Patients with chronic obstructive pulmonary disease (COPD) who also have non-tuberculous mycobacterial pulmonary disease (NTM-PD) are more likely to be hospitalized and die, according to a German study that urges improved care for this particular disease.
The study, “Burden of non-tuberculous mycobacterial pulmonary disease in Germany,” appeared in the European Respiratory Journal in an article.
In the past decade, the incidence of infections caused by Mycobacterium tuberculosis have decreased in the industrialized world. However, infections caused by other Mycobacterium strains have started to be recognized worldwide.
Although over 150 different species are linked with NTM-PD, the disease is most commonly associated with Mycobacterium avium complex. Because it doesn’t always present signs of active infection and because its symptoms often overlap with those of other chronic pulmonary diseases, NTM-PD can be difficult to diagnose and even harder to eradicate — requiring prolonged therapy regimens with high risk of recurrence or relapse of infection.
In the present study, authors evaluated the real NTM-PD burden by comparing 125 newly diagnosed NTM-PD patients with 1,250 matched control patients over a 39 month-period. They found that although the incidence of NTM-PD was only 2.6 per 100,000, those with NTM-PD had a nearly fourfold increase in mortality (22.4 percent) than those in the control group (6 percent).
Among COPD patients with NTM-PD, the mortality rate was 41.5 percent, compared to 15.9 percent for COPD patients without the disease. In addition, hospitalization costs were three times higher for NTM-PD patients (accounting for 63 percent of total costs).
Even so, the authors noted discrepancies across individual treatments. Only 54 percent of the NTM-PD patients analyzed had received antibiotics on diagnosis, while 26 percent received no antibiotics at all. They also counted 29 different drug combinations across all treatments, suggesting a lack of treatment guidelines for this condition.
“Although NTM-PD is considered rare, these findings highlight that the burden of the disease is high,” the study’s author, Michael Loebinger, said in a press release. “Treatment can be hard to tolerate and may be unsuccessful, making treatment decisions complex. To help with this challenge, the British Thoracic Society will be releasing new guidelines this year.”