Related Experiment Video
Updated: May 2, 2026
10:29
A High-throughput Compatible Assay to Evaluate Drug Efficacy against Macrophage Passaged Mycobacterium tuberculosis
Published on: March 24, 2017
7.4K
Intermittent versus Daily Therapy for Noncavitary Mycobacterium avium Complex Pulmonary Disease: An Open-Label
Taku Nakagawa1, Kohei Fujita2, Mari Miki3,4
1Department of Respiratory Medicine, NHO Higashinagoya National Hospital, Aichi, Japan.
Annals of the American Thoracic Society
|March 28, 2025
Summary
Intermittent therapy for noncavitary nodular bronchiectatic Mycobacterium avium complex pulmonary disease (MAC-PD) showed similar efficacy to daily treatment. However, daily therapy led to more elevated liver enzymes, while intermittent therapy caused more taste disturbances.
Area of Science:
- Pulmonology
- Infectious Diseases
- Clinical Trials
Background:
- Noncavitary nodular bronchiectatic (NB) Mycobacterium avium complex pulmonary disease (MAC-PD) is typically treated with intermittent, thrice-weekly regimens.
- No randomized controlled trials have directly compared intermittent to daily treatment for this condition.
Purpose of the Study:
- To evaluate the tolerability, safety, and efficacy of intermittent versus daily treatment for previously untreated noncavitary NB MAC-PD.
- To compare regimen modification rates, culture conversion, and adverse events between the two treatment schedules.
Main Methods:
- An open-label study randomized 138 treatment-naive patients to either intermittent (clarithromycin, rifampicin, ethambutol thrice-weekly) or daily (lower doses) therapy for one year.
- The primary endpoint was the proportion of patients requiring treatment regimen modification.
Main Results:
- Regimen modification rates (20.0% vs. 33.8%) and culture conversion rates (70.3% vs. 80.0%) did not significantly differ between intermittent and daily groups.
- Daily treatment was associated with higher rates of elevated AST and ALT, while intermittent therapy led to more elevated bilirubin and dysgeusia.
- The daily group showed a greater decrease in physical quality of life scores compared to the intermittent group.
Conclusions:
- Intermittent therapy is not significantly better tolerated than daily treatment for noncavitary NB MAC-PD.
- Both regimens demonstrated comparable efficacy, but with different safety profiles.
- Larger studies are needed to further elucidate optimal treatment strategies for MAC-PD.
Related Concept Videos
01:31Pulmonary Tuberculosis III
1.8K
Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
The first classification is based on the development of the disease, and it includes the following categories:
The first classification is based on the development of the disease, and it includes the following categories:
1.8K
01:28Pulmonary Tuberculosis V
1.0K
Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
1.0K
01:11Bioavailability Study Design: Single Versus Multiple Dose Studies
383
Bioavailability studies are essential for understanding how a drug is absorbed, distributed, metabolized, and excreted in the body. These studies assess the extent and rate at which the active pharmaceutical agent becomes available at the site of action. The design of bioavailability studies can involve single-dose or multiple-dose regimens, each with distinct advantages and limitations.Single-dose studies are the preferred approach due to their simplicity and reduced drug exposure for...
383
01:15Bioavailability Study Design: Healthy Subjects Versus Patients
248
Bioavailability studies are essential for evaluating a drug's therapeutic efficacy and understanding its absorption patterns under various physiological conditions. Conducting such studies on target patient populations provides more relevant data by simulating real-world disease states. However, practical challenges often necessitate the use of young, healthy adult volunteers as study subjects.Patients may exhibit altered drug absorption patterns due to the effects of the disease itself,...
248
01:24Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
423
Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
423
01:19Chronic Obstructive Pulmonary Disease IV: Clinical Manifestations
30
Chronic Obstructive Pulmonary Disease, or COPD, is a long-term condition marked by persistent and only partially reversible airflow limitation. It involves two overlapping conditions—chronic bronchitis and emphysema—which often co-appear but differ in dominant symptoms and underlying mechanisms.Chronic Bronchitis FeaturesChronic bronchitis presents with a persistent productive cough and thick, sometimes purulent mucus due to airway inflammation, enlarged mucus glands, and goblet...
30