Amikacin Liposome Inhalation Suspension for Mycobacterium avium Complex Lung Disease: A 12-Month Open-Label Extension Clinical Trialстатья из журнала
Аннотация: Rationale: Patients with refractory Mycobacterium avium complex (MAC) lung disease have limited treatment options. In the CONVERT study, amikacin liposome inhalation suspension (ALIS) added to guideline-based therapy (GBT) increased culture conversion rates versus GBT alone by Month 6. Limited data are available regarding >6-month treatment in a refractory population.Objectives: Evaluate 12-month safety, tolerability, and efficacy of ALIS+GBT.Methods: Adults with refractory MAC lung disease not achieving culture conversion by CONVERT Month 6 could enroll in this open-label extension (INS-312) to receive 590 mg once-daily ALIS+GBT for 12 months. Two cohorts enrolled: the "ALIS-naive" cohort included patients randomized to GBT alone in CONVERT, and the "prior-ALIS" cohort included those randomized to ALIS+GBT in CONVERT. Safety and tolerability of ALIS over 12 months (primary endpoint) and culture conversion by Months 6 and 12 were assessed.Results: In the ALIS-naive cohort, 83.3% of patients (n = 75/90) experienced respiratory treatment-emergent adverse events (TEAEs), and 35.6% (n = 32) had serious TEAEs; 26.7% (n = 24) achieved culture conversion by Month 6 and 33.3% (n = 30) by Month 12. In the prior-ALIS cohort, 46.6% of patients (n = 34/73) experienced respiratory TEAEs, and 27.4% (n = 20) had serious TEAEs; 9.6% (n = 7) achieved culture conversion by Month 6 (≤14 mo ALIS exposure) and 13.7% (n = 10) by Month 12 (≤20 mo ALIS exposure). Nephrotoxicity-related TEAEs and measured hearing decline were infrequent in both cohorts.Conclusions: In up to 20 months of ALIS use, respiratory TEAEs were common, nephrotoxicity and hearing decline were infrequent, and culture conversion continued beyond 6 months of therapy.Clinical trial registered with www.clinicaltrials.gov (NCT02628600).
Год издания: 2020
Авторы: Kevin Winthrop, Patrick A. Flume, Rachel Thomson, Kevin C. Mange, Dayton W. Yuen, Monika Ciesielska, Kozo Morimoto, Stephen J. Ruoss, Luigi Ruffo Codecasa, Jae‐Joon Yim, Theodore K. Marras, Jakko van Ingen, Richard J. Wallace, Barbara A. Brown‐Elliott, Chris Coulter, David E. Griffith
Издательство: American Thoracic Society
Источник: Annals of the American Thoracic Society
Ключевые слова: Mycobacterium research and diagnosis, Infectious Diseases and Mycology, Tuberculosis Research and Epidemiology
Другие ссылки: Annals of the American Thoracic Society (HTML)
Radboud Repository (Radboud University) (HTML)
PubMed Central (HTML)
PubMed (HTML)
Radboud Repository (Radboud University) (HTML)
PubMed Central (HTML)
PubMed (HTML)
Открытый доступ: hybrid
Том: 18
Выпуск: 7
Страницы: 1147–1157