AI Article Synopsis
- Amikacin liposome inhalation suspension (ALIS) showed effectiveness in increasing sputum culture conversion rates in patients with refractory Mycobacterium avium complex pulmonary disease (MAC-PD) after 6 months of treatment in a phase 3 trial.
- A study involving 12 patients at Toho University revealed that 58.3% achieved culture conversion, with factors like shorter previous treatment duration and fewer cavitary lesions on chest CT linked to better outcomes.
- While improvements in chest CT findings were noted, they did not always match with culture conversion results, indicating that the correlation between imaging and treatment success is complex.
Article Abstract
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.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11386315 | PMC |
| http://dx.doi.org/10.1186/s12890-024-03261-w | DOI Listing |
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