PT  - JOURNAL ARTICLE
AU  - Nakwon Kwak
AU  - Margareth Pretti Dalcolmo
AU  - Charles L. Daley
AU  - Geoffrey Eather
AU  - Regina Gayoso
AU  - Naoki Hasegawa
AU  - Byung Woo Jhun
AU  - Won-Jung Koh
AU  - Ho Namkoong
AU  - Jimyung Park
AU  - Rachel Thomson
AU  - Jakko van Ingen
AU  - Sanne M.H. Zweijpfenning
AU  - Jae-Joon Yim
TI  - <em>M</em><em>ycobacterium abscessus</em> pulmonary disease: individual patient data meta-analysis
AID  - 10.1183/13993003.01991-2018
DP  - 2019 Jul 01
TA  - European Respiratory Journal
PG  - 1801991
VI  - 54
IP  - 1
4099  - http://erj.ersjournals.com/content/54/1/1801991.short
4100  - http://erj.ersjournals.com/content/54/1/1801991.full
SO  - Eur Respir J2019 Jul 01; 54
AB  - Treatment of Mycobacterium abscessus pulmonary disease (MAB-PD), caused by M. abscessus subsp. abscessus, M. abscessus subsp. massiliense or M. abscessus subsp. bolletii, is challenging.We conducted an individual patient data meta-analysis based on studies reporting treatment outcomes for MAB-PD to clarify treatment outcomes for MAB-PD and the impact of each drug on treatment outcomes. Treatment success was defined as culture conversion for ≥12 months while on treatment or sustained culture conversion without relapse until the end of treatment.Among 14 eligible studies, datasets from eight studies were provided and a total of 303 patients with MAB-PD were included in the analysis. The treatment success rate across all patients with MAB-PD was 45.6%. The specific treatment success rates were 33.0% for M. abscessus subsp. abscessus and 56.7% for M. abscessus subsp. massiliense. For MAB-PD overall, the use of imipenem was associated with treatment success (adjusted odds ratio (aOR) 2.65, 95% CI 1.36–5.10). For patients with M. abscessus subsp. abscessus, the use of azithromycin (aOR 3.29, 95% CI 1.26–8.62), parenteral amikacin (aOR 1.44, 95% CI 1.05–1.99) or imipenem (aOR 7.96, 95% CI 1.52–41.6) was related to treatment success. For patients with M. abscessus subsp. massiliense, the choice among these drugs was not associated with treatment outcomes.Treatment outcomes for MAB-PD are unsatisfactory. The use of azithromycin, amikacin or imipenem was associated with better outcomes for patients with M. abscessus subsp. abscessus.For Mycobacterium abscessus pulmonary disease in general, imipenem use is associated with improved outcome. For M. abscessus subsp. abscessus, the use of either azithromycin, amikacin or imipenem increases the likelihood of treatment success. http://ow.ly/w24n30nSakf