Annals of the American Thoracic Society最新文献

{"title":"The Flavor Conundrum: How E-Cigarette Additives Recruit Kids, Harm Lungs, and Stall Policy.","authors":"Ilona Jaspers","doi":"10.1093/annalsats/aaoag271","DOIUrl":"https://doi.org/10.1093/annalsats/aaoag271","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868337","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":"Temporal trends and mortality in tracheobronchial stenting in the United States: a national cohort study.","authors":"Max T Wayne, Jeffery Thiboutot, Christopher M Kapp, Lonny B Yarmus, Fabien Maldonado, Hallie C Prescott","doi":"10.1093/annalsats/aaoag080","DOIUrl":"10.1093/annalsats/aaoag080","url":null,"abstract":"<p><strong>Background: </strong>Recently published guidelines suggest tracheobronchial stenting for palliating symptomatic central airway obstruction (CAO) that is not amenable to definitive surgical intervention. However, population-based data on the use of tracheobronchial stenting for CAO are lacking.</p><p><strong>Methods: </strong>This is an observational cohort study of adults who underwent tracheobronchial stenting while hospitalized using the National Inpatient Sample (2016-2022), which represents 97% of all acute care hospitalizations in the United States. The primary outcome of interest was the annual incidence of tracheobronchial stenting per 100 000 residents. Separately, to determine the proportion of procedures performed during inpatient hospitalization as opposed to as an ambulatory procedure, we used the State Inpatient Databases and State Ambulatory Surgery and Services Databases across 6 states in 2019 (which include data for individual states).</p><p><strong>Results: </strong>Among all hospitalizations in the United States from 2016 to 2022, 0.71 hospitalizations per 100 000 residents received tracheobronchial stenting (95% CI, 0.66-0.76), increasing from 0.58 in 2016, peaking at 0.77 in 2021, and 0.67 in 2022. Among hospitalized patients who received tracheobronchial stenting, 69.7% had a diagnosis of malignancy and 12.3% died before discharge. The proportion of patients undergoing tracheobronchial stenting with a diagnosis of malignancy increased from 65.9% in 2016 to 74.6% in 2022. In-hospital mortality among patients receiving tracheobronchial stenting during hospitalization increased from 11.3% in 2016 to 12.7% in 2022. In 2019, across 6 geographically diverse states in the United States, 73.3% of tracheobronchial stenting procedures were performed during inpatient hospitalizations.</p><p><strong>Conclusion: </strong>Tracheobronchial stenting incidence and mortality for CAO have both increased over time. Regional variation and high in-hospital mortality highlight the need to better define indications and track outcomes of tracheobronchial stenting in patients with CAO.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1296-1303"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730866","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 PRECIsE study: a prospective, multicenter study of shape-sensing robotic-assisted bronchoscopy with 2 years of follow-up.","authors":"David E Ost, Erik E Folch, Janani S Reisenauer, Adnan Majid, Roberto F Casal, Colleen Keyes, Mihir S Parikh, Javier Diaz-Mendoza, Sebastian Fernandez-Bussy, Michael J Simoff","doi":"10.1093/annalsats/aaoag049","DOIUrl":"10.1093/annalsats/aaoag049","url":null,"abstract":"<p><strong>Rationale: </strong>Guidelines recommend nonsurgical biopsy for indeterminate pulmonary lesions >8 mm. Shape-sensing robotic-assisted bronchoscopy (ssRAB) is growing in use to biopsy small pulmonary nodules; however, current literature is limited to single-center studies with limited follow-up.</p><p><strong>Objectives: </strong>This study, PRECIsE, assessed safety and performance of the first ssRAB iteration across multiple sites and nascent users.</p><p><strong>Methods: </strong>This was a prospective, multicenter, observational study evaluating ssRAB without cone-beam computed tomography guidance in patients with nodules 10 to 30 mm located in or beyond the sub-segmental airways. Patients were followed for 2 years; the primary endpoint was sensitivity for malignancy with diagnostic yield, and safety as secondary endpoints. Multilevel logistic regression models were used to control for factors associated with sensitivity and diagnostic yield.</p><p><strong>Results: </strong>A total of 305 procedures were performed across 6 centers. Median nodule size was 17.0 mm (IQR, 14.0-23.0) with bronchus sign present in 37% of cases. Sensitivity for malignancy through 2 years was 81.3% (95% CI, 75.7%-86.1%). Multilevel modeling demonstrated that female sex, smaller nodule size, lower lobe location, semi-solid density, and higher body mass index were associated with lower sensitivity. Diagnostic yield was 74.1% (95% CI, 68.8%-78.9%) according to the American Thoracic Society/American College of Chest Physicians (ATS/ACCP) criteria and 77.5% (95% CI, 72.4%-81.8%) according to the intermediate criteria. Multilevel modeling demonstrated a nonsignificant site/center-level effect on ATS/ACCP diagnostic yield (P = .36). Pneumothorax requiring intervention was 1.6% (5/305); bleeding was 1.0% (3/305) with 2 Nashville grade 2 events and one Nashville grade 3 event.</p><p><strong>Conclusions: </strong>The first iteration of ssRAB demonstrated encouraging performance and a strong safety profile among nascent users for the biopsy of small peripheral nodules.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1360-1368"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147346093","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":"Endoscopic En-bloc Resection of Transmural Schwannoma and Granular Cell Tumor: A Two-Case Video Report.","authors":"Taeho Youn, Boram Lee, Joungho Han, Byeong-Ho Jeong","doi":"10.1093/annalsats/aaoag266","DOIUrl":"https://doi.org/10.1093/annalsats/aaoag266","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876821","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":"Safety and efficacy of elexacaftor/tezacaftor/ivacaftor in adolescents and adults with cystic fibrosis and F508del-gating and F508del-residual function genotypes: results from an open-label extension study.","authors":"James F Chmiel, Kimberly McBennett, Bradley S Quon, Carla Colombo, Elke De Wachter, Isabelle Fajac, Pedro Mondejar-Lopez, Deepika Polineni, Philip Robinson, Sivagurunathan Sutharsan, Marcus A Mall, Edward F McKone, Bonnie Ramsey, Jennifer L Taylor-Cousar, Elizabeth Tullis, Nina E Suresh, Yaohua Zhang, Patrick Sosnay, Mark Jennings, Peter J Barry","doi":"10.1093/annalsats/aaoag053","DOIUrl":"10.1093/annalsats/aaoag053","url":null,"abstract":"<p><strong>Rationale: </strong>In an 8-week, active-controlled, phase 3 study (445-104), elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA) was shown to be efficacious and safe in participants ≥ 12 years of age with cystic fibrosis (CF) and F508del-gating (F/G) or F508del-residual function (F/RF) genotypes, conferring additional clinical benefits relative to IVA and TEZ/IVA. Participants who completed this 8-week parent study continued to an open-label extension.</p><p><strong>Objective: </strong>To assess the long-term safety and efficacy of ELX/TEZ/IVA in adolescents and adults with CF and F/G or F/RF genotypes.</p><p><strong>Methods: </strong>This 2-part (Part A [96 weeks] and Part B [48 weeks]) phase 3 open-label extension study enrolled adolescents and adults age ≥ 12 years with CF and F/G or F/RF genotypes who completed study 445-104. Primary endpoint (Part A and Part B) was safety and tolerability. Secondary endpoints (Part A only) included absolute changes in percent predicted FEV1 (ppFEV1), sweat chloride concentration, CF Questionnaire-Revised (CFQ-R) respiratory domain score, and body mass index (BMI).</p><p><strong>Results: </strong>A total of 251 participants received ≥ 1 dose of ELX/TEZ/IVA in Part A; 217 (86.5%) completed treatment. In Part A, 96.0% of participants had ≥ 1 adverse event (AE), which for most were mild (32.3%) or moderate (55.0%) in severity. Thirteen participants (5.2%) discontinued due to treatment-emergent AEs. Participants who received ELX/TEZ/IVA in the parent study maintained improvements in ppFEV1, sweat chloride concentration, CFQ-R respiratory domain score, and BMI while participants who received IVA or TEZ/IVA (active controls) in parent study had similar improvements after transitioning to ELX/TEZ/IVA. Eighty-four participants (33.5%) entered Part B, 96.4% of whom discontinued due to commercial drug availability. In Part B, 62 participants (73.8%) had ≥ 1 AE, which for most were mild or moderate in severity and none of which led to discontinuation.</p><p><strong>Conclusions: </strong>ELX/TEZ/IVA remained generally safe and well-tolerated with no new safety findings. Improvements in lung function, CFTR function, respiratory symptoms, and nutritional status after starting ELX/TEZ/IVA were maintained through 96 weeks of follow-up. These results demonstrate the safety and durable efficacy of ELX/TEZ/IVA in adolescents and adults with F/G or F/RF genotypes.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1286-1295"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470169","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":"Longitudinal changes in body composition and obstructive sleep apnea severity among older men: the Osteoporotic Fractures in Men (MrOS) sleep study.","authors":"Raquel P Hirata, Tianyi Huang, Katie L Stone, Susan Redline, Pedro R Genta","doi":"10.1513/AnnalsATS.202506-576RL","DOIUrl":"10.1513/AnnalsATS.202506-576RL","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1374-1377"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294692","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":"Idiopathic inflammatory myopathy-related interstitial lung disease patients present to pulmonology: a tertiary center experience.","authors":"Andrea E Davis, Deja Wilson, Erica A Ludtke, Joao A De Andrade, Narender Annapureddy, Jennifer Young-Glazer, Adenrele A Olajide, Rosemarie B Dudenhofer, Justin C Hewlett, Erin M Wilfong","doi":"10.1093/annalsats/aaoag134","DOIUrl":"10.1093/annalsats/aaoag134","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1389-1392"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977770","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":"Elexacaftor-tezacaftor-ivacaftor for individuals with residual CFTR activity: an open-label, nonrandomized clinical trial.","authors":"Rachel W Linnemann, George M Solomon, Adrianna L Westbrook, Rachel Rich, Ashleigh Streby, Eric Hunter, Andras Rab, Shasha Bai, Carmel M McNicholas, Jeong S Hong, Candela Manfredi, William R Hunt, Arlene A Stecenko, Cristina Barillà, Shingo Suzuki, Brian R Davis, Eric J Sorscher","doi":"10.1093/annalsats/aaoag136","DOIUrl":"10.1093/annalsats/aaoag136","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1383-1388"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220959","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":"Low-dose vs standard-dose nintedanib at initiation in fibrosing interstitial lung disease: a target-trial emulation of treatment persistence and lung function.","authors":"Shota Kaburaki, Toru Tanaka, Koichiro Kamio, Yosuke Tanaka, Namiko Taniuchi, Kazuo Kasahara, Masahiro Seike","doi":"10.1093/annalsats/aaoag069","DOIUrl":"10.1093/annalsats/aaoag069","url":null,"abstract":"<p><strong>Background: </strong>Early intolerance to nintedanib may shorten time spent on treatment. Whether initiating treatment at 100 mg vs 150 mg twice daily improves treatment persistence for 12 months without compromising lung function is uncertain.</p><p><strong>Objectives: </strong>To estimate the effects of 100 mg vs 150 mg at initiation on 12-month time on treatment and ∼1-year lung function.</p><p><strong>Methods: </strong>An observational emulation of an individually randomized target trial in a single-center new-user cohort was conducted. Baseline confounding was addressed using stabilized inverse probability of treatment weighting (IPTW) with 1st to 99th percentile trimming. The primary estimand was the difference in the restricted mean time on treatment (RMST) over 12 months. Key secondary estimands were the IPTW-adjusted absolute risk difference (RD) in 12-month treatment discontinuation (accounting for competing death) and the mean difference in change in forced vital capacity (ΔFVC) %predicted at ∼12 months among survivors. Uncertainty was quantified by patient-level bootstrapping.</p><p><strong>Results: </strong>Among 172 initiators (100 mg, n = 94; 150 mg, n = 78), 100-mg initiation extended the 12-month RMST by 52.9 days (95% CI, 11.8-97.1 days) and decreased the 12-month discontinuation risk (cumulative incidence function, 0.135 vs 0.281; RD, 0.146). The ΔFVC %predicted was broadly similar among survivors, but the estimates were imprecise.</p><p><strong>Conclusions: </strong>In this target-trial emulation, starting at 100 mg twice daily improved 12-month treatment persistence. One-year FVC %predicted estimates among survivors were broadly similar but imprecise and should be interpreted with caution; a start-low, escalate-as-tolerated policy warrants prospective evaluation.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1304-1312"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147501009","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":"Natural course of untreated obstructive sleep apnea in adults with coronary artery disease in the RICCADSA cohort.","authors":"Yüksel Peker, Mustafa Saygin, Yeliz Celik, Beyza Demirci, Erik Thunström, Helena Glantz, Patrick J Strollo, Susan Redline, Baran Balcan","doi":"10.1093/annalsats/aaoag072","DOIUrl":"10.1093/annalsats/aaoag072","url":null,"abstract":"<p><strong>Rationale: </strong>Recent randomized controlled trials failed to show cardiovascular benefits of treating obstructive sleep apnea (OSA) in intention-to-treat analyses, which has been a matter of debate since publication of the results.</p><p><strong>Objectives: </strong>To address whether untreated OSA persists after 1 year in adults with coronary artery disease (CAD) following revascularization and to explore whether major cardiovascular and cerebrovascular events (MACCEs) differ between the patients who persist vs improve in OSA severity.</p><p><strong>Measurements: </strong>The study population included 119 CAD patients with moderate to severe OSA from the RICCADSA trial. All participants had an apnea-hypopnea index (AHI) ≥ 15/hour and were randomized to no continuous positive airway pressure (CPAP) therapy (n = 81) or were not using the device (n = 38). Patients without OSA (AHI < 5/h) at baseline (n = 85) were included as a control group. Home sleep apnea tests were performed at baseline and after 1 year.</p><p><strong>Main results: </strong>The median AHI decreased from 24.5 (19.4-36.0 events/h) to 15.1 (8.2-27.3 events/h) and oxygen desaturation index (4%) decreased from 14.8 (7.3-22.9 events/h) to 6.6 events/h (2.7-14.4 events/h) after 1 year (P < .001 for both). In all, 73 (61.3%) improved in OSA severity (59 had AHI 5-14.9 events/h and 14 had AHI < 5 events/h), whereas 46 (38.7%) had persistent OSA. The control group had a median AHI 4.4 (2.9-7.9 events/h) after 1 year. N-terminal-pro-B-type natriuretic peptide values decreased significantly in the overall cohort, with similar directional trends across OSA trajectory groups. The patients with improvement in OSA had significantly lower risk for MACCEs (hazard ratio [HR] = 0.25, 95% CI, 0.08-0.76; P = .015) compared to the patients with persistent OSA.</p><p><strong>Conclusions: </strong>Most of the CAD patients with moderate to severe OSA improve in OSA severity 1 year after revascularization, probably due to the improved cardiac function, and have a decreased risk for MACCEs compared to individuals with persistent OSA. Identifying patients with persistent OSA after revascularization may help target those most likely to benefit from focused intervention, particularly in settings where CPAP therapy is not initiated or is poorly tolerated.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1337-1348"},"PeriodicalIF":5.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663631","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}