changes a treatment or screening decision.
At a glance
| Rank | Paper | Journal and tier | Design and sample | Primary result | Early cited-by signal |
|---|---|---|---|---|---|
| 1 | Blinatumomab for replacing chemotherapy in pediatric acute lymphoblastic leukemia 1 | The New England Journal of Medicine; very high impact tier | Phase 3, randomized, open-label, multicentre trial; 709 children | 4-year event-free survival 83.0% vs 70.3%; hazard ratio 0.51, 95% CI 0.35-0.73, P=.0002 | 1 2 |
| 2 | Injectable cabotegravir-rilpivirine every 8 weeks in adolescents with HIV 3 | The Lancet; very high impact tier | Phase 3, randomized, open-label, noninferiority trial; 476 adolescents | Confirmed viral load of 50 copies/mL or higher by week 96 in 0.9% vs 6.4%; estimated difference -5.5%, 99% CI -10.3 to -1.5 | 0 4 |
| 3 | Colonoscopy intervals after removal of high-risk adenomas 5 | The New England Journal of Medicine; very high impact tier | Randomized noninferiority trial in eight European countries; 10,799 patients | 5-year cumulative colorectal cancer incidence 0.77% vs 0.82%; difference -0.05 percentage points, upper boundary of the 99.12% CI 0.68 | 2 6 |
| 4 | Short or long systemic antibiotics after orthopedic infection surgery 7 | The New England Journal of Medicine; very high impact tier | Multicentre, open-label, noninferiority trial; 500 adults | Definite treatment failure by 12 months 14.1% vs 11.1%; risk difference -3.0 percentage points, 95% CI -9.0 to 3.0 | 0 8 |
| 5 | Intrauterine mepivacaine for pain during IUD placement 9 | JAMA; very high impact tier | Multicentre, double-blind, randomized, placebo-controlled trial in Sweden; 370 nulliparous participants | Mean pain score during placement 43.8 mm vs 58.6 mm on a 100-mm scale; mean difference 14.8 mm, 95% CI 10.0-19.6, P<.001 | 0 10 |
1. Blinatumomab replaces two chemotherapy cycles in pediatric ALL
Journal and impact tier: The New England Journal of Medicine, very high impact tier. PubMed entered the paper on September 16, 2026, under PMID 42748428. 1
Author and affiliation: First author Martin Schrappe is in the Department of Pediatrics I, Pediatric Hematology and Oncology, ALL-Berlin-Frankfurt-Münster Study Group, at Christian Albrechts University Kiel and University Hospital Schleswig-Holstein, Campus Kiel, in Germany. Senior author Andrea Biondi is at the Tettamanti Center, Fondazione IRCCS San Gerardo dei Tintori, Monza, and the School of Medicine and Surgery, University of Milan-Bicocca. 1
Design, setting, and sample: AIEOP-BFM ALL 2017 is a phase 3, randomized, open-label, multicentre trial in children with newly diagnosed high-risk B-cell acute lymphoblastic leukemia. After consolidation, participants were randomly assigned 1:1 to two cycles of blinatumomab, a bispecific T-cell engager targeting CD19, or to two cycles of conventional chemotherapy. 709 of 768 eligible patients (92.3%) underwent randomization, 358 to blinatumomab and 351 to the control group. The registry lists the trial as NCT03643276, with an estimated enrollment of 5,000 and 115 locations; the sponsor of record is the lead investigator with Deutsche Krebshilfe as collaborator. 11
Primary endpoint and quantitative result: The primary endpoint was event-free survival, defined as the time from randomization to resistance to protocol treatment, relapse, second cancer, or death from any cause. At a planned interim analysis with a median follow-up of 2.9 years, estimated 4-year event-free survival was 83.0% (95% CI 77.4-87.4) with blinatumomab and 70.3% (95% CI 63.8-75.9) with chemotherapy, P=.0002 in the intention-to-treat analysis, and the hazard ratio for a primary endpoint event was 0.51 (95% CI 0.35-0.73). Infection related to trial treatment occurred in 23.9% of the blinatumomab group and 69.4% of the control group (P<.001). Life-threatening adverse events occurred in 2 patients (0.5%) on blinatumomab, one of them fatal (0.3%), and in 16 patients (4.7%) on chemotherapy. Neurotoxic events were reported in 12.0% versus 3.2% (P<.001), and cytokine release syndrome of grade 2 or higher occurred in 1.1% of the blinatumomab group. 1
Why it matters: Blinatumomab pulls cytotoxic T cells onto CD19-positive B cells, which lets it do the work of two cycles of intensive chemotherapy without the same marrow and infection burden. In this trial the substitution raised 4-year event-free survival by about 13 percentage points while cutting treatment-related infection by roughly two thirds, and the journal ran an accompanying editorial on blinatumomab as a new standard in acute lymphoblastic leukemia. 12
Limitation and evidence boundary: The reported figures come from a planned interim analysis at a median of 2.9 years, so the 4-year estimate can still move as follow-up matures; the registry lists primary completion in July 2028. The result applies to children with newly diagnosed high-risk B-cell disease who reached randomization after consolidation, which is the population the trial enrolled. The safety trade runs in both directions: infections and life-threatening events fell sharply, while neurotoxic events rose from 3.2% to 12.0%. 1
Funding or disclosure: The listed grants include Deutsche Krebshilfe (70112517) and the Czech Ministry of Health (NU23-05-00353). Registrations are EudraCT 2016-001935-12, EU Clinical Trials 2023-509856-32-00, and ClinicalTrials.gov NCT03643276. 111
2. Injectable cabotegravir-rilpivirine every 8 weeks in adolescents with HIV
Journal and impact tier: The Lancet, very high impact tier. PubMed entered the paper on September 17, 2026, under PMID 42753775. 3
Author and affiliation: First author Mutsa Bwakura-Dangarembizi is at the University of Zimbabwe Clinical Research Centre in Harare. Senior authors Deborah Ford and Sarah Pett are at the UCL Innovative Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London. 3
Design, setting, and sample: LATA is a phase 3, randomized, open-label, noninferiority trial at five clinics in Kenya, South Africa, Uganda, and Zimbabwe. Participants were adolescents with HIV aged 12 to under 20 who had maintained viral suppression below 50 copies/mL for more than 12 months and had no previous treatment failure. They were randomly assigned 1:1 to long-acting intramuscular cabotegravir 600 mg plus rilpivirine 900 mg at weeks 4, 8, and 16 and every 8 weeks thereafter, or to daily oral dolutegravir-lamivudine-tenofovir disoproxil fumarate. 476 of 560 screened adolescents were enrolled, 235 in the injectable group and 241 in the oral group, with viral load measured every 24 weeks and a median follow-up of 120 weeks. The registry lists the trial as NCT05154747, sponsored by University College London with the European and Developing Countries Clinical Trials Partnership, Janssen-Cilag, ViiV Healthcare, and other partners as collaborators. 13
Primary endpoint and quantitative result: The primary outcome was the proportion of participants with two consecutive confirmed viral loads of 50 copies/mL or higher by week 96. Two participants in the injectable group reached that outcome (Kaplan-Meier estimate 0.9%, 95% CI 0.0-2.2) against 15 in the oral group (6.4%, 95% CI 3.7-9.8), an estimated difference of -5.5% (99% CI -10.3 to -1.5). The injectable regimen met the noninferiority criterion and showed superiority over daily oral therapy (p=0.0013). Serious adverse events occurred in 14 participants on the injectable regimen and 18 on oral therapy (hazard ratio 1.16, 95% CI 0.54-2.51; p=0.71), and grade 3 or higher adverse events in 31 and 34 (hazard ratio 1.07, 95% CI 0.62-1.83; p=0.81). Seven participants discontinued the injectable regimen permanently. 3
Why it matters: Daily oral therapy for life is the standard these participants were already taking, and the enrolled adolescents had been on antiretroviral treatment for a median of 11.7 years; 98% acquired HIV vertically. An eight-weekly injection held suppression better than the daily tablet in this group, which matters where sustained adherence is the main threat to long-term control. 3
Limitation and evidence boundary: Participants and clinical staff were unmasked, while laboratory staff measuring viral loads were masked. The result describes maintenance in adolescents already suppressed for more than a year, so it says nothing about starting or rescuing treatment. Seven of 235 participants on the injectable regimen stopped it permanently, including two for adverse events and two who were planning pregnancy. 3
Funding or disclosure: The trial was funded by the European and Developing Countries Clinical Trials Partnership (EDCTP2), Janssen, and the UK Medical Research Council. The senior author reports grants from EDCTP, the UK Medical Research Council, the UK National Institute for Health and Care Research, Gilead Sciences, ViiV Healthcare, Janssen-Cilag, and the US National Institutes of Health paid to University College London, and other authors report advisory roles with ViiV Healthcare, Merck, and Gilead Sciences. 3
3. Five years instead of three between surveillance colonoscopies
Journal and impact tier: The New England Journal of Medicine, very high impact tier; the paper appears in volume 395, issue 11, pages 1051-1061. PubMed entered it on September 16, 2026, under PMID 42748427. 5
Author and affiliation: First author Rodrigo Jover is at Servicio de Medicina Digestiva, Hospital General Universitario Dr. Balmis, CIBERehd, and the Instituto de Investigacion Sanitaria y Biomedica de Alicante, in Spain. Senior author Mette Kalager is in the Clinical Effectiveness Research Group at the University of Oslo and the Department of Transplantation Medicine at Oslo University Hospital. 5
Design, setting, and sample: EPoS II is an ongoing noninferiority trial in eight European countries. Patients who had high-risk adenomas removed — at least one adenoma of 10 mm or more, high-grade dysplasia, villous growth, or three to ten adenomas of any kind — were randomly assigned to a first surveillance colonoscopy at 5 years or at 3 years, with the 3-year group also examined at 5 years. 10,799 patients underwent randomization, 5,398 to the 5-year interval and 5,401 to the 3-year interval, and the reporting here is an interim analysis after 5.5 years of follow-up. The registry lists the trial as NCT02319928, sponsored by the Asociación Española de Gastroenterología. 14
Primary endpoint and quantitative result: The primary endpoint is the cumulative incidence of colorectal cancer at 10 years, with a prespecified noninferiority margin of 0.7 percentage points on the upper boundary of the confidence interval for the difference between groups. At 5 years, cumulative incidence was 0.77% with the 5-year interval and 0.82% with the 3-year interval, a difference of -0.05 percentage points, with an upper boundary of the one-sided 99.12% confidence interval of 0.68, which met the noninferiority criterion. Cancer stage at diagnosis was similar in the two groups, and five patients died of colorectal cancer, three (0.06%) in the 5-year group and two (0.04%) in the 3-year group. 5
Why it matters: Guidelines currently put the first surveillance colonoscopy at 3 years after high-risk adenoma removal. This trial puts a 5-year first interval alongside it on 5-year cancer incidence and on the stage at which cancers were found, which is the comparison that decides how many colonoscopies a patient has to have. The journal ran an accompanying editorial on the same question. 15
Limitation and evidence boundary: These are interim results at 5.5 years of follow-up from a trial whose primary endpoint is measured at 10 years, and the registry lists primary completion in December 2028, so the 10-year comparison remains open. The incidence in both groups was under 1% at 5 years, and the trial enrolled patients with the specific high-risk adenoma definitions listed above. 514
Funding or disclosure: The published grants include the Research Council of Norway (235271, 315410), KWF Kankerbestrijding (10274), the Instituto de Salud Carlos III (PI14/01386, PI17/01756, PI20/01527, PI23/01974), and others. The trial is registered as NCT02319928. 5
4. A week of systemic antibiotics after orthopedic infection surgery
Journal and impact tier: The New England Journal of Medicine, very high impact tier. PubMed entered the paper on September 16, 2026, under PMID 42748421. 7
Author and affiliation: First author Martin McNally and the trial team are in the Bone Infection Unit at the Nuffield Orthopaedic Centre, Oxford University Hospitals, in the United Kingdom; senior author Matthew Scarborough is in the Nuffield Department of Medicine at the University of Oxford. Recruiting sites across the United Kingdom, Portugal, Spain, Austria, and Germany appear among the affiliations. 7
Design, setting, and sample: SOLARIO is a multicentre, open-label, noninferiority trial. Adults who had undergone surgery for orthopedic infection with implantation of a local-antibiotic carrier were randomly assigned 1:1 to postoperative systemic antibiotic therapy for 4 weeks or more or for 7 days or less. 500 patients underwent randomization and 475 were assessed in the primary analysis, 241 in the long-duration group and 234 in the short-duration group. The outcome was definite treatment failure by 12 months, judged by a clinical end-point committee working from redacted records without knowledge of group assignment. The registry lists the trial as NCT03806166, sponsored by Oxford University Hospitals NHS Trust across 23 listed locations, and records it as completed with 500 participants actually enrolled. 16
Primary endpoint and quantitative result: Against a noninferiority margin of 10 percentage points, definite treatment failure by 12 months occurred in 34 of 241 patients (14.1%) on long-duration therapy and 26 of 234 (11.1%) on short-duration therapy, a risk difference of -3.0 percentage points (95% CI -9.0 to 3.0), which met the margin. Sensitivity analyses gave -2.4 percentage points (95% CI -8.2 to 3.5) in the included population and -2.7 percentage points (95% CI -8.8 to 3.4) per protocol. By week 6 after surgery, symptoms potentially related to treatment had occurred in 45.2% of the long-duration group and 17.2% of the short-duration group (risk difference -28.0 percentage points, 95% CI -36.4 to -19.6). 7
Why it matters: Orthopedic infection has been managed with surgery plus prolonged systemic antibiotics, and weeks of intravenous or high-dose oral therapy bring line complications, organ toxicity, and resistance pressure. With an antibiotic-eluting carrier implanted at the infection site, a course of a week or less matched four weeks or more on treatment failure while roughly halving the proportion of patients reporting treatment-related symptoms. 7
Limitation and evidence boundary: Participants and treating clinicians knew the assigned duration, and only the committee judging treatment failure was blinded. The confidence interval allows the short course to be as much as 9 percentage points worse on failure, and follow-up ends at 12 months, so later relapse lies outside the endpoint. The population is adults in whom a local-antibiotic carrier was implanted during surgery for orthopedic infection. 7
Funding or disclosure: The paper reports funding from the European Bone and Joint Infection Society and others, and registers the trial as NCT03806166. 7
5. Local anaesthetic inside the uterus before IUD placement
Journal and impact tier: JAMA, very high impact tier. PubMed entered the paper on September 17, 2026, under PMID 42752558, with the article identifier e2614217. 9
Author and affiliation: First author Karin Elgemark and senior author Helena Kopp Kallner are in the Department of Clinical Sciences at Danderyd Hospital, Karolinska Institutet, and the Department of Obstetrics and Gynecology at Danderyd Hospital, in Stockholm. 9
Design, setting, and sample: The trial was multicentre, double-blind, randomized, and placebo-controlled, and ran from May 2021 through June 2024 at 11 outpatient gynecology, maternal health, and youth clinics in Sweden. Nulliparous individuals aged 18 to 31 who chose intrauterine devices with smaller-diameter placement tubes — levonorgestrel 19.5 mg, levonorgestrel 13.5 mg, or a copper device — were eligible. 370 participants were randomized, 185 per group, to intrauterine instillation of 10 mL of mepivacaine 20 mg/mL or sodium chloride 9 mg/mL through a hydrosonography catheter two minutes before placement. Participants, clinicians, and outcome assessors were all blinded to allocation, and the trial is registered as EudraCT 2020-002271-36. 9
Primary endpoint and quantitative result: The primary outcome was the difference in pain during placement on a 100-mm visual analog scale, adjusted for the individual clinician. Mean pain scores were 43.8 mm (SD 24.7) with mepivacaine and 58.6 mm (SD 21.5) with placebo, a mean difference of 14.8 mm (95% CI 10.0-19.6, P<.001); adjustment for clinician gave 14.2 mm (95% CI 9.7-18.6, P<.001). Tolerable pain was reported by 172 of 175 participants (98.3%) in the mepivacaine group and 159 of 174 (91.4%) in the placebo group (relative risk 1.08, 95% CI 1.02-1.13), with a number needed to treat of 15 (95% CI 9-43). 9
Why it matters: Concern about pain at placement is a documented reason people decline an intrauterine device, and nulliparous patients are the group in which the procedure is most painful. The instillation cut the reported pain score by about a quarter of the placebo mean without sedation or an additional procedure beyond the catheter already used, and it moved the proportion who found the procedure tolerable from 91.4% to 98.3%. 9
Limitation and evidence boundary: The enrolled population was nulliparous people aged 18 to 31 at Swedish clinics using smaller-diameter devices; parous patients and devices placed with larger tubes sit outside that group. The trial tested instillation two minutes before placement, which leaves other approaches to procedural pain unaddressed, and it reports the placement itself rather than insertion success or later continuation. 9
Funding or disclosure: The PubMed record lists no funding grant for the trial. The disclosure statement reports the second author's personal fees from Organon Sweden and Bayer Sweden for educational activities and honoraria from Medsphere for expert opinions on long-acting reversible contraception, and the senior author's lecture honoraria, expert opinions, investigator roles, and teaching for a list of manufacturers including Bayer, Organon, Gedeon Richter, and Takeda. 9
What to open first
- Pediatric high-risk B-cell leukemia: Open AIEOP-BFM ALL 2017 if your question is whether two cycles of blinatumomab can stand in for two cycles of chemotherapy after consolidation, and what that swap does to infection and neurotoxicity. 1
- Adolescent HIV on maintenance therapy: Open LATA if your question is whether an injection every 8 weeks holds viral suppression better than a daily oral regimen in adolescents who are already suppressed. 3
- Colorectal cancer surveillance: Open EPoS II if your question is how much colorectal cancer incidence changes when the first surveillance colonoscopy moves from 3 years to 5 years after high-risk adenoma removal. 5
- Orthopedic infection: Open SOLARIO if your question is how short a course of systemic antibiotics can be when a local-antibiotic carrier is implanted at the infection site. 7
- Pain during IUD placement: Open the mepivacaine trial if your question is how much intrauterine local anaesthetic reduces pain at placement and how many patients find the procedure tolerable with it. 9
The five papers cover a chemotherapy-free interval in pediatric leukemia, an injectable maintenance regimen for adolescents with HIV, a surveillance interval after high-risk adenoma removal, the duration of systemic antibiotics after orthopedic infection surgery, and pain control during IUD placement. Each reports what happened inside its enrolled population, and the boundary stated in each entry marks how far that answer reaches.
References
- 1Blinatumomab for Replacing Chemotherapy in Pediatric Acute Lymphoblastic Leukemia
pubmed.ncbi.nlm.nih.gov
- 2
- 3
- 4OpenAlex record for the LATA report
openalex.org
- 5Colonoscopy Intervals and Colorectal Cancer Incidence after Adenoma Removal
pubmed.ncbi.nlm.nih.gov
- 6OpenAlex record for the EPoS II report
openalex.org
- 7Short or Long Antibiotic Regimens in Orthopedics
pubmed.ncbi.nlm.nih.gov
- 8OpenAlex record for the SOLARIO report
openalex.org
- 9
- 10OpenAlex record for the mepivacaine trial
openalex.org
- 11
- 12Blinatumomab - A New Standard of Care in Acute Lymphoblastic Leukemia
pubmed.ncbi.nlm.nih.gov
- 13Long-Acting Treatment in Adolescents (LATA)
clinicaltrials.gov
- 14European Polyp Surveillance Trial
clinicaltrials.gov
- 15When More Is Not Better - Colonoscopy Surveillance after High-Risk Adenomas
pubmed.ncbi.nlm.nih.gov
- 16Short or Long Antibiotic Regimes in Orthopaedics
clinicaltrials.gov
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