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Article History

Received: 16 April 2026

Accepted: 27 May 2026

First Online: 5 June 2026

Declarations

:

: HO has received lecture fees from GlaxoSmithKline, AstraZeneca, UCB Japan, Asahi Kasei Pharma, Chugai Pharmaceutical Co., Ltd., Sandoz, Otsuka Pharmaceutical Co., Ltd., AYUMI Pharmaceutical Corporation, Taisho Pharmaceutical Co., Ltd., Boehringer Ingelheim, and Eisai Co., Ltd. The other authors declare no conflicts of interest.

: This study complied with the Declaration of Helsinki, and the institutional review board of Hiroshima City Hiroshima Citizens Hospital approved this study (approval no. 2025 − 115; approval date: October 10, 2025). The need to obtain informed consent from patients was waived in accordance with the regulations for retrospective cohort studies. Information for patients regarding this study was provided on the hospital website.

: During the preparation of this work, the authors used ChatGPT (GPT-5.5 Thinking; OpenAI, accessed in May 2026) to assist with English editing, manuscript refinement, and preparation of the conceptual illustration in Fig. 1A. The authors reviewed and edited the output and take full responsibility for the content of the manuscript.