Raphael Chiron1,2, Wouter Hoefsloot3, Jakko Van Ingen4, Hélène Marchandin1,5, Laurent Kremer6,7, Hélène Morisse-Pradier8, Jeremy Charriot9,10, Jean-Pierre Mallet9, Jean-Louis Herrmann11,12, Davide Caimmi2, Johan Moreau13,14, Yann Dumont15, Sylvain Godreuil15, Anne Bergeron16,17, Margot Drevait2, Elodie Bouzat-Rossigneux18, Nicolas Terrail19, Claire Andrejak20,21, Nicolas Veziris22,23, Dominique Grenet24, Alexandre Coudrat2, Emilie Catherinot25. 1. HydroSciences Montpellier, Centre National de la Recherche pour la Santé (CNRS), Institut de Recherche pour le Développement (IRD), Université Montpellier, Montpellier, France. 2. CF Center, University Hospital Centre Montpellier, Montpellier, France. 3. Pulmonary Diseases, Radboud University Medical Center, Nijmegen, The Netherlands. 4. Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands. 5. Service de Microbiologie et Hygiène Hospitalière, University Hospital Centre Nimes, Nimes, France. 6. Institut de Recherche en Infectiologie de Montpellier, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique UMR 9004, Université Montpellier, Montpellier, France. 7. Institut de Recherche en Infectiologie de Montpellier, Institut National de la Santé et de la Recherche Médicale (INSERM), Montpellier, France. 8. Quantif-LITIS Laboratory EA 4108, Rouen University, Rouen, France. 9. Respiratory Diseases Department, University Hospital Centre Montpellier, Montpellier, France. 10. PhyMedExp, Institut National de la Santé et de la Recherche Médicale (INSERM) U1046, Université Montpellier, Montpellier, France. 11. Université Paris-Saclay, Hopital Raymond Poincaré, GHU-AP-HP, Paris, France. 12. Service de Microbiologie, Garches UVSQ, Institut National de la Santé et de la Recherche Médicale (INSERM), Montigny le Bretonneux, France. 13. PhyMedExp, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de la Recherche pour la Santé (CNRS), Montpellier, France. 14. Paediatric and Respiratory Departments, University Hospital Centre Montpellier, CF Center, Montpellier, France. 15. Laboratoire de bactériologie, University Hospital Centre Montpellier, MIVEGEC, IRD-CNRS-UM, Montpellier, France. 16. Service de Pneumologie, AP-HP, Hôpital Saint-Louis, Paris, France. 17. Biostatistics and Clinical Epidemiology Research Team, Université Paris Diderot, Sorbonne Paris Cité, U1153 CRESS, Paris, France. 18. Centre Hospitalier Universitaire Pointe-à-Pitre Abymes, Pointe-a-Pitre, Guadeloupe, France. 19. Pharmacy Department, University Hospital Centre Montpellier, Montpellier, France. 20. Respiratory Department, Centre Hospitalier Universitaire (CHU) Amiens-Picardie, Avenue Laënenc, Amiens, France. 21. Amiens University, EA 4294 AGIR, Amiens, France. 22. Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, AP-HP, Paris, France. 23. Centre d'Immunologie et des Maladies Infectieuses, Sorbonne Université, Paris, France. 24. Pneumologie et Transplantation Pulmonaire, Hopital Foch, Suresnes, France. 25. Pneumology Department, Hôpital Foch, Suresnes, France.
Abstract
Background: Mycobacterium abscessus infections remain difficult to manage in both cystic fibrosis (CF) and non-CF patients and reported clinical outcomes are largely unsatisfactory. Clinical trial data are limited and no approved therapies are currently available for the management of M abscessus lung diseases. As an alternative, cohort studies may provide insightful information into the management of M abscessus pulmonary disease. Methods: Based on a retrospective observational cohort study, we investigated the safety and efficacy of amikacin liposome inhaled suspension (ALIS) as an adjunct to a standard antibiotic regimen for M abscessus lung infection in both CF and non-CF patients. We also assessed the association of patient drug compliance with culture conversion and clinical outcomes. Results: Twenty-six patients had long-term follow-up data available. Culture conversion was achieved in 54% (14/26) of the patients with no difference between CF and non-CF patients after an average treatment duration of 10 months. Patient treatment compliance was significantly better in the converter group compared to nonconverters with an odds ratio of 44.78 associated with good compared to poor patient compliance. Overall, 9 patients (35%) experienced an adverse event that led to treatment discontinuation. Conclusions: ALIS appears beneficial in both CF and non-CF populations with M abscessus lung disease.
Background: Mycobacterium abscessus infections remain difficult to manage in both cystic fibrosis (CF) and non-CF patients and reported clinical outcomes are largely unsatisfactory. Clinical trial data are limited and no approved therapies are currently available for the management of M abscessus lung diseases. As an alternative, cohort studies may provide insightful information into the management of M abscessus pulmonary disease. Methods: Based on a retrospective observational cohort study, we investigated the safety and efficacy of amikacin liposome inhaled suspension (ALIS) as an adjunct to a standard antibiotic regimen for M abscessus lung infection in both CF and non-CF patients. We also assessed the association of patient drug compliance with culture conversion and clinical outcomes. Results: Twenty-six patients had long-term follow-up data available. Culture conversion was achieved in 54% (14/26) of the patients with no difference between CF and non-CF patients after an average treatment duration of 10 months. Patient treatment compliance was significantly better in the converter group compared to nonconverters with an odds ratio of 44.78 associated with good compared to poor patient compliance. Overall, 9 patients (35%) experienced an adverse event that led to treatment discontinuation. Conclusions: ALIS appears beneficial in both CF and non-CF populations with M abscessus lung disease.
Authors: David E Griffith; Gina Eagle; Rachel Thomson; Timothy R Aksamit; Naoki Hasegawa; Kozo Morimoto; Doreen J Addrizzo-Harris; Anne E O'Donnell; Theodore K Marras; Patrick A Flume; Michael R Loebinger; Lucy Morgan; Luigi R Codecasa; Adam T Hill; Stephen J Ruoss; Jae-Joon Yim; Felix C Ringshausen; Stephen K Field; Julie V Philley; Richard J Wallace; Jakko van Ingen; Chris Coulter; James Nezamis; Kevin L Winthrop Journal: Am J Respir Crit Care Med Date: 2018-12-15 Impact factor: 21.405
Authors: Diana Bilton; Tacjana Pressler; Isabelle Fajac; John Paul Clancy; Dorota Sands; Predrag Minic; Marco Cipolli; Ivanka Galeva; Amparo Solé; Alexandra L Quittner; Keith Liu; John P McGinnis; Gina Eagle; Renu Gupta; Michael W Konstan Journal: J Cyst Fibros Date: 2019-08-23 Impact factor: 5.527