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Second‐line Therapy in patients with mycobacterium avium complex pulmonary disease

Ching, D., Perera, R., Waring, J. and Bowden, R. (2021) Second‐line Therapy in patients with mycobacterium avium complex pulmonary disease. Respirology, 26 (S2). p. 199.

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Introduction/Aim: Mycobacterium avium complex pulmonary disease (MAC‐PD) rates are increasing worldwide, prompting a greater need for effective and well‐tolerated therapeutic options. First‐line therapy is standardized across international guidelines. However, there is a paucity of research into the significant proportion of patients who fail first‐line therapy, and in those with recurrent disease. This study aims to characterize patients with MAC‐PD who are being considered for second‐line therapy.

Methods: An observational study was performed on patients aged 18 years or older with MAC‐PD who were seen in the Royal Perth Hospital respiratory outpatient clinic from 2010 onwards. Patients who failed or were intolerant of first‐line therapy, and those with recurrent disease, defined as early (<18 months) or late (≥18 months) were included. Patient demographics, microbiology, radiology and treatment regimens were obtained from hospital medical records.

Results: Data on 26 patients have been collected so far. Mean age was 68.8(range 45‐91) years, 16(61.5%) female. At the time of the initial diagnosis of MAC‐PD, 10(38%) were current or former smokers, and 8(31%) had co‐morbid lung disease. 21(81%) presented with nodular bronchiectasis. 16(62%) were treated with standardized first‐line therapy, mean treatment time 15.8 (range 0‐27) months. 12(46%) patients developed late recurrence of MAD‐PD, 2(8%) early recurrence, 4(15%) were intolerant of first‐line therapy and 8(31%) failed first‐line treatment. 13(50%) patients commenced second‐line therapy with curative intent, 6(23%) on suppressive therapy and 7(27%) were not given therapy.

Conclusion: Patients with MAC‐PD who are being considered for second‐line therapy represent a diverse population of patients with differing disease phenotypes. Therefore, further data is required to better understand the population, in order to design suitable interventional clinical trials. Additional patient data is currently being collected for this study. Following this, the plan is to assess second‐line therapy outcome data.

Item Type: Journal Article
Publisher: Wiley-Blackwell
Copyright: © 2021 Asian Pacific Society of Respirology
Other Information: Poster abstract: TSANZSRS 2021 The Australia & New Zealand Society of Respiratory Science and The Thoracic Society of Australia and New Zealand (ANZSRS/TSANZ) Annual Scientific Meeting for Leaders in Lung Health & Respiratory Science, 1–2 May 2021
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