Tag: pubmed

Cochrane Database Syst Rev. 2026 Jul 13;7:CD013562. doi: 10.1002/14651858.CD013562.pub2.

ABSTRACT

RATIONALE: After inadequate response to first-line biologic or targeted synthetic (b/ts) disease-modifying antirheumatic drug (DMARD) therapy in adults with rheumatoid arthritis, there are numerous alternative DMARD options, and current understanding of their comparative benefits and harms is limited.

OBJECTIVES: The aim of this living systematic review and network meta-analysis was to compare the benefits and harms of DMARDs after failure of biologic or targeted synthetic DMARDs in adults with rheumatoid arthritis.

SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, and two trial registries (ClinicalTrials.gov and the WHO ICTRP) from inception until 28 November 2025, with no restrictions on language or date of publication.

ELIGIBILITY CRITERIA: We included randomised controlled trials (RCTs) of adults aged 18 years or older diagnosed with rheumatoid arthritis according to 1958, 1987, or 2010 classification criteria who previously demonstrated inadequate response to a b/ts DMARD. Eligible interventions included conventional synthetic DMARDs (methotrexate, antimalarials, sulfasalazine, leflunomide, ciclosporin, and azathioprine), biologic DMARDs (adalimumab, certolizumab, etanercept, golimumab, infliximab, abatacept, rituximab, tocilizumab, sarilumab, and anakinra), and targeted synthetic DMARDs (tofacitinib, baricitinib, and upadacitinib).

OUTCOMES: Our critical outcomes were American College of Rheumatology 50% (ACR50) response, withdrawals due to adverse events, radiographic progression, Disease Activity Score 28 (DAS28) remission, pain as measured by visual analogue scale, function as measured by the Health Assessment Questionnaire (HAQ), and serious adverse events. Important outcomes included ACR20, ACR70, serious infections, fatigue, and quality of life.

RISK OF BIAS: We used Cochrane’s RoB 1 tool to assess risk of bias in the included studies.

SYNTHESIS METHODS: We first screened the records using an approach that combined machine learning and crowdsourcing to identify probable RCTs. We then reviewed the records identified as RCTs for eligibility and simultaneously classified them to the appropriate Population, Intervention, Comparator, and Outcome (PICO) question(s). Two review authors then extracted relevant data from the included studies in duplicate and independently, with any disagreements resolved by a third review author. A Bayesian random-effects network meta-analysis was conducted using a semi-informative prior probability distribution. We assessed the certainty of evidence for each outcome using the GRADE approach.

INCLUDED STUDIES: We included 19 unique studies (4779 participants) in the review, all of which were parallel-design RCTs. Eleven trials were placebo controlled; two trials had an inactive comparator arm; and six trials had an active comparator arm. The trials were performed in a well-established rheumatoid arthritis population, with the median baseline disease duration ranging from 6.4 to 14 years, median age of participants ranging from 49 to 58 years, and median baseline disease activity (DAS28) ranging from 4.87 to 6.79.

SYNTHESIS OF RESULTS: ACR50 response We found moderate-/high-certainty evidence that using a tumour necrosis factor (TNF) inhibitor not previously tried, interleukin-6 (IL-6) inhibitors, abatacept, rituximab, and Janus kinase (JAK) inhibitors was more effective than placebo: TNF inhibitor not previously tried (odds ratio (OR) 6.04, 95% credible interval (CrI) 2.49 to 16.3; high-certainty evidence), sarilumab (OR 3.11, 95% CrI 1.25 to 7.76; high-certainty evidence), tocilizumab 4 mg/kg intravenous (OR 5.31, 95% CrI 2.09 to 12.09; high-certainty evidence), tocilizumab 8 mg/kg intravenous (OR 10.03, 95% CrI 3.65 to 31.27; high-certainty evidence), subcutaneous abatacept (OR 4.31, 95% CrI 0.97 to 18.28; moderate-certainty evidence), intravenous abatacept (OR 4.57, 95% CrI 2.21 to 10.18; high-certainty evidence), rituximab (OR 5.50, 95% CrI 2.31 to 13.12; high-certainty evidence), upadacitinib (OR 3.93, 95% CrI 1.53 to 10.32; high-certainty evidence), tofacitinib (OR 3.93, 95% CrI 1.53 to 10.32; high-certainty evidence), baricitinib 2 mg (OR 2.00, 95% CrI 0.77 to 5.23; moderate-certainty evidence), baricitinib 4 mg (OR 2.79, 95% CrI 1.10 to 7.22; high-certainty evidence). With an assumed risk for placebo of 78 out of 1000 patients, the expected effects for the active drugs ranged from 143 (baricitinib 2 mg) to 455 (tocilizumab 8 mg/kg). Withdrawals due to adverse events For most interventions, there were sparse data with low-certainty evidence, except for TNF inhibitor not previously tried (risk ratio (RR) 0.32, 95% CrI 0.07 to 1.1; moderate-certainty evidence), which is probably less harmful than placebo, and sarilumab (RR 1.98, 95% CrI 0.57 to 7.19; moderate-certainty evidence), which is probably more harmful than placebo. Low-certainty evidence suggests that intravenous abatacept (RR 0.92, 95% CrI 0.34 to 2.79), upadacitinib (RR 0.41, 95% CrI 0.08 to 1.83), and baricitinib 2 mg (RR 0.93, 95% CrI 0.22 to 4.01) may be less harmful than placebo. Low-certainty evidence suggests that tocilizumab 4 mg/kg (RR 1.39, 95% CrI 0.39 to 5.28), tocilizumab 8 mg/kg (RR 1.49, 95% CrI 0.51 to 4.81), subcutaneous abatacept (RR 3.11, 95% CrI 0.05 to 249.6), rituximab (RR 2.38, 95% CrI 0.44 to 23.31), tofacitinib (RR 1.37, 95% CrI 0.35 to 5.58), and baricitinib 4 mg (RR 1.43, 95% CrI 0.38 to 5.81) may be more harmful than placebo. Data were insufficient to perform a network meta-analysis for radiographic progression. For DAS28 and the HAQ, there was mostly moderate-/high-certainty evidence of a benefit, with some exceptions for comparisons with indirect evidence only that was of low or very low certainty. For the other efficacy outcomes, data were sparse with wide credible intervals, and the certainty of evidence was typically low.

AUTHORS’ CONCLUSIONS: We found high-certainty evidence that nine therapies and moderate-certainty evidence that two therapies provide a clinically important benefit in improving disease activity compared to placebo for people with rheumatoid arthritis after failure of b/ts DMARD therapy. There was significant uncertainty surrounding treatment-related harms, with the evidence having been downgraded for serious or extremely serious imprecision. Pair-wise comparisons showed no significant differences among therapies, although the certainty of evidence was low. The lack of clarity regarding safety and comparative efficacy suggests that treatment decisions should be guided by individual patient characteristics and preferences.

FUNDING: This work was supported by grants from the Canadian Institutes for Health Research (CIHR) [Funding Reference Numbers (FRN) 178375 and 180324] and the National Health and Medical Research Council (NHMRC) Cochrane Collaboration. This research was supported by Arthritis Society Canada (Doctoral Studentship TGP-23-0211).

REGISTRATION: This study was outlined in a Cochrane protocol (CD013562; DOI 10.1002/14651858.CD013562).

PMID:42440279 | DOI:10.1002/14651858.CD013562.pub2

Otol Neurotol. 2026 Aug 1;47(7):860-867. doi: 10.1097/MAO.0000000000004933. Epub 2026 May 1.

ABSTRACT

OBJECTIVE: To evaluate whether cochlear implantation reduces listening-related fatigue in children with unilateral hearing loss.

STUDY DESIGN: Prospective within-subjects crossover study.

SETTING: Three academic medical centers specializing in pediatric cochlear implantation.

METHODS: Fatigue was assessed using the Vanderbilt Fatigue Scale and PedsQL™ 3.0 Multidimensional Fatigue Scale. Parent- and child-reported versions were completed after consecutive days of baseline cochlear implant use and following a three-day discontinuation during a holiday break. Paired t-tests compared conditions (P <0.05). Univariable regressions examined associations with age, sex, and deafness duration. Intraclass correlation coefficients assessed parent-child agreement.

RESULTS: Of 69 eligible patients, 37 responded; 18 declined due to reluctance to discontinue CI use. Nineteen children (mean age 8.6 y, 26.3% male, mean deafness duration 3.4 y) completed the study. Parent-reported fatigue significantly worsened after implant non-use in mental (P=0.01) and physical domains (P=0.04) on the Vanderbilt scale, and in cognitive fatigue (P=0.03) on the PedsQL. Child-reported scores trended toward greater fatigue during non-use, though not statistically significant. Younger age and male sex were associated with higher fatigue in parent reports. Intraclass correlation coefficients indicated moderate to good parent-child agreement.

CONCLUSION: Cochlear implantation alleviates listening-related fatigue in children with unilateral hearing loss, particularly in cognitive and physical domains as perceived by parents. Fatigue represents a clinically meaningful, non-audiological outcome in candidacy assessment and postoperative evaluation.

PMID:42440270 | DOI:10.1097/MAO.0000000000004933

Cell Biochem Biophys. 2026 Jul 13. doi: 10.1007/s12013-026-02117-w. Online ahead of print.

ABSTRACT

This research aims to explore the human-like taste response of three bitter molecules (chloroquine, denatonium, and saccharin) on the human bronchi receptor T2R agonist using a statistical physics approach. By fitting the concentration-taste response curves, we estimate three model parameters (R_M, n, C_1/2) to assess the intermolecular interactions with T2R receptor sites. In addition, the transduction coefficient (α) of the three tasting molecules has been determined. This analysis provides valuable insights into the binding energy spectrum (AES) and establishes a common gustatory band for the bitter tastes, with adhesive energies distributed over a relatively wide range (2.5-22.5 kJ mol⁻¹). In addition, molecular docking simulations were conducted, revealing that denatonium exhibits stronger binding affinities (28.87 kJ/mol) with the T₂R₁₀ human taste receptor site compared to chloroquine (26.78 kJ/mol). Conversely, saccharin displayed a binding affinity of approximately 23.85 kJ/mol with the binding pocket of the T₂R₃₁ ion channel receptors. This three molecules undergoes theoretical analysis using the DFT/B3LYP/6-311 G(d, p) basis set to determine its frontier orbital features and stability. The type and strength of interactions were identified using the topological parameters of the “Atoms in Molecules” (AIM) method, NCI analysis was used to study intra- and intermolecular noncovalent interactions within a molecular system, as well as natural bond orbital (NBO) analysis. NBO analyses indicate that all three tasting molecules exhibits significant stability. NCI interaction analyses indicate that Van der Waals forces and steric effects are observed in the three tasting molecules. 3D shaded potential surface revealed a projection of LOL examination and the electron localization function (ELF) indicated that an area of electron depletion is observed in the three tasting molecules.

PMID:42440246 | DOI:10.1007/s12013-026-02117-w

Clin Rheumatol. 2026 Jul 13. doi: 10.1007/s10067-026-08131-w. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to describe the clinical characteristics of patients with progressive pulmonary fibrosis (PPF) in systemic sclerosis (SSc)-associated interstitial lung disease (ILD) and to explore factors associated with PPF.

METHODS: Medical records of patients with SSc who visited Seoul St. Mary’s Hospital between April 2015 and March 2025 were retrospectively reviewed. PPF in SSc-ILD was defined as a relative decline in predicted forced vital capacity (FVC) ≥ 10% within 24 months. Clinical characteristics and outcomes were compared using logistic regression and survival analyses.

RESULTS: Among 319 patients with SSc evaluated with thoracic CT, ILD was identified in 168 (52.7%). Of the 140 patients with SSc-ILD who had serial spirometry, 27 (19.3%) developed PPF. Patients with PPF exhibited digital gangrene (25.9% vs. 8.8%, P = 0.02), pulmonary hypertension (40.7% vs. 20.0%, P = 0.04), and mixed NSIP-UIP (11.1% vs. 1.8%, P = 0.049) more frequently than those without PPF. Treatment with methotrexate (37.0% vs. 15.0%, P = 0.01) and nintedanib (18.5% vs. 1.8%, P = 0.003) was also more prevalent. None of the variables remained statistically significant in the multivariable analysis, and overall survival did not differ between patients with and without PPF.

CONCLUSION: In patients with SSc-associated ILD, PPF was associated with prominent vascular manifestations and mixed NSIP-UIP. These findings underscore the heterogeneity of SSc-ILD and highlight the importance of close and longitudinal pulmonary function monitoring to identify disease progression. Key Points • ILD is common in systemic sclerosis, and a subset of patients with SSc-ILD develop PPF. • Patients with PPF more frequently exhibit vascular manifestations and distinct radiologic features, including mixed NSIP-UIP. • Regular longitudinal monitoring with pulmonary function tests is essential for early detection of disease progression in SSc-ILD.

PMID:42440242 | DOI:10.1007/s10067-026-08131-w

J Endocrinol Invest. 2026 Jul 13. doi: 10.1007/s40618-026-02984-3. Online ahead of print.

ABSTRACT

BACKGROUND: Testicular adrenal rest tumors (TARTs) are benign, hormonally responsive testicular lesions in male patients with congenital adrenal hyperplasia (CAH). TARTs represent a leading contributor to gonadal dysfunction and infertility in this population. This study aimed to investigate the clinical and genetic characteristics of TARTs and to identify clinical indicators that may facilitate their early detection.

METHODS: A retrospective cohort study included 38 male patients with biochemically and molecularly confirmed CAH who were followed at our pediatric endocrinology clinic between January 2019 and January 2025. Demographic characteristics, underlying enzymatic defects, CYP21A2 and CYP11B1 genotype, clinical phenotype, hormonal profiles-including adrenocorticotropic hormone (ACTH) and 17-hydroxyprogesterone (17-OHP) concentrations-pubertal status, skeletal maturation as assessed by bone age, and scrotal ultrasonographic findings were systematically retrieved from medical records and analyzed.

RESULTS: TARTs were identified in 14 of 38 patients, corresponding to a prevalence of 36.8%. Of the affected individuals, 12 (85.7%) harbored 21-hydroxylase deficiency and 2 (14.3%) had 11β-hydroxylase deficiency. No statistically significant differences were observed in ACTH or 17-OHP levels between patients with and without TART (p = 0.75 and p = 0.36, respectively). TARTs were significantly more prevalent among patients with the salt-wasting phenotype relative to other clinical forms (p = 0.002) and among pubertal compared with prepubertal patients (p = 0.016). Skeletal maturation, as reflected by bone age advancement, was significantly more pronounced in the TART-positive group (p = 0.012). Multivariable logistic regression analysis identified bone age advancement (OR = 1.76; 95% CI: 1.10-2.83; p = 0.019) and pubertal status (OR = 12.5; 95% CI: 1.7-91.6; p = 0.013) as factors independently associated with the presence of TART.

CONCLUSIONS: Bone age advancement was independently associated with the presence of TART and may represent a clinically useful marker associated with TART in male patients with CAH. These findings suggest that bone age assessment may complement isolated hormonal measurements and may help identify patients who could benefit from closer ultrasonographic surveillance. Early detection and timely therapeutic intervention remain important for preserving gonadal function and future fertility.

PMID:42440236 | DOI:10.1007/s40618-026-02984-3

Radiol Med. 2026 Jul 13. doi: 10.1007/s11547-026-02260-7. Online ahead of print.

ABSTRACT

PURPOSE: Clinical application of late iodine enhancement (LIE) for myocardial scar identification is limited by low contrast-to-noise ratio (CNR). Photon-counting detector-CT (PCD-CT) can improve image quality providing spectral information and low image noise. The aim of the study was to assess the impact of spectral analysis and reconstruction parameters on LIE image quality using PCD-CT.

MATERIAL AND METHODS: This single-center retrospective study included 74 patients undergoing PCD-CT between May 2024 and July 2025 for myocardial scar evaluation. Images from patients with visible LIE were reconstructed using four parameter combinations (Qr40 and Qr36 kernels; 0.4-mm and 2-mm slice thickness) and analyzed at monoenergetic levels (40-120 keV, 10 keV increment) using a dedicated workstation. CNR and signal-to-noise ratio (SNR) were calculated for each reconstruction.

RESULTS: Among 74 patients, 41 (55%) had myocardial scar (M:F 32:9; 62 years [IQR,56-71]) and 24/41 (59%) had an implantable cardioverter defibrillator (ICD). Scars were predominantly transmural (21/41, 51%). A 40-keV VMI achieved the highest CNR and SNR, regardless of reconstruction parameters (p < 0.05), with median CNR of 5.36 [IQR, 4.07-6.88] using 2-mm slice thickness and Qr36 kernel. Scar pattern, ICD, and BMI did not significantly affect either CNR or SNR (p > 0.05). In the exploratory subgroup of 16 patients undergoing LGE-MRI, CNR is not statistically different between LIE-CT at 40 keV with 2-mm slice thickness from LGE-MRI (5.36 [IQR,4.07-6.88] vs. 8.04 [IQR,6.67-9.89]; p = 0.178).

CONCLUSION: PCD-CT LIE demonstrated the highest CNR at 40-keV VMI with 2-mm slice thickness, regardless of scar pattern, BMI, or ICD presence.

PMID:42440227 | DOI:10.1007/s11547-026-02260-7

Bull Math Biol. 2026 Jul 13;88(8):135. doi: 10.1007/s11538-026-01702-7.

ABSTRACT

This paper provides a rigorous mathematical resolution of the open global stability problem for a “shock-and-kill” model of HIV-1/SIV infection in brain reservoirs recently formulated by Roda et al. (2021). The model explicitly incorporates the effects of latency-reversing agents and enhanced immune clearance of reactivated cells. We derive an explicit formula for the basic reproduction number $R_0$ , which serves as the sole threshold parameter governing viral eradication versus persistence and integrates infection pathways from both productive and latent compartments. By combining the next-generation matrix approach with an extended graph-theoretic Lyapunov method for multigraphs with parallel arcs, we rigorously establish that the disease-free equilibrium is globally asymptotically stable when $R_0\le 1$ , whereas a unique productive equilibrium exists and is globally asymptotically stable when $R_0>1$ . To resolve the sign-indefinite quadratic perturbations induced by structurally distinct parallel transmission arcs-a fundamental bottleneck of classical graph-theoretic Lyapunov schemes-we develop a refined composite Lyapunov framework equipped with hierarchically calibrated parameters. Systematic asymptotic scaling and multi-parameter tuning eliminate indefinite cyclic quadratic interactions, securing strict negative definiteness of the Lyapunov derivative and overcoming key limitations of conventional graph-based methods. These global stability results provide a definitive mathematical answer to whether therapeutic interventions guarantee viral eradication or lead to persistent brain-reservoir infection. Furthermore, they furnish a rigorous theoretical foundation for the “shock-and-kill” strategy and establish mathematically precise conditions to guide the design of safe, effective interventions for eliminating HIV-1/SIV from CNS reservoirs.

PMID:42440225 | DOI:10.1007/s11538-026-01702-7

Eur J Clin Microbiol Infect Dis. 2026 Jul 13. doi: 10.1007/s10096-026-05593-3. Online ahead of print.

ABSTRACT

BACKGROUND: Cellulitis is a common cause of hospital admission, yet the clinical relevance and predictors of bacteremia remain incompletely characterized. Identifying patients at risk of bloodstream infection may help optimize diagnostic strategies and clinical management.

METHODS: We conducted a retrospective observational study at a tertiary-care hospital including all consecutive patients hospitalized with cellulitis between January 2019 and December 2024. Patients without blood cultures were excluded. Clinical severity was stratified using the CREST classification. Microbiological data, antibiotic therapy, hospital outcomes, and follow-up at 1 and 3 months were analyzed.

RESULTS: Among 311 episodes included, bacteremia was confirmed in 46 cases (14.8%). Patients with bacteremia showed significantly higher clinical severity at admission, with CREST grades III-IV present in 56.5% compared with 36.6% in non-bacteremia patients (p < 0.001). Sepsis occurred in 65.2% of bacteremia cases versus 24.5% of non-bacteremia cases (p < 0.001). Bacteremia was associated with longer hospital stay (18 ± 18.3 vs 13 ± 9.7 days; p = 0.003) and more frequent antibiotic modifications during admission (p = 0.023). Streptococcal species and Staphylococcus aureus showed a higher propensity for bloodstream invasion. In-hospital mortality was higher among bacteremia patients (13.0% vs 7.9%), although the difference was not statistically significant. Three-month mortality reached 14.3% in the bacteremia group compared with 9.9% in non-bacteremia patients.

CONCLUSION: Bacteremia complicating cellulitis is uncommon but associated with greater clinical severity, longer hospitalization, and increased therapeutic complexity. Severity stratification tools such as CREST may assist in identifying patients at increased risk of bacteremia; however, given their limited discriminatory performance, they should not be used in isolation to guide blood culture collection or other clinical decisions.

PMID:42440220 | DOI:10.1007/s10096-026-05593-3

Discov Ment Health. 2026 Jul 13. doi: 10.1007/s44192-026-00536-y. Online ahead of print.

ABSTRACT

BACKGROUND: Mental health disorders including depression, anxiety, and substance use disorders affect an estimated 150 million people across Africa, yet services remain grossly under-resourced and largely inaccessible. In many settings, including Nigeria, limited awareness, stigmatizing attitudes, and suboptimal mental health practices further compound the burden. This study assessed knowledge, attitudes, and practices (KAP) toward mental health among adults in northwest Nigeria.

METHODS: We conducted a community-based cross-sectional study in Jigawa State, northwest Nigeria, guided by the classical Knowledge-Attitude-Practice (KAP) framework. A total of 398 adults were recruited using a multistage sampling technique. Data were collected through a combination of online surveys and interviewer-administered questionnaires. Statistical analyses were performed using IBM SPSS version 22.0, with significance set at p ≤ 0.05.

RESULTS: Participants had a mean age of 34.5 ± 8.2 years (range: 18-65), with 83.9% aged 25-45 years. Although 70.9% demonstrated adequate mental health knowledge, attitudes and practices were considerably poorer. Less than half expressed willingness to interact comfortably with individuals living with mental illness (43.2%), believed they could lead productive lives (44.2%), or had ever sought professional help for mental or emotional concerns (43.7%). Only 34.7% rejected the notion that individuals with mental illness are inherently dangerous, and just 20.4% would permit their children to interact with someone experiencing mental illness. Overall, 48.5% exhibited positive attitudes, and 46.7% reported satisfactory practices. Female sex independently predicted both knowledge and attitudes. Females were twice as likely as males to have adequate knowledge (aOR = 2.0; 95% CI: 1.1-3.6) and nearly twice as likely to demonstrate positive attitudes (aOR = 1.9; 95% CI: 1.1-3.5). Prior hospitalization and known family history of mental illness were significantly associated with more favorable attitudes. Residence in the southwest senatorial zone independently predicted satisfactory practices (aOR = 0.4; 95% CI: 0.2-0.9), while absence of prior mental illness was associated with lower odds of appropriate practices (aOR = 0.4; 95% CI: 0.2-0.9). Knowledge scores demonstrated moderate positive correlations with both attitudes (r = 0.4, p < 0.001) and practices (r = 0.4, p < 0.001).

CONCLUSION: Despite relatively adequate levels of knowledge, attitudes and practices toward mental health remain suboptimal among adults in northwest Nigeria. Consistent with the classical KAP framework, knowledge was positively associated with both attitudes and practices. Strengthening community-level mental health literacy, reducing stigma, and expanding accessible services are urgently needed to translate knowledge gains into improved behavioral outcomes.

PMID:42440215 | DOI:10.1007/s44192-026-00536-y

Drugs Real World Outcomes. 2026 Jul 13. doi: 10.1007/s40801-026-00568-4. Online ahead of print.

ABSTRACT

BACKGROUND: Rare cases of myocarditis and pericarditis following mRNA coronavirus disease-19 (COVID-19) vaccination have been reported, primarily among males under 30 years of age. Although the underlying mechanisms remain unclear, cardiovascular risk factors such as hypertension, diabetes, dyslipidemia, and obesity have been hypothesized as potential contributors. Using the Vaccine Adverse Event Reporting System (VAERS), this study investigated whether these comorbidities were disproportionately reported among young adult males with myocarditis or pericarditis following mRNA COVID-19 vaccination compared with vaccinated and general populations. Additionally, this study represents a novel application of disproportionality principles in spontaneous reporting databases to explore, beyond signal detection, the factors that might be associated with the occurrence of an adverse event.

METHODS: An observed-versus-expected analysis was conducted using reports of myocarditis or pericarditis following mRNA COVID-19 vaccination among males aged 18-30 recorded in VAERS between 2021 and 2022. The prevalence of hypertension, diabetes, dyslipidemia, and obesity among reported cases was compared with prevalence estimates derived from epidemiological studies of vaccinated populations and national population statistics. In addition, disproportionality analyses were performed using comparator groups consisting of reports associated with other vaccines and other adverse events following immunization (AEFIs) within VAERS.

RESULTS: A total of 859 eligible reports of myocarditis/pericarditis following mRNA COVID-19 vaccination were identified among males aged 18-30. The prevalence of hypertension, diabetes, dyslipidemia, and obesity was 0.35%, 0.58%, 0.81%, and 1.75%, respectively and was significantly lower than those reported in vaccinated and prepandemic general populations. In disproportionality analyses, myocarditis/pericarditis reports following mRNA vaccination showed higher prevalence of dyslipidemia and obesity, but lower prevalence of hypertension, compared with selected VAERS comparator groups. However, absolute comorbidity prevalence remained low across all groups.

CONCLUSIONS: No evidence of a modifying role for hypertension, diabetes, dyslipidemia, or obesity was observed for the increased reporting of myocarditis/pericarditis among young adult males following mRNA COVID-19 vaccination. Despite the limitations inherent to spontaneous reporting systems, this study highlights a novel application of disproportionality-based approaches within VAERS to explore potential risk modifiers of vaccine-related adverse events in a hypothesis-generating manner.

PMID:42440199 | DOI:10.1007/s40801-026-00568-4