Persistent use of amikacin liposome inhalation suspension associated with lower risk of hospitalizations and emergency room visits in refractory Mycobacterium avium complex lung disease.
Kevin L Winthrop, Catherine Waweru, Emily Welch, Ping Wang, Leona E Markson
{"title":"Persistent use of amikacin liposome inhalation suspension associated with lower risk of hospitalizations and emergency room visits in refractory Mycobacterium avium complex lung disease.","authors":"Kevin L Winthrop, Catherine Waweru, Emily Welch, Ping Wang, Leona E Markson","doi":"10.1016/j.rmed.2025.108406","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Amikacin liposome inhalation suspension (ALIS) as add-on treatment to a multidrug regimen is the only therapy approved for treatment of adults with refractory Mycobacterium avium complex lung disease (rMACLD). Data on the impact of persistent use of ALIS on patient outcomes may be informative during clinical decision making. We used claims data to examine the association between persistent use of ALIS and healthcare resource use.</p><p><strong>Methods: </strong>This retrospective study used the Merative® MarketScan Commercial and Medicare Supplemental databases. Patients who initiated ALIS between October 2018 and March 2021, with ≥3 months continuous enrollment before and ≥12 months after index (ie, date of first ALIS prescription) were included. ALIS use was stratified into two groups: persistent ALIS use (≥6 months total supply) and less persistent ALIS use (<6 months total supply) over a 12-month post-index period. Hospitalizations and emergency room (ER) visits between ALIS-use groups were assessed using Kaplan-Meier analysis and multivariate Cox proportional hazards models.</p><p><strong>Results: </strong>In total, 103 ALIS-treated patients were included, with 54 (52.4%) and 49 (47.6%) in the persistent and less persistent ALIS-use groups, respectively. Compared with the less persistent ALIS-use group, the persistent ALIS-use group had a lower risk of all-cause (hazard ratio [95% CI], 0.17 [0.07-0.40], p<0.0001), respiratory-related (0.16 [0.06-0.40], p<0.0001), and NTM-related hospitalizations (0.14 [0.05-0.38], p<0.0001), and ER visits (0.41 [0.18-0.92], p=0.03), based on multivariate modeling.</p><p><strong>Conclusions: </strong>Persistent use of ALIS during the first 12 months of treatment was associated with a lower risk of hospitalizations and ER visits.</p><p><strong>Notation of prior abstract publication/presentation: </strong>Part of this study has been presented at CHEST on October 6-9, 2024, in Boston, MA, USA, and AMCP Nexus on October 14-17, 2024, in Las Vegas, NV, USA.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108406"},"PeriodicalIF":3.1000,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respiratory medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.rmed.2025.108406","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Amikacin liposome inhalation suspension (ALIS) as add-on treatment to a multidrug regimen is the only therapy approved for treatment of adults with refractory Mycobacterium avium complex lung disease (rMACLD). Data on the impact of persistent use of ALIS on patient outcomes may be informative during clinical decision making. We used claims data to examine the association between persistent use of ALIS and healthcare resource use.
Methods: This retrospective study used the Merative® MarketScan Commercial and Medicare Supplemental databases. Patients who initiated ALIS between October 2018 and March 2021, with ≥3 months continuous enrollment before and ≥12 months after index (ie, date of first ALIS prescription) were included. ALIS use was stratified into two groups: persistent ALIS use (≥6 months total supply) and less persistent ALIS use (<6 months total supply) over a 12-month post-index period. Hospitalizations and emergency room (ER) visits between ALIS-use groups were assessed using Kaplan-Meier analysis and multivariate Cox proportional hazards models.
Results: In total, 103 ALIS-treated patients were included, with 54 (52.4%) and 49 (47.6%) in the persistent and less persistent ALIS-use groups, respectively. Compared with the less persistent ALIS-use group, the persistent ALIS-use group had a lower risk of all-cause (hazard ratio [95% CI], 0.17 [0.07-0.40], p<0.0001), respiratory-related (0.16 [0.06-0.40], p<0.0001), and NTM-related hospitalizations (0.14 [0.05-0.38], p<0.0001), and ER visits (0.41 [0.18-0.92], p=0.03), based on multivariate modeling.
Conclusions: Persistent use of ALIS during the first 12 months of treatment was associated with a lower risk of hospitalizations and ER visits.
Notation of prior abstract publication/presentation: Part of this study has been presented at CHEST on October 6-9, 2024, in Boston, MA, USA, and AMCP Nexus on October 14-17, 2024, in Las Vegas, NV, USA.
期刊介绍：
Respiratory Medicine is an internationally-renowned journal devoted to the rapid publication of clinically-relevant respiratory medicine research. It combines cutting-edge original research with state-of-the-art reviews dealing with all aspects of respiratory diseases and therapeutic interventions. Topics include adult and paediatric medicine, epidemiology, immunology and cell biology, physiology, occupational disorders, and the role of allergens and pollutants.
Respiratory Medicine is increasingly the journal of choice for publication of phased trial work, commenting on effectiveness, dosage and methods of action.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
