Effectiveness of Amikacin liposome inhalation suspension for refractory Mycobacterium avium complex pulmonary disease at 6 months post initiation.

Autor: Urabe N; Department of Respiratory Medicine Omori Medical Center, Toho University, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan. naohisa.urabe@med.toho-u.ac.jp., Sakamoto S; Department of Respiratory Medicine Omori Medical Center, Toho University, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan., Tokita N; Department of Respiratory Medicine Omori Medical Center, Toho University, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan., Yoshida H; Department of Respiratory Medicine Omori Medical Center, Toho University, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan., Usui Y; Department of Respiratory Medicine Omori Medical Center, Toho University, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan., Shimizu H; Department of Respiratory Medicine Omori Medical Center, Toho University, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan., Sekiya M; Department of Respiratory Medicine Omori Medical Center, Toho University, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan., Miyoshi S; Department of Respiratory Medicine Omori Medical Center, Toho University, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan., Nakamura Y; Department of Respiratory Medicine Omori Medical Center, Toho University, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan., Isobe K; Department of Respiratory Medicine Omori Medical Center, Toho University, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan., Kishi K; Department of Respiratory Medicine Omori Medical Center, Toho University, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan.
Jazyk: angličtina
Zdroj: BMC pulmonary medicine [BMC Pulm Med] 2024 Sep 10; Vol. 24 (1), pp. 442. Date of Electronic Publication: 2024 Sep 10.
DOI: 10.1186/s12890-024-03261-w
Abstrakt: Background: Amikacin  liposome inhalation suspension (ALIS) improved sputum culture conversion rate at 6 months for patients with refractory Mycobacterium avium complex pulmonary disease (MAC-PD) in an international phase 3 trial. Patient characteristics and chest high-resolution CT (HRCT) findings associated with ALIS effectiveness are poorly documented.
Objective: We aimed to clarify ALIS effectiveness for refractory MAC-PD at 6 months, elucidating associated patient characteristics and chest CT findings.
Methods: We reviewed medical records of 12 patients with refractory MAC-PD for whom ALIS treatment was initiated at Toho University Omori Medical Center from November 2021 through September 2022. All patients demonstrated treatment persistence for at least 3 months. They were divided into culture conversion and non-conversion groups using sputum culture conversion status after 6-month ALIS treatment initiation. Clinical and radiological characteristics were compared.
Results: Seven of the 12 patients (58.3%) achieved sputum culture conversion within 6 months. The culture conversion group had shorter pre-ALIS initiation treatment duration [21 months (16-25) vs. 62 months (32-69); p = 0.045]; lower cavitary lesion incidence on HRCT (28.6% vs. 100%; p = 0.028); and fewer clarithromycin (CLA)-resistant strains [0/7 (0%) vs. 3/5 (60%); p = 0.045]. Chest HRCT findings improved in 4 of 7 (57.1%) and 1 of 5 (20%) patients in the culture conversion and non-conversion groups, respectively.
Conclusion: ALIS facilitated sputum culture conversion within 6 months in 58.3% of patients with refractory MAC-PD. Sputum culture conversion was significantly more frequent for CLA-susceptible strains and patients with fewer cavitary lesions. Improved CT findings after ALIS did not always correspond to sputum culture conversion.
(© 2024. The Author(s).)
Databáze: MEDLINE
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