Adverse events, tolerability, and efficacy of treatment for pulmonary MAC disease in elderly patients

概要

Introduction: Although the number of patients with pulmonary Mycobacterium avium complex (MAC) disease has been increasing among elderly individuals due to population aging in Japan, few studies reported treatment for elderly patients with MAC pulmonary disease. We conducted a retrospective cohort study to evaluate the difference in tolerability, adverse events and efficacy of treatment for pulmonary MAC disease in elderly and non-elderly patients.

Methods: The medical records of 96 newly diagnosed patients with pulmonary MAC disease at Nagoya City University Hospital between April 2014 and March 2019 were reviewed.

Results: The mean ages at diagnosis were 69.0 ± 12.5 year in a total. Females and NB- type disease predominated. Elderly patients ≥75 years old started multidrug treatment less often than non-elderly patients <75 years old (17 of 41 patients, 41.5% vs. 41 of 55 patients, 74.5%, P = 0.001). The treated elderly patients had more symptoms, extensive radiological disease and positive sputum smear than the treated non-elderly patients. Eleven elderly patients and 19 non-elderly patients continued the initial multidrug regimen (64.7% vs. 46.3%, P = 0.20). Adverse events occurred in 6 elderly patients and 25 non-elderly patients (35.4% vs. 61.0%, P = 0.07). Sputum conversion and radiological　improvement after treatment for over 1 year were similarly achieved between the elderly and non-elderly patients (61.5% vs. 75.0%, P = 0.37; 76.9% vs. 78.1%, P = 0.98).

Conclusions: In patients with pulmonary MAC disease who intended to be treated, tolerability, adverse events, and efficacy of treatment for elderly patients were not noticeably different with those for non-elderly patients.

この論文で使われている画像