Nationwide evaluation of treatment outcomes and survival of patients with non-tuberculous mycobacterial pulmonary disease

Makek, M.J.; Glodić, Goran; Sabol, Ivan; Žmak, Ljiljana; Samaržija, Miroslav; Šola, Ana Marija; Marušić, Ante; Mareković, Ivana; Bulat, L.K.; Čorak, Luka; Obrovac, Mihaela; van Ingen, Jakko (2024) Nationwide evaluation of treatment outcomes and survival of patients with non-tuberculous mycobacterial pulmonary disease. The International Journal of Tuberculosis and Lung Disease, 28 (10). pp. 482-487. ISSN 1815-7920

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Abstract

Treatment outcomes and long-term survival of non-tuberculous mycobacterial pulmonary disease (NTM-PD) in a real-world setting are difficult to assess, especially for species other than Mycobacterium avium complex (MAC). This was a retrospective cohort study on all Croatian residents with respiratory NTM isolates from 2006 to 2015, with follow-up to 2020. Therapy was started in 98/137 (71.5%) of patients, significantly more often in patients with fibrocavitary disease and/or sputum smear positivity. Unsuccessful treatment outcomes were recorded in 39/98 (39.8%) patients (14 deaths and 25 treatment failures). One-year and 5-year all-cause mortality were respectively 18.2% and 37.6%. Guideline-based treatment (GBT) was started in 50/98 (51%) of treated patients and followed for the recommended duration in 35.7% (35/98). This resulted in a higher chance of cure (OR 3.79, 95% CI 1.29 to 11.1; P = 0.012) than inadequately treated/untreated patients. For Mycobacterium xenopi disease, high cure rates (>80%) were achieved both with GBT and non-GBT treatment regimens. Guideline-based therapy resulted in a four-time higher chance of being cured. The impact of GBT on treatment outcomes was clear for MAC disease, but no apparent effect was observed for patients with M. xenopi disease.

Item Type:	Article
Uncontrolled Keywords:	NTM-PD; long-term survival; treatment outcomes
Subjects:	BIOMEDICINE AND HEALTHCARE > Clinical Medical Sciences BIOMEDICINE AND HEALTHCARE > Public Health and Health Care > Epidemiology BIOMEDICINE AND HEALTHCARE > Public Health and Health Care > Public Health
Divisions:	Division of Molecular Medicine
Depositing User:	Ivan Sabol
Date Deposited:	28 Jan 2025 08:45
URI:	http://fulir.irb.hr/id/eprint/9436
DOI:	10.5588/ijtld.24.0068

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