American Thoracic Society (ATS) Conference 2026 Review
Orlando, Florida | 15 - 20th May 2026
ATS 2026 was a meeting shaped by a broader shift toward earlier, more precise, and more globally scalable approaches to lung health.
Across the programme, the strongest scientific signal was the move beyond traditional disease control toward prevention, remission, phenotype-led treatment, and clinically meaningful convenience. Data presented at the meeting highlighted expanding expectations for biologics in asthma, growing recognition of pre-disease states in COPD, renewed momentum in bronchiectasis, and, a growing interest across respiratory disease areas in cough and an increasingly explicit ambition to standardise lung health measurement across settings and populations.
This review focuses on sessions that connected scientific discovery with real-world implementation: how to identify patients earlier, measure lung health more consistently, communicate evidence more effectively, and ensure emerging therapies deliver meaningful clinical benefit. Collectively, ATS 2026 showcased a field redefining how respiratory disease is detected, stratified, treated, and measured.
Global lung health: Building a framework for earlier detection
One of the most strategically significant discussions came from the FIRS Lung Health Task Force, which highlighted the absence of a globally applicable framework for defining and measuring lung health. This session framed measurement itself as an intervention priority. Standardisation, not just innovation, is emerging as a core requirement for earlier detection, equitable care, and more credible global respiratory policy.
The strongest practical outputs were the proposed global spirometry standard operating procedure and training framework, both designed to improve consistency, quality assurance, and accessibility across settings. The proposed Lung Health Index is strategically important because it shifts the conversation from disease-specific diagnosis to broader risk identification, awareness, and population-level comparability. The emphasis on collecting exposure, symptom, and function data in a simple digital format also suggests a route to more scalable public-health and primary care application.
Asthma: Expanding beyond exacerbation control
The asthma narrative at ATS 2026 was not driven by a single therapeutic breakthrough, but by a broader ambition to reduce disease burden, achieve remission, and address inflammatory complexity earlier in the disease course.
Data presented reinforced the expanding role of biologics beyond exacerbation control, with growing emphasis on comorbidity benefit, remission, and dosing convenience.
Tezepelumab (1) and dupilumab (2) were positioned as therapies with broader clinical value, including benefit in nasal polyposis, airway inflammation, and mucus pathology. Epolimumab3 highlighted the strategic appeal of six-month dosing for high-exacerbation patients, even without clear symptom or lung function gains.
Meta-analysis data (4) suggest remission is achievable for a meaningful minority, particularly in patients with stronger T2 signals and fewer comorbidities, but remains far from routine. Paediatric data (5) supported as-needed ICS-formoterol as a credible step-change in mild asthma management. Mechanistic work from SARP (3) also sharpened the message that non-T2 biology may help explain incomplete corticosteroid responsiveness and continued unmet need.
Cough: Growing interest across respiratory disease areas
Cough featured across multiple posters and industry-led sessions spanning several disease areas, with a strong focus on its impact as a clinically important symptom and a substantial quality-of-life burden. Speakers repeatedly highlighted the challenges of diagnostic assessment, given that cough is a non-specific symptom with diverse and often overlapping underlying causes. At the same time, increasing attention was given to refractory chronic cough as a disease in its own right, with several sessions reviewing the evidence supporting current therapeutic targets.
Industry engagement was notable. GSK delivered several educational sessions aimed at improving understanding of refractory chronic cough and reinforcing its recognition as a distinct disease. However, there were no major treatment announcements, likely reflecting anticipation of the Phase 3 camlipixant results expected later this year.
Industry-sponsored sessions also highlighted advances in cough monitoring, with expert researchers and clinicians discussing the value of objective cough measurement. Particular emphasis was placed on distinguishing cough from related events such as throat clearing and laryngeal sounds, while exploring whether distinct cough subtypes may exist across conditions including IPF and refractory or unexplained chronic cough. Speakers also stressed the importance of combining objective and subjective assessments to better characterise disease burden and treatment response.
Poster presentations further underscored the burden of cough on patients. Data highlighted impacts on quality of life, including anxiety, depression, insomnia, and urinary incontinence, alongside low treatment response rates with current pharmacological management. Additional posters reflected growing interest in cough as a clinical trial endpoint across respiratory diseases, including COPD, bronchiectasis, and IPF.
Pre-COPD and early disease: Redefining timelines
A major theme across COPD-focused sessions was the growing recognition that COPD should be viewed as a long-term disease process rather than a diagnosis triggered by a single spirometric threshold.
Discussion around PRISM, GOLD 0, and pre-COPD signalled a deliberate challenge to obstruction-based definitions of COPD. Speakers argued that structural, inflammatory, and developmental abnormalities precede conventional spirometric thresholds and carry meaningful risk of progression and mortality.
Imaging and tissue data strengthened the case that early disease is biologically real, while progression data suggested that apparently mild or borderline states are not clinically neutral. This creates a strategic opening for earlier identification, better-risk stratification, and eventually intervention before fixed airflow limitation is established. These concepts have important implications for future clinical trials, regulatory frameworks, and prevention-focused treatment strategies.
Bronchiectasis: Advancing towards precision-led care
The most important shift in bronchiectasis is conceptual as much as therapeutic: from a historically neglected condition managed reactively to a disease area increasingly defined by stratification, targeted anti-inflammatory treatment, and clearer clinical pathways.
Bronchiectasis was presented as an under-recognised, heterogeneous disease in which earlier diagnosis and more systematic management could materially improve outcomes.
The data presented reinforced the need to move beyond repeated empirical antibiotic treatment toward structured work-up, CT-based diagnosis, microbiological characterisation, and risk-based escalation. Frequent exacerbators and patients with chronic infection remain the key high-risk population. Brensocatib stood out as the clearest therapeutic advance, supporting renewed confidence in neutrophilic inflammation as a tractable target, while the broader pipeline suggested that the category is entering a more innovation-rich phase.
Summary
Taken together, these sessions suggest that ATS 2026 was united by a common strategic theme: respiratory science is moving toward earlier intervention, more precise patient segmentation, and stronger links between measurement, mechanism, and implementation.
Whether through global lung health frameworks, biologic-driven asthma management, emerging pre-COPD concepts, or advances in bronchiectasis, the direction of travel is clear. Future success will depend not only on scientific innovation, but also on the ability to identify risk earlier, measure outcomes consistently, and translate evidence into meaningful improvements in patient care.
References
Lipworth B.J., Han J.K., Desrosiers M., et al. (2025). Tezepelumab in Adults with Severe Chronic Rhinosinusitis with Nasal Polyps. New England Journal of Medicine. DOI: 10.1056/NEJMoa2414482
Castro M, Papi A, Porsbjerg C, et al. "Effect of dupilumab on exhaled nitric oxide, mucus plugs, and functional respiratory imaging in patients with type 2 asthma (VESTIGE): a randomised, double-blind, placebo-controlled, phase 4 trial." The Lancet Respiratory Medicine, 2025; 13(4): 367-379.
Jackson, D.J., Wechsler, M.E., Zangrilli, J.G., Bleecker, E.R., Castro, M., Corren, J., Menzies-Gow, A., Peters, M.C., Pilette, C., Bourdin, A., Brusselle, G., Chanez, P., Han, M.K., Pavord, I.D., Tran, T.N., Albers, F.C., Cole, J., Yancey, S.W., Bradford, E.S., and Fitzpatrick, S. (2024) 'Twice-Yearly Depemokimab in Severe Asthma with an Eosinophilic Phenotype', New England Journal of Medicine, 391(24), pp. 2337-2349
Shackleford A, Heaney L, Redmond C et al.Clinical remission attainment, definitions, and correlates among patients with severe asthma treated with biologics: a systematic review and meta-analysis. The Lancet Respiratory Medicine, 2024; 13, 23-34
Hatter L, Holliday M, Oldfield K et al. Budesonide–formoterol versus salbutamol as reliever therapy in children with mild asthma (CARE): a 52-week, open-label, multicentre, superiority, randomised controlled trial. The Lancet, 2025; 406, 1473-1483
