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A randomized, open-label, multicenter study of liposomal amikacin for inhalation in adult patients with nontuberculous mycobacteria (NTM) lung infections caused by mycobacterium avium complex (MAC)

David Griffith, Patrick Flume, Kevin Winthrop, Rachel Thomson, Dirk Wagner, Jakko Van Ingen, Liza Micioni, John P. McGinnis II, Carlos Fernandez, Gina Eagle
European Respiratory Journal 2015 46: PA3945; DOI: 10.1183/13993003.congress-2015.PA3945
David Griffith
1Department of Medicine, The University of Texas Health Science Center at Tyler, Tyler, TX United States
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Patrick Flume
2Division of Pulmonary, Critical Care and Sleep Medicine, Medical University of South Carolina, Charleston, SC United States
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Kevin Winthrop
3Division of Infectious Diseases, Oregon Health & Science University, Portland, OR United States
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Rachel Thomson
4Thoracic Medicine, Gallipoli Medical Research Centre, Greenslopes Private Hospital, Brisbane, Queensland Australia
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Dirk Wagner
5Center of Infectious Diseases and Travel Medicine & Center for Chronic Immunodeficiency, University Medical Center, Freiburg, Germany
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Jakko Van Ingen
6Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, Netherlands
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Liza Micioni
7Clinical, Insmed Incorporated, Bridgewater, NJ United States
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John P. McGinnis II
7Clinical, Insmed Incorporated, Bridgewater, NJ United States
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Carlos Fernandez
7Clinical, Insmed Incorporated, Bridgewater, NJ United States
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Gina Eagle
7Clinical, Insmed Incorporated, Bridgewater, NJ United States
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Abstract

Mycobacterium avium: complex (MAC) lung infections are associated with significant morbidity and mortality. Treatment of NTM lung infection is complicated by lengthy multidrug regimens often associated with drug toxicity and suboptimal outcomes. Liposomal amikacin for inhalation (LAI) is a novel inhaled amikacin formulation in development for the treatment of MAC lung infections. In an initial placebo-controlled study of patients with treatment-refractory NTM lung infections, which studied both MAC and M abscessus, (TR02-112), those who had LAI added to their multidrug regimen produced more negative sputum cultures at Day 84 than those on placebo (25.0% vs 6.7%; P=.01).Study INS-212 will evaluate this further by assessing culture conversion (3 consecutive negative sputum cultures) with longer-term LAI treatment added to multidrug regimens.Up to 351 adults ≥18 years with treatment-refractory MAC lung infection (≥2 positive sputum cultures while on a multidrug regimen for ≥6 months) will be stratified by smoking status and multidrug regimen use, and randomized 2:1 to LAI 590 mg QD added to a multidrug regimen or continued on a multidrug regimen alone.The primary endpoint is the proportion of subjects achieving culture conversion by Month 6. Other endpoints include the 6-minute walk test, patient-reported outcomes, and QOL scores.Converters will continue in the study for 12 months from their first negative culture used to define culture conversion. Subjects exiting study for any reason will be contacted for safety follow-up at Month 12.

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A randomized, open-label, multicenter study of liposomal amikacin for inhalation in adult patients with nontuberculous mycobacteria (NTM) lung infections caused by mycobacterium avium complex (MAC)
David Griffith, Patrick Flume, Kevin Winthrop, Rachel Thomson, Dirk Wagner, Jakko Van Ingen, Liza Micioni, John P. McGinnis II, Carlos Fernandez, Gina Eagle
European Respiratory Journal Sep 2015, 46 (suppl 59) PA3945; DOI: 10.1183/13993003.congress-2015.PA3945

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A randomized, open-label, multicenter study of liposomal amikacin for inhalation in adult patients with nontuberculous mycobacteria (NTM) lung infections caused by mycobacterium avium complex (MAC)
David Griffith, Patrick Flume, Kevin Winthrop, Rachel Thomson, Dirk Wagner, Jakko Van Ingen, Liza Micioni, John P. McGinnis II, Carlos Fernandez, Gina Eagle
European Respiratory Journal Sep 2015, 46 (suppl 59) PA3945; DOI: 10.1183/13993003.congress-2015.PA3945
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