Improvement in Health-Related Quality of Life Following Antibiotic Treatment in Nontuberculous Mycobacterial Pulmonary Disease: Initial Analysis of the NTM-KOREA Cohort

Nakwon Kwak; Emily Henkle; Hyeontaek Hwang; Doosoo Jeon; Byung Woo Jhun; Kyung-Wook Jo; Young Ae Kang; Hyung-Jun Kim; Joong-Yub Kim; Young Ran Kim; Yong-Soo Kwon; Jae Ho Lee; Jeongha Mok; Youngmok Park; Tae Sun Shim; Hojoon Sohn; Jake Whang; Jae-Joon Yim

doi:10.1093/cid/ciae131

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Improvement in Health-Related Quality of Life Following Antibiotic Treatment in Nontuberculous Mycobacterial Pulmonary Disease: Initial Analysis of the NTM-KOREA Cohort

Authors: Nakwon Kwak ; Emily Henkle ; Hyeontaek Hwang ; Doosoo Jeon ; Byung Woo Jhun ; Kyung-Wook Jo ; Young Ae Kang ; Hyung-Jun Kim ; Joong-Yub Kim ; Young Ran Kim ; Yong-Soo Kwon ; Jae Ho Lee ; Jeongha Mok ; Youngmok Park ; Tae Sun Shim ; Hojoon Sohn ; Jake Whang ; Jae-Joon Yim

Citation: CLINICAL INFECTIOUS DISEASES, Vol.78(6) : 1690-1697, 2024-06

Journal Title: CLINICAL INFECTIOUS DISEASES

ISSN: 1058-4838

Issue Date: 2024-06

MeSH: Aged ; Anti-Bacterial Agents* / therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Mycobacterium Infections, Nontuberculous* / drug therapy ; Mycobacterium Infections, Nontuberculous* / microbiology ; Nontuberculous Mycobacteria / drug effects ; Prospective Studies ; Quality of Life* ; Republic of Korea ; Treatment Outcome

Keywords: health-related quality of life ; improvement ; nontuberculous mycobacteria ; outcome ; treatment

Abstract: Background: Improving health-related quality of life (HRQOL) has emerged as a priority in the management of nontuberculous mycobacterial pulmonary disease (NTM-PD). We aimed to evaluate HRQOL and its changes after 6 months' treatment in patients with NTM-PD.

Methods: The NTM-KOREA is a nationwide prospective cohort enrolling patients initiating treatment for NTM-PD in 8 institutions across South Korea. We conducted the Quality of Life-Bronchiectasis (QOL-B) at 6-month intervals and evaluated baseline scores (higher scores indicate better quality of life) and changes after 6 months' treatment. Multivariate logistic regression was performed to identify factors associated with improvement in the QOL-B physical functioning and respiratory symptoms domains.

Results: Between February 2022 and August 2023, 411 patients were included in the analysis. Baseline scores (95% confidence interval [CI]) for physical functioning and respiratory symptoms were 66.7 (46.7-86.7) and 81.5 (70.4-92.6), respectively. Among 228 patients who completed the QOL-B after 6 months' treatment, improvements in physical functioning and respiratory symptoms were observed in 61 (26.8%) and 71 (31.1%) patients, respectively. A lower score (adjusted odds ratio; 95% CI) for physical functioning (0.93; 0.91-0.96) and respiratory symptoms (0.92; 0.89-0.95) at treatment initiation was associated with a greater likelihood of physical functioning and respiratory symptom improvement, respectively; achieving culture conversion was not associated with improvement in physical functioning (0.62; 0.28-1.39) or respiratory symptoms (1.30; 0.62-2.74).

Conclusions: After 6 months of antibiotic treatment for NTM-PD, HRQOL improved in almost one-third, especially in patients with severe initial symptoms, regardless of culture conversion.

Clinical trials registration: ClinicalTrials.gov identifier: NCT03934034.