Amikacin Liposomal Inhalation Suspension for Non-Tuberculous Mycobacteria Lung Infection: A Greek Observational Study

Area of Science:

• Pulmonology
• Infectious Diseases
• Pharmacology

Background:

• Intravenous amikacin is crucial for severe Mycobacterium avium complex (MAC) and M. abscessus lung disease but has significant toxicities.
• Inhaled Amikacin Liposome Inhalation Suspension (ALIS) improves lung drug delivery and reduces systemic side effects.
• ALIS is a new add-on therapy for refractory or inadequately treated NTM infections.

Purpose of the Study:

• To retrospectively evaluate the outcomes of Greek patients with difficult-to-treat non-tuberculous mycobacterial (NTM) lung disease treated with ALIS as an add-on therapy.
• To assess the safety and efficacy of ALIS in patients with NTM lung disease who experienced adverse effects from standard treatments.

Main Methods:

• Seventeen patients with recurrent or refractory NTM lung disease received ALIS alongside standard regimens from 2020-2023.
• Clinical, radiological, and microbiological data were collected to evaluate treatment response and outcomes.
• Focus on patients with limited treatment options due to prior adverse events.

Main Results:

• 14 out of 17 patients completed or continued ALIS therapy.
• 85.7% (12/14) demonstrated clinical, microbiological, and radiological improvement at 6 months.
• 25% (3/12) with M. abscessus lung disease relapsed post-therapy; adverse effects were mostly mild and respiratory-related.

Conclusions:

• ALIS is effective and safe as an add-on therapy for refractory/recurrent NTM lung disease in Greek patients, particularly those intolerant to intravenous aminoglycosides.
• Notable treatment responses were observed in MAC lung disease.
• Further research is needed to confirm findings and explore ALIS for other NTM species.