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Amikacin Liposome Inhalation Suspension in Refractory Mycobacterium avium Complex Lung Disease: A Profile of Its Use

Sheridan M Hoy1

  • 1Springer Nature, Private Bag 65901, Mairangi Bay, Auckland, 0754, New Zealand. demail@springer.com.

Clinical Drug Investigation
|March 16, 2021
PubMed

Insights

Amikacin liposome inhalation suspension (ALIS) significantly improves treatment outcomes for refractory Mycobacterium avium complex lung disease. This add-on therapy enhances sputum culture conversion rates compared to guideline-based therapy alone.

Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Pharmacology

Background:

  • Treatment-refractory Mycobacterium avium complex (MAC) lung disease presents a significant unmet need.
  • Limited alternative treatment options exist for patients with advanced MAC lung disease.

Purpose of the Study:

  • To evaluate the efficacy and safety of amikacin liposome inhalation suspension (ALIS) as an add-on therapy for treatment-refractory MAC lung disease.
  • To assess the impact of ALIS on sputum culture conversion rates and treatment outcomes.

Main Methods:

  • A study involving adults with treatment-refractory MAC lung disease receiving ALIS as add-on therapy to guideline-based therapy (GBT).
  • Sputum culture conversion (three consecutive monthly MAC-negative cultures) was a primary endpoint.
  • Assessment of conversion rates at 6 and 12 months, and 3 months post-treatment.

Main Results:

  • ALIS addition to GBT significantly improved the likelihood of sputum culture conversion by month 6 compared to GBT alone.
  • The observed conversion response was maintained over up to 12 months of therapy and 3 months post-treatment.
  • Increased respiratory adverse reactions were noted with ALIS, but systemic amikacin adverse events were infrequent.

Conclusions:

  • ALIS is an effective add-on therapy for improving sputum culture conversion in adults with treatment-refractory MAC lung disease.
  • While respiratory side effects are a consideration, ALIS offers a valuable therapeutic option for patients with limited alternatives.
  • The sustained conversion response highlights the potential long-term benefits of ALIS in managing MAC lung disease.

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