Evidence map›Paper›PMID 41642742›Full record

ArticleRespiration; international review of thoracic diseases2026

Sex-Specific Phenotypes and Outcomes in Non-Idiopathic Pulmonary Fibrosis Interstitial Lung Disease: Results from the INSIGHTS-ILD Registry.

Dirk Koschel, Francesco Bonella, Andreas Günther, Michael Kreuter, David Pittrow, Benjamin Seeliger, Christine Pausch, Dirk Skowasch, Heinrike Wilkens, Hubert Wirtz and 42 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Respiration; international review of thoracic diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

52 authors.

Dirk KoschelMedical Department I, Division of Pneumology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany, dirk.koschel@ukdd.de.
Francesco BonellaCenter for Interstitial and Rare Lung Diseases, Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany.
Andreas GüntherDepartment of Internal Medicine II, Center for Interstitial and Rare Lung Diseases, Biomedical Research Center Seltersberg (BFS), Justus Liebig University Giessen, Giessen, Germany.
Michael KreuterMainz Center for Pulmonary Medicine, Department of Pneumology, Mainz University Medical Center, Mainz, Germany.
David PittrowInstitute for Clinical Pharmacology, Technical University, Faculty of Medicine, Dresden, Germany.
Benjamin SeeligerDepartment of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Hannover, Germany.
Christine PauschInnovation Center Real-World Evidence, GWT-TUD GmbH, Dresden, Germany.
Dirk SkowaschDepartment of Internal Medicine II, University Hospital Bonn, Bonn, Germany.
Heinrike WilkensMedical Clinic V, Saarland University Medical Center, Homburg, Germany.
Hubert WirtzUniversity Hospital Leipzig, Leipzig, Germany.
Marlene HechtnerBoehringer Ingelheim Pharma GmbH and Co. KG, Medical Department, Ingelheim, Germany.
Heike BillerLungenClinic Großhansdorf, Großhansdorf, Germany.
Antje PrasseDepartment of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Hannover, Germany.
Christian GrohéGerman Center for Lung Research (DZL), Giessen, Germany.
Lars HagmeyerClinic for Pneumology and Allergology, Krankenhaus Bethanien, Solingen, Germany.
Stephan BudweiserMedical Clinic III, RoMed Klinikum Rosenheim, Rosenheim, Germany.
Ioana AndreicaRuhr University Bochum and Rheumazentrum Ruhrgebiet, Herne, Germany.
Ulrich NeffKlinikum Nürnberg, Nürnberg, Germany.
Sven GläserClinic for Internal Medicine - Pneumology, Vivantes Hospital, Berlin, Germany.
Martin SchwaiblmairDepartment of Internal Medicine, University Hospital Augsburg, Augsburg, Germany.
Peter SchrammLungenzentrum München, Klinikum Bogenhausen, München Klinik gGmbH, Munich, Germany.
Joachim MeyerLungenzentrum München, Klinikum Bogenhausen, München Klinik gGmbH, Munich, Germany.
Tobias VeitGerman Center for Lung Research (DZL), Giessen, Germany.
Marion FrankenbergerGerman Center for Lung Research (DZL), Giessen, Germany.
Wolfgang GesierichAsklepios Lungenklinik Gauting, Gauting, Germany.
Bernd SeeseThoraxzentrum Bezirk Unterfranken, Münnerstadt, Germany.
Achim GrünewaldtAlice Hospital Darmstadt, Darmstadt, Germany.
Philipp MarkartMedical Clinic V, Heart and Thorax Center Fulda, Fulda, Germany.
Michael WesthoffCenter for Pneumology and Thoracic Surgery, Hemer, Germany.
Matthias HeldKlinikum Würzburg Mitte - Missioklinik, Würzburg, Germany.
Joachim KirschnerCIMS Study Center, Bamberg, Germany.
Julia WälscherCenter for Interstitial and Rare Lung Diseases, Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany.
Stephan EisenmannUniversity Hospital Halle (Saale), Halle, Germany.
Stephan WalterspacherStudy Center Medicine, Klinikum Konstanz, Konstanz, Germany.
Claus NeurohrRBK Lungenzentrum Stuttgart, Stuttgart, Germany.
Claus-Peter KreutzAsklepios Lungenklinik Gauting, Gauting, Germany.
Daniel GrundDepartment of Pneumology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Sabine HaberlDepartment of Internal Medicine, University Hospital Augsburg, Augsburg, Germany.
Ralf EwertUniversity Hospital Greifswald, Greifswald, Germany.
Beate StubbeUniversity Hospital Greifswald, Greifswald, Germany.
Markus PolkeCenter for Interstitial and Rare Lung Diseases, Pneumology and Critical Care Medicine, Thoraxklinik, Heidelberg University Hospital, Heidelberg, Germany.
Frank ReichenbergerAugustinum, Munich, Germany.
Werner von WulffenAugustinum, Munich, Germany.
Ekaterina KraussDepartment of Internal Medicine II, Center for Interstitial and Rare Lung Diseases, Biomedical Research Center Seltersberg (BFS), Justus Liebig University Giessen, Giessen, Germany.
Michael WeberZentralklinik Bad Berka, Bad Berka, Germany.
Elaine KochThoraxzentrum Bezirk Unterfranken, Münnerstadt, Germany.
Michael DreherDepartment of Pneumology and Intensive Care Medicine, University Hospital RWTH Aachen, Aachen, Germany.
Tim OquekaII Medical Clinic and Polyclinic, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
Maximilian MalfertheinerCenter of Pneumology, Caritas-Krankenhaus St. Maria, Donaustauf, Germany.
Torsten WitteDepartment of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany.
Martin AringerDivision of Rheumatology, Medicine III, and University Center for Autoimmune and Rheumatic Entities (UCARE), University Medical Center and Faculty of Medicine, TU Dresden, Dresden, Germany.
Jürgen BehrGerman Center for Lung Research (DZL), Giessen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSex-related differences in interstitial lung disease (ILD) phenotypes are well recognized, but it remains unclear whether sex itself independently influences outcomes in non-idiopathic pulmonary fibrosis (non-IPF) ILD once comorbidities, lung function, and treatment are considered.

methodsIn the prospective INSIGHTS-ILD registry (data cut 17 September 2025), we compared men and women with non-IPF ILD using descriptive analyses and Cox models with prespecified adjustment steps: model A (age, comorbidity count, and smoking), model B (A + forced vital capacity [FVC] and diffusing capacity of the lung for carbon monoxide [DLCO]), and model C (B + antifibrotic therapy). Prespecified subgroup analyses included age strata (≤55 and >55 years) and ILD entities. Longitudinal FVC and DLCO trajectories were assessed over 24 months.

resultsAmong 883 patients (483 men and 400 women), exposures and disease entities differed significantly by sex: men reported more occupational/environmental exposures and had higher rates of fibrotic idiopathic interstitial pneumonia, whereas women more frequently had autoimmune-related ILD and a family history of ILD. Men had a higher comorbidity burden and more often received antifibrotic therapy at baseline. Survival was shorter in men (HR: 1.51; 95% CI: 1.03-2.21), but this association disappeared after adjustment in model A (HR: 1.04; 95% CI: 0.65-1.68), model B (HR: 1.03; 95% CI: 0.61-1.74), and model C (HR: 1.04; 95% CI: 0.62-1.77). Progression-free survival and transplant-free survival showed no consistent sex-related differences. Longitudinal FVC and DLCO declines were modest and largely parallel in both sexes, with no significant between-group differences. Findings were similar across age groups and ILD entities.

conclusionMen and women with non-IPF ILD differ in exposures, phenotypes, and comorbidities, but after accounting for these factors, sex is not an independent predictor of survival or functional progression. Risk assessment should therefore primarily be based on objective disease characteristics rather than sex alone.

Indexed as

Antifibrotic therapyInterstitial lung diseaseMultivariate adjustmentPrognosisProspective real-world registriesSex characteristicsSurvival

Identifiers

PMID41642742
PMCPMC13043131

What Socratic holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.