Outcomes associated with antibiotic regimens for treatment of Mycobacterium abscessus in cystic fibrosis patients

DaCosta, Alison; Jordan, Cameron L.; Giddings, Olivia K.; Lin, Feng; Gilligan, Peter H.; Esther, Charles R.

doi:10.1016/j.jcf.2017.04.013

Cited by 23 publications

(20 citation statements)

References 21 publications

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“…The utility of pulmonary function monitoring as a general biomarker of treatment response for NTM lung disease will likely be limited by the tremendous heterogeneity in underlying chronic lung diseases and NTM disease presentations (for example, nodular bronchiectatic vs. fibrocavitary disease). In a single center study of 37 cystic fibrosis patients with pulmonary M. abscessus infection, early improvements in FEV1 after treatment initiation (either 30 or 60 days) were not associated with long-term microbiologic outcomes or sustained improvements in pulmonary function ( DaCosta et al, 2017 ).…”

Section: Current Approaches To Monitoring Treatment Response To Ntm Dmentioning

confidence: 99%

Assessing Response to Therapy for Nontuberculous Mycobacterial Lung Disease: Quo Vadis?

Vinnard¹,

Mezochow

Oakland

et al. 2018

Front. Microbiol.

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Assessing progression of disease or response to treatment remains a major challenge in the clinical management of nontuberculous mycobacterial (NTM) infections of the lungs. Serial assessments of validated measures of treatment response address whether the current therapeutic approach is on track toward clinical cure, which remains a fundamental question for clinicians and patients during the course of NTM disease treatment. The 2015 NTM Research Consortium Workshop, which included a patient advisory panel, identified treatment response biomarkers as a priority area for investigation. Limited progress in addressing this challenge also hampers drug development efforts. The Biomarker Qualification Program at the FDA supports the use of a validated treatment response biomarker across multiple drug development programs. Current approaches in clinical practice include microbiologic and radiographic monitoring, along with symptomatic and quality-of-life assessments. Blood-based monitoring, including assessments of humoral and cell-mediated NTM-driven immune responses, remain under investigation. Alignment of data collection schemes in prospective multicenter studies, including the support of biosample repositories, will support identification of treatment response biomarkers under standard-of-care and investigational therapeutic strategies. In this review, we outline the role of treatment monitoring biomarkers in both clinical practice and drug development frameworks.

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Section: Current Approaches To Monitoring Treatment Response To Ntm Dmentioning

confidence: 99%

Assessing Response to Therapy for Nontuberculous Mycobacterial Lung Disease: Quo Vadis?

Vinnard¹,

Mezochow

Oakland

et al. 2018

Front. Microbiol.

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show abstract

“…72 A retrospective U.S. study evaluated MABSC treatment outcomes at their CF center, which included 37 cases over an 8-year period, of which the majority were placed on a guideline-based regimen of an oral macrolide, IVamikacin, and IV β-lactam. 73 Only 10 patients were able to eradicate MABSC. Nonetheless, there was significant transient improvement in lung function during the intense treatment, and no further decline in lung function when compared with pretreatment values.…”

Section: Discussionmentioning

confidence: 99%

Nontuberculous Mycobacteria in Cystic Fibrosis

Furukawa

Flume

2018

Semin Respir Crit Care Med

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Nontuberculous mycobacteria (NTM) can cause chronic pulmonary infection in susceptible hosts. Individuals with cystic fibrosis (CF), a multisystem disease predominated by progressive structural lung disease, are particularly vulnerable. Only recently have NTM been recognized for their potential to cause lung deterioration in CF patients. The reported prevalence varies widely from 4 to 40%, significantly more common than in the general population, but this varies because of multiple factors including inconsistent screening practices. complex and complex are the two most common species recovered. Defining NTM pulmonary disease in a CF patient can present challenges as it can be difficult to distinguish from the other potentially pathogenic organisms in the lung microbiome. In general, treatment regimens do not differ from the non-CF population but the clinician should be aware of potential interactions with other CF therapies. Recent population-level genomics has raised serious concern for indirect person-to-person transmission of several dominating NTM clones worldwide, raising awareness for increase prevention strategies when CF patients potentially congregate, such as clinic visits. Lung transplantation is controversial in those with NTM present in sputum culture but the available evidence suggests that this is not an absolute contraindication.

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“…Treatment of pulmonary disease due to MABSC is complicated because of the high level of in vitro resistance, need for intravenous antibiotics, high frequency of adverse reactions, and generally lower rates of successful treatment compared to MAC. MABSC culture conversion rates are typically reported in the 40‐50% range . Among MABSC subspecies, M. abscessus susp.…”

Section: Treatment Of Ntm Pulmonary Diseasementioning

confidence: 99%

Nontuberculous mycobacteria in cystic fibrosis: Updates and the path forward

Martiniano

Davidson

Nick

2017

Pediatric Pulmonology

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Nontuberculous mycobacteria (NTM) are troublesome pathogens that can cause significant pulmonary disease in patients with cystic fibrosis (CF). Diagnosis can be difficult in the setting of underlying CF and treatment regimens are burdensome on both patients and providers. Recent consensus guidelines for treatment of NTM in CF have provided a guide for the CF community, however research is lagging regarding accuracy of our diagnostic abilities and treatment efficacy. In this review, we provide new insights into the complexity of NTM from emerging whole genome sequencing data, a summary of current NTM diagnosis and treatment guidelines, highlight new treatment options, and discuss future research projects which aim to better define which patients to treat and timing and duration of treatment.

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Outcomes associated with antibiotic regimens for treatment of Mycobacterium abscessus in cystic fibrosis patients

Abstract: Treatment of M. abscessus resulted in short term improvement in lung function that is inversely related to pre-treatment FEV.

Cited by 23 publications

References 21 publications

Assessing Response to Therapy for Nontuberculous Mycobacterial Lung Disease: Quo Vadis?

Assessing Response to Therapy for Nontuberculous Mycobacterial Lung Disease: Quo Vadis?

Nontuberculous Mycobacteria in Cystic Fibrosis

Nontuberculous mycobacteria in cystic fibrosis: Updates and the path forward

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