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Review
. 2022 Feb 9;31(163):210212.
doi: 10.1183/16000617.0212-2021. Print 2022 Mar 31.

Management of Mycobacterium avium complex and Mycobacterium abscessus pulmonary disease: therapeutic advances and emerging treatments

Kartik Kumar  1   2 , Charles L Daley  3   4 , David E Griffith  3 , Michael R Loebinger  5   2
Affiliations
Review

Management of Mycobacterium avium complex and Mycobacterium abscessus pulmonary disease: therapeutic advances and emerging treatments

Kartik Kumar et al. Eur Respir Rev. .

Abstract

Nontuberculous mycobacterial pulmonary disease (NTM-PD) remains a challenging condition to diagnose and treat effectively. Treatment of NTM-PD is prolonged, frequently associated with adverse effects and has variable success. In this review, we consider the factors influencing clinicians when treating NTM-PD and discuss outcomes from key studies on the pharmacological management of Mycobacterium avium complex pulmonary disease and M. abscessus pulmonary disease. We highlight issues relating to treatment-related toxicity and provide an overview of repurposed and emerging therapies for NTM-PD.

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Conflict of interest statement

Conflict of interest: K. Kumar reports support from the National Institute for Health Research (NIHR) Imperial Biomedical Research Centre (BRC) and the Lee Family endowment to the Faculty of Medicine at Imperial College London. Conflict of interest: C.L. Daley reports receiving grants or contracts from Insmed and BugWorks. Consulting fees received from Insmed, Spero, Paratek, AN2, Matinas, Cipla, Johnson and Johnson, outside the submitted work. Conflict of interest: D.E. Griffith reports support from Insmed Inc. and AN2 Pharmaceuticals. Research grant received from Insmed Inc. Consulting fees received from Insmed Inc., and AN2 Pharmaceuticals. Payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events received from Insmed Inc. Support received from Insmed Inc. for attending meetings and/or travel. Participation on an Advisory Board for Insmed Inc., outside the submitted work. Conflict of interest: M.R. Loebinger reports receiving consulting fees from Insmed, Savara and Meiji. Payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events received from Insmed. Participation on a Data Safety Monitoring Board or Advisory Board for Redhill, outside the submitted work.

Figures

FIGURE 1
FIGURE 1
Inducible macrolide resistance in Mycobacterium abscessus (MAB) isolates: flowchart demonstrating the mechanisms underlying inducible macrolide resistance and macrolide susceptibility in MAB isolates. erm: erythromycin resistance methylase.
FIGURE 2
FIGURE 2
Site of action of current and emerging treatments for nontuberculous mycobacterial (NTM) pulmonary disease: schematic showing the site of action of antimicrobials against NTM.
See this image and copyright information in PMC

References

    1. Griffith DE, Aksamit T, Brown-Elliott BA, et al. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med 2007; 175: 367– 416. doi: 10.1164/rccm.200604-571ST - DOI - PubMed
    1. Fedrizzi T, Meehan CJ, Grottola A, et al. Genomic characterization of nontuberculous mycobacteria. Sci Rep 2017; 7: 45258. doi: 10.1038/srep45258 - DOI - PMC - PubMed
    1. Winthrop KL, Marras TK, Adjemian J, et al. Incidence and prevalence of nontuberculous mycobacterial lung disease in a large U.S. managed care health plan, 2008–2015. Ann Am Thorac Soc 2020; 17: 178– 185. doi: 10.1513/AnnalsATS.201804-236OC - DOI - PMC - PubMed
    1. Shah NM, Davidson JA, Anderson LF, et al. Pulmonary Mycobacterium avium-intracellulare is the main driver of the rise in non-tuberculous mycobacteria incidence in England, Wales and Northern Ireland, 2007–2012. BMC Infect Dis 2016; 16: 195. doi: 10.1186/s12879-016-1521-3 - DOI - PMC - PubMed
    1. Aitken ML, Limaye A, Pottinger P, et al. Respiratory outbreak of Mycobacterium abscessus subspecies massiliense in a lung transplant and cystic fibrosis center. Am J Respir Crit Care Med 2012; 185: 231– 232. doi: 10.1164/ajrccm.185.2.231 - DOI - PubMed

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