Improvement in Health-Related Quality of Life Following Antibiotic Treatment in Nontuberculous Mycobacterial Pulmonary Disease: Initial Analysis of the NTM-KOREA Cohort

Nakwon Kwak; Emily Henkle; Hyeontaek Hwang; Doosoo Jeon; Byung Woo Jhun; Kyung-Wook Jo; Young Ae Kang; Hyung-Jun Kim; Joong-Yub Kim; Young Ran Kim; Yong-Soo Kwon; Jae Ho Lee; Jeongha Mok; Youngmok Park; Tae Sun Shim; Hojoon Sohn; Jake Whang; Jae-Joon Yim

doi:10.1093/cid/ciae131

Improvement in Health-Related Quality of Life Following Antibiotic Treatment in Nontuberculous Mycobacterial Pulmonary Disease: Initial Analysis of the NTM-KOREA Cohort

Clin Infect Dis. 2024 Apr 2:ciae131. doi: 10.1093/cid/ciae131. Online ahead of print.

Authors

Nakwon Kwak^{1

2}, Emily Henkle³, Hyeontaek Hwang⁴, Doosoo Jeon⁵, Byung Woo Jhun⁶, Kyung-Wook Jo⁷, Young Ae Kang⁸, Hyung-Jun Kim^{2

9}, Joong-Yub Kim^{1

2}, Young Ran Kim¹⁰, Yong-Soo Kwon¹¹, Jae Ho Lee^{2

9}, Jeongha Mok¹², Youngmok Park⁸, Tae Sun Shim⁷, Hojoon Sohn¹³, Jake Whang¹⁴, Jae-Joon Yim^{1

2}

Affiliations

¹ Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.
² Department of Internal Medicine, Seoul National University, Seoul National University College of Medicine, Seoul, South Korea.
³ OHSU-PSU School of Public Health, Portland, Oregon, USA.
⁴ Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, South Korea.
⁵ Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea.
⁶ Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, South Korea.
⁷ Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
⁸ Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
⁹ Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
¹⁰ Division of Clinical Research, International Tuberculosis Research Centre, Seoul, South Korea.
¹¹ Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea.
¹² Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea.
¹³ Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, South Korea.
¹⁴ Korea Mycobacterium Resource Center and Basic Research Section, The Korean Institute of Tuberculosis, Cheongju, South Korea.

PMID: 38563246
DOI: 10.1093/cid/ciae131

Abstract

Background: Improving health-related quality of life (HRQOL) has emerged as a priority in the management of nontuberculous mycobacterial pulmonary disease (NTM-PD). We aimed to evaluate HRQOL and its changes after 6 months' treatment in patients with NTM-PD.

Methods: The NTM-KOREA is a nationwide prospective cohort enrolling patients initiating treatment for NTM-PD in 8 institutions across South Korea. We conducted the Quality of Life-Bronchiectasis (QOL-B) at 6-month intervals and evaluated baseline scores (higher scores indicate better quality of life) and changes after 6 months' treatment. Multivariate logistic regression was performed to identify factors associated with improvement in the QOL-B physical functioning and respiratory symptoms domains.

Results: Between February 2022 and August 2023, 411 patients were included in the analysis. Baseline scores (95% confidence interval [CI]) for physical functioning and respiratory symptoms were 66.7 (46.7-86.7) and 81.5 (70.4-92.6), respectively. Among 228 patients who completed the QOL-B after 6 months' treatment, improvements in physical functioning and respiratory symptoms were observed in 61 (26.8%) and 71 (31.1%) patients, respectively. A lower score (adjusted odds ratio; 95% CI) for physical functioning (0.93; 0.91-0.96) and respiratory symptoms (0.92; 0.89-0.95) at treatment initiation was associated with a greater likelihood of physical functioning and respiratory symptom improvement, respectively; achieving culture conversion was not associated with improvement in physical functioning (0.62; 0.28-1.39) or respiratory symptoms (1.30; 0.62-2.74).

Conclusions: After 6 months of antibiotic treatment for NTM-PD, HRQOL improved in almost one-third, especially in patients with severe initial symptoms, regardless of culture conversion.

Clinical trials registration: ClinicalTrials.gov identifier: NCT03934034.

Keywords: health-related quality of life; improvement; nontuberculous mycobacteria; outcome; treatment.

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Associated data

ClinicalTrials.gov/NCT03934034

Abstract

Associated data

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