Real-life evaluation of clinical outcomes in patients undergoing treatment for non-tuberculous mycobacteria lung disease: A ten-year cohort study

Outcome recognition is a crucial step in the management of non-tuberculous mycobacteria lung disease (NTM-LD). In order to explore NTM-LD outcomes in a real-life setting, an observational, retrospective study enrolling consecutive adults who received treatment for NTM-LD in Milan, Italy, from 2007 t...

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Published in:Respiratory medicine 2020-04, Vol.164, p.105899-105899, Article 105899
Main Authors: Aliberti, Stefano, Sotgiu, Giovanni, Castellotti, Paola, Ferrarese, Maurizio, Pancini, Lisa, Pasat, Ana, Vanoni, Nicolò, Spotti, Maura, Mazzola, Ester, Gramegna, Andrea, Saderi, Laura, Perno, Carlo Federico, van Ingen, Jakko, Codecasa, Luigi Ruffo, Blasi, Francesco
Format: Article
Language:English
Subjects:
Adults
Atypical mycobacteria infection
Bronchoscopy
Clinical outcomes
Cohort analysis
Health services
Infections
Intolerance
Lung diseases
Medical treatment
Patients
Population
Population studies
Tuberculosis
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Summary:Outcome recognition is a crucial step in the management of non-tuberculous mycobacteria lung disease (NTM-LD). In order to explore NTM-LD outcomes in a real-life setting, an observational, retrospective study enrolling consecutive adults who received treatment for NTM-LD in Milan, Italy, from 2007 to 2017 was conducted. Among 170 patients (68.2% females; median age: 68 years), NTM-LD was mainly due to M. avium complex (MAC) (71.2%), M. kansasii (9.4%) and M. xenopi (7.1%). Along a median follow-up of 31 months, adverse events occurred in 37.6% of the patients. Treatment outcomes of the entire study population included an unsuccessful outcome in 35.3% of the patients, including treatment halted in 13.5%, recurrence in 11.2%, re-infection in 5.3%, treatment failure in 4.1% and relapse in 1.2%. The main reason for treatment halted was drug intolerance. No differences were detected between patients with MAC-LD vs. those with other NTM-LD in terms of unsuccessful outcome in general (35.5% vs. 34.7%). A significantly higher prevalence of patients who underwent treatment halted was found in patients with NTM-LD other than MAC in comparison to patients with MAC-LD (22.4% vs. 9.9%, p = 0.030). One third of adults undergoing treatment for a NTM-LD experiences an unsuccessful outcome with adverse events and treatment discontinuation being major challenges in patients’ management.
ISSN:0954-6111
1532-3064
DOI:10.1016/j.rmed.2020.105899