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Amikacin liposome inhalation suspension as a treatment for patients with refractory mycobacterium avium complex lung

Yang Zhang1, Adam T Hill1,2

  • 1Centre for Inflammation Research, Centre for Inflammation Research at the University of Edinburgh, Queen's Medical Research Institute, Edinburgh BioQuarter, Edinburgh, Scotland.

Expert Review of Respiratory Medicine
|May 27, 2021
PubMed

Insights

Amikacin liposome inhalation suspension (ALIS) improves sputum culture conversion in MAC lung disease patients. While generally safe, ALIS may increase respiratory side effects but shows potential as an adjunctive therapy.

Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Pharmacology

Background:

  • Amikacin liposome inhalation suspension (ALIS) is an inhaled antibiotic approved for refractory Mycobacterium Avium Complex (MAC) lung disease.
  • Inhaled antibiotics like ALIS target infections directly, potentially reducing systemic toxicity.

Purpose of the Study:

  • To review the pharmacodynamics, pharmacokinetics, efficacy, safety, and regulatory aspects of ALIS as an add-on therapy for adult MAC lung disease.
  • To analyze data from preclinical, clinical, and post-marketing studies.

Main Methods:

  • Systematic literature search of Medline/PubMed up to October 2020.
  • Analysis of preclinical studies, clinical trials, and original research on ALIS.
  • Review of post-marketing surveillance and regulatory information.

Main Results:

  • ALIS as add-on therapy significantly improved sputum culture conversion rates compared to guideline-recommended therapy alone.
  • ALIS demonstrated a similar risk of serious adverse events and low renal adverse event rates.
  • Respiratory adverse events were more frequent with ALIS compared to guideline-recommended therapy alone.

Conclusions:

  • ALIS shows significant microbiological benefits in MAC lung disease patients.
  • While clinical outcome data is limited, ALIS holds potential as an adjunctive treatment for MAC lung disease.
  • Further research may be needed to fully elucidate clinical outcome improvements.
Keywords:
Amikacinantibiotic treatmentmac lung diseaserespiratory adverse eventsputum culture conversion

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