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

Clin Infect Dis. 2024 Jun 14;78(6):1690-1697. doi: 10.1093/cid/ciae131.

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.

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

Publication types

  • Multicenter Study

MeSH terms

  • 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

Substances

  • Anti-Bacterial Agents

Associated data

  • ClinicalTrials.gov/NCT03934034