Annals of the American Thoracic Society最新文献

{"title":"Xe MRI Detects Ongoing Ventilation Improvements in People with Cystic Fibrosis Receiving Highly Effective Modulator Therapy.","authors":"Riaz Hussain, Bilal I Masokano, Joseph W Plummer, Abdullah S Bdaiwi, Matthew M Willmering, Elizabeth L Kramer, Laura L Walkup, Zackary I Cleveland","doi":"10.1513/AnnalsATS.202505-497RL","DOIUrl":"10.1513/AnnalsATS.202505-497RL","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endobronchial Ultrasound Guided Sampling: Diagnostic Yield of Needle Biopsy and Cryobiopsy in Addition to Needle Aspiration.","authors":"Jason Beattie, Hamad Nasim, Jacqueline Chen, Annika Bharwani, Juan Lara, Raymond Parrish, Kai Swenson, Mihir Parikh, Kirill Karlin, Paul A VanderLaan, Adnan Majid","doi":"10.1513/AnnalsATS.202502-223OC","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202502-223OC","url":null,"abstract":"<p><strong>Background: </strong>Endobronchial ultrasound (EBUS) guided sampling for evaluation of benign conditions and lymphoma is not standardized. Sampling methods remain under study as new tools become available.</p><p><strong>Methods: </strong>We performed a single center study with protocolized sampling and processing to evaluate the diagnostic utility of transbronchial needle aspiration (TBNA), Franseen needle biopsy (TBNB), and cryobiopsy in patients with mediastinal and hilar abnormality with concern for sarcoid, lymphoma, or undifferentiated lymphadenopathy. Following TBNA, exploratory sampling was performed. A tract was created with a TBNB needle pass followed by cryobiopsy. Sampling was subsequently alternated for a total of 3 passes per tool. The primary outcome was diagnostic yield-using a strict criterion modeled from recent ATS/ACCP guidelines. Secondary outcomes included procedural outcomes and pathologic assessment of TBNB and cryobiopsy samples.</p><p><strong>Results: </strong>Between January and December 2024, 56 nodes were sampled in 51 patients. The overall diagnostic yield per node was 86% (48/56). Regarding individual tools, the yield was 50% for TBNA, 73% for TBNB, and 82% for cryobiopsy (p=0.0001 TBNA vs cryobiopsy; p=0.006 TBNA vs TBNB; p=0.13 TBNB vs cryobiopsy). In subgroup analysis, TBNB and cryobiopsy enhanced diagnostic yield in benign conditions (TBNA- 59%, TBNB-88%, and cryobiopsy-100%; p=0.002 TBNA vs cryobiopsy, p=0.01 TBNA vs TBNB, p=0.11 TBNB vs cryobiopsy). For lymphoma, the diagnostic yield per node was 3/10 for TBNA, 5/10 for TBNB, and 6/10 for cryobiopsy (p=.001 TBNA vs cryobiopsy, p=0.1 TBNA vs TBNB, p=0.1 TBNB vs cryobiopsy). Upon pathology review, TBNB provided larger samples compared to cryobiopsy however TBNB samples contained a larger proportion of blood; these differences translated to similar resultant areas of diagnostic tissue for both tools. Sample usage for immunohistochemistry and special staining was higher for cryobiopsy (61%) vs TBNB (33%). Study sampling was feasible in all patients with a 2% complication rate (1 pneumothorax).</p><p><strong>Conclusion: </strong>Both TBNB and cryobiopsy provide intact histologic sampling that enhance the diagnostic yield of EBUS TBNA in benign conditions. Multiple passes with three biopsy tools at an individual lymph node is safe and feasible. Cryobiopsy provides superior sample quality relative to TBNB and superior yield vs TBNA in lymphoma.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence Rate and Prevalence of Idiopathic Pulmonary Fibrosis in the United States 2017-2022.","authors":"Yanni Fan, Haikun Bao, Pratik Pimple, Amy L Olson, Steven D Nathan","doi":"10.1513/AnnalsATS.202503-262OC","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202503-262OC","url":null,"abstract":"<p><p><b>Rationale</b> Idiopathic pulmonary fibrosis (IPF) is an incurable chronic progressive fibrotic lung disease with median survival of 3-5 years from diagnosis. Estimates of incidence rate and prevalence of IPF are outdated and vary widely due to differences in study methodology and diagnostic definitions. <b>Objectives</b> To provide an up-to-date estimate of IPF incidence rates and prevalence and describe the comorbidity burden for people with IPF in the United States (US). <b>Methods</b> This non-interventional retrospective study used claims data from the Optum^® Clinformatics^® Data Mart database from 2017 to 2022. Individuals were required to have at least 365-day continuous enrollment in the database to enter the study. Individuals with IPF were identified based on claims with the International Classification of Diseases, Tenth Revision code for IPF (J84.112) following study entry. IPF definitions varied by requirement for one or two qualifying IPF claims and computed tomography scan of the chest and/or lung biopsy. In this analysis, three primary case definitions and two sensitivity analysis definitions were used to identify individuals with IPF. <b>Results</b> By primary case definitions, the overall crude and age- and sex-adjusted incidence rates (per 100,000 person-years) were 14.5-26.1 and 9.8-18.4, respectively; the crude and adjusted prevalences (per 100,000 persons) were 46.3-88.9 and 34.4-67.1, respectively. Incidence rate and prevalence increased markedly with age and varied with ethnicity and region. The most frequent comorbidities were systemic hypertension, chronic obstructive pulmonary disease, and coronary artery disease. <b>Conclusions</b> This study provides an up-to-date summary of the incidence rate and prevalence of IPF in the US and shows a substantial burden of comorbidities among patients diagnosed with IPF.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home Blood Pressure Trajectories During 6 Months of Continuous Positive Airway Pressure Therapy: Results from the eMEUSE-SANTE and SLEEPCONNECT Clinic.","authors":"Ophélie Coiffier, Sébastien Bailly, Marie Joyeux-Faure, Renaud Tamisier, Khier Amrani, Jean-Claude Cornu, Thibaut Gentina, Robin Terrail, Christian Caussé, Carolina Lombardi, Martino F Pengo, Gianfranco Parati, Jean-Louis Pépin","doi":"10.1513/AnnalsATS.202505-504OC","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202505-504OC","url":null,"abstract":"<p><strong>Rationale: </strong>Obstructive sleep apnea (OSA) and hypertension are common comorbidities, and are associated with poor prognosis. Blood pressure (BP) trajectories using home BP monitoring (HBPM) after initiation of continuous positive airway pressure (CPAP) therapy for OSA are poorly documented.</p><p><strong>Objectives: </strong>To describe BP trajectories in the first 6 months after CPAP therapy initiation based on repeated longitudinal measurements of home BP, to evaluate the impact of CPAP on morning and evening home BP, and to identify predictors of home BP evolution during CPAP.</p><p><strong>Methods: </strong>This prospective cohort study enrolled patients with OSA. HBPM was used to assess morning and evening home BP values over a 7-day period at baseline, and over the first 6 months after starting CPAP therapy.</p><p><strong>Measurements and main results: </strong>98 patients were enrolled and 36,600 home BP measurements were available for analysis. Morning and evening systolic/diastolic home BP decreased significantly during the first 6 months of CPAP therapy (p<0.05 vs. baseline). Morning home BP was significantly higher than evening home BP throughout the study (p<0.01). After adjustment for OSA severity at baseline and CPAP adherence, factors associated with limited home BP response to CPAP were older age, weight gain during CPAP therapy, current smoking, and previous hypertension.</p><p><strong>Conclusions: </strong>CPAP improved home BP trajectories during the first 6 months but the response was heterogeneous and less marked for morning BP values. Based on the predictors of BP response during CPAP therapy, weight control appears key to the effective management of patients with OSA and hypertension.</p><p><strong>Clinical trial registration: </strong>NCT04963192 and NCT04054180.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse Drug Reactions During Nontuberculous Mycobacterial Pulmonary Disease Treatment: A Systematic Review and Meta-analysis.","authors":"Jihoon Kim, Jaehyun Oh, Young Ae Kang, Inkyung Jung, Jae Il Shin, Youngmok Park","doi":"10.1513/AnnalsATS.202412-1307OC","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202412-1307OC","url":null,"abstract":"<p><strong>Rationale: </strong>Nontuberculous mycobacterial pulmonary disease (NTM-PD) treatment involves the long-term administration of multiple drugs, often associated with adverse drug reactions (ADRs). However, the incidence and severity of ADRs during treatment are not fully understood.</p><p><strong>Objective: </strong>We performed a systematic review and meta-analysis of prospective studies reporting ADRs up to June 11, 2025, to assess the burden of ADRs during NTM-PD treatment.</p><p><strong>Methods: </strong>We evaluated the incidence rates of ADRs, medication discontinuation, and ADR-related deaths. Secondary outcomes included the clinical manifestations of ADRs and incidence rates according to the causative species.</p><p><strong>Results: </strong>In total, 8,061 studies were identified through database searches, 36 of which were included in the analysis, including 26 non-randomized prospective studies (1,784 patients) and 10 randomized controlled studies (1,511 patients). The overall ADR incidence rate was 59% (95% confidence interval CI, 39%-78%), with ADR-related drug discontinuation and death rates of 15% (95% CI, 10%-20%) and 2% (95% CI, 1%-3%), respectively. The clinical manifestation rates of ADRs ranged from 2% to 65%, with gastrointestinal symptoms being the most common. For the treatment of NTM-PD caused by Mycobacterium avium complex, the ADR incidence rate was 57% (95% CI, 31%-79%), whereas that for Mycobacterium abscessus was 39% (95% CI 15%-70%). The outcomes were similar between randomized and non-randomized studies.</p><p><strong>Conclusions: </strong>ADRs during NTM-PD treatment are notably frequent, leading to drug discontinuation and possible mortality. Clinicians should be vigilant of ADRs during NTM-PD management, and further research is required to alleviate their burden and improve outcomes.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity Paradox and Lung Cancer Mortality: The Contributing Roles of Airflow Limitation and Pre-COPD.","authors":"Robert P Young, Raewyn J Scott, Zhitian Wang, Gerard A Silvestri","doi":"10.1513/AnnalsATS.202505-499OC","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202505-499OC","url":null,"abstract":"<p><strong>Background: </strong>Increased body mass index (BMI, Kgm-2) has been consistently associated with reduced mortality from lung cancer, relative to low BMI, and termed the \"Obesity Paradox\". Whilst the basis of the obesity paradox remains unknown, mediating effects from sex, smoking status, diabetes mellitus (DM) and methodological issues (including bias), have been suggested causes. Our aim was to examine whether respiratory co-morbidity may contribute to this paradox.</p><p><strong>Methods: </strong>In this secondary analysis of 18,463 high-risk subjects participating in the National Lung Screening Trial (NLST), we examined factors contributing to lung cancer mortality (primary end-point) using stratification analyses and regression models according to baseline demographics, comorbidity, specifically respiratory-related comorbidity based on lung function and/or clinical history.</p><p><strong>Findings: </strong>With increasing BMI, both respiratory and lung cancer (LC) mortality decreased (P<0.001), consistent with the obesity paradox. However, increasing BMI was associated with a linear decrease in the prevalence of airflow limitation (halving) and linear increases in both Pre-COPD (2-fold) and DM (8-fold) across BMI septiles (all P<0.0001). In a sequentially-constructed competing risk model for LC death, and after adjustment for smoking, age, sex, BMI and other comorbidities, we found airflow limitation, Pre-COPD and DM remained significant predictors of increased LC death(p<0.01), albeit from opposite ends of the BMI continuum. When subjects with airflow limitation, Pre-COPD and DM were sequentially removed, the obesity paradox for LC mortality was substantially attenuated and almost abolished.</p><p><strong>Interpretation: </strong>We propose that the obesity paradox in high-risk ever smokers who develop lung cancer results, in large part, from the stronger deleterious effect of airflow limitation on LC mortality, with a lesser effect associated with DM-Pre-COPD, where each predominate at opposite ends of the BMI continuum.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Privacy and Dignity for Undocumented People? Clinicians' Duties and Responses to Patient Immigration Status Inquiries.","authors":"David M Chooljian, Aaron D Baugh, Erin DeMartino, Matthew Griffith, E Wesley Ely, Kathleen M Akgün","doi":"10.1513/AnnalsATS.202506-648IP","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202506-648IP","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Bethesda Declaration Demands Action by All Members of the Pulmonary, Critical Care, and Sleep Disciplines to Safeguard Public Health.","authors":"Stella Ogake, Gabriel T Bosslet, C Corey Hardin, Mary E Crocker","doi":"10.1513/AnnalsATS.202507-705IP","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202507-705IP","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variation in Lung Cancer Risk Distribution by Race Across Modified PLCO_m2012 Risk Models Among Lung Cancer Screening Participants.","authors":"Haley M Evans, Rebecca Landy, Christine S Shusted, Brooke Ruane, Eboni Anderson, Teresa Giamboy, Mary McMullen, Gregory C Kane, Hee-Soon Juon, Julie A Barta","doi":"10.1513/AnnalsATS.202503-284RL","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202503-284RL","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Clinical Characteristics of Persistent Airflow Limitation in the NOVELTY Cohort.","authors":"Richard Beasley, Rod Hughes, Alvar Agusti, Peter Calverley, Bradley Chipps, Ricardo Del Olmo, Alberto Papi, David Price, Hiromasa Inoue, Christer Janson, Maarten van den Berge, Helen Reddel, Hana Müllerová, Anastasios Mangelis, Eleni Rapsomaniki","doi":"10.1513/AnnalsATS.202412-1273OC","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202412-1273OC","url":null,"abstract":"<p><strong>Rationale: </strong>The clinical characteristics of persistent airflow limitation (PAL) were explored in patients aged ≥12 years with physician-assigned diagnoses of asthma, asthma plus chronic obstructive pulmonary disease (COPD), or COPD in the NOVEL Observational longiTudinal studY (NOVELTY) cohort. The NOVELTY study is a prospective study conducted in primary and secondary care in 18 countries.</p><p><strong>Objectives: </strong>To determine the proportion of patients with PAL at baseline, their baseline characteristics, and the stability and prognostic utility of PAL during follow-up.</p><p><strong>Methods: </strong>PAL was defined as post-bronchodilator forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) ratio less than the lower limit of the normal range (European Respiratory Society [ERS]/American Thoracic Society [ATS]) or as <0.7 (Global Initiative for Chronic Obstructive Lung Disease [GOLD] criteria).</p><p><strong>Results: </strong>We studied 9,081 patients over 3 years (asthma: 4,754; asthma+COPD; 1,147; COPD: 3,180). Baseline prevalence of PAL was 24.2% and 29.2% (asthma), 63.3% and 74.1% (asthma+COPD), and 65.4% and 75.8% (COPD) using ERS/ATS and GOLD criteria, respectively. Patients with PAL had markedly worse symptom burden and a history of more frequent moderate and severe exacerbations. In patients with asthma PAL was associated with higher blood eosinophils and fractional exhaled nitric oxide (FeNO) values; 60% had never smoked. Of patients with PAL at baseline 84% continued to meet PAL criteria at Year 3. Irrespective of physician diagnosis, PAL was a marker of increased risk of moderate and severe exacerbations and poor symptom control during the 3-year follow-up.</p><p><strong>Conclusions: </strong>PAL is a stable trait, associated with more severe disease and poor outcomes in adults with a physician-assigned diagnosis of asthma and/or COPD. Clinical Trial Registration (if any): NOVELTY: NCT02760329.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}