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Early treatment interruption and nutritional status as predictors of mortality in Mycobacterium avium complex

Hye Young Hong1, Youngmok Park1, Song Yee Kim1

  • 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.

Plos One
|May 27, 2026
PubMed

Insights

Early treatment interruption (ETI) in Mycobacterium avium complex pulmonary disease (MAC-PD) affects 30% of patients. Poor nutrition and adverse drug reactions (ADRs) increase ETI risk and long-term mortality, necessitating nutritional support and ADR monitoring.

Area of Science:

  • Pulmonary Medicine
  • Infectious Diseases
  • Clinical Research

Background:

  • Mycobacterium avium complex pulmonary disease (MAC-PD) treatment is prolonged and often suboptimal.
  • Early treatment interruption (ETI) is a significant challenge in MAC-PD management.
  • Limited data exists on ETI prevalence, risk factors, and long-term outcomes in MAC-PD.

Purpose of the Study:

  • To identify factors associated with ETI in MAC-PD patients.
  • To evaluate the impact of ETI on long-term mortality.
  • To determine the role of nutritional status and adverse drug reactions (ADRs) in ETI and mortality.

Main Methods:

  • Retrospective cohort study of 420 MAC-PD patients (2010-2023).
  • Patients categorized into ETI (<12 months) and standard (≥12 months) treatment groups.
  • Logistic regression and multivariate Cox proportional hazards regression used to analyze risk factors and mortality.

Main Results:

  • ETI occurred in 30% of patients.
  • Low prognostic nutritional index (PNI) and grade ≥2 ADRs were significant risk factors for ETI.
  • ETI was associated with a 2.86-fold increased mortality risk.
  • Low PNI also independently predicted higher mortality.

Conclusions:

  • ETI is prevalent in MAC-PD and linked to poor nutrition and ADRs.
  • These factors (low PNI, ADRs) also predict higher long-term mortality.
  • Early ADR monitoring and nutritional support are crucial for improving treatment adherence and patient outcomes.

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