Persistent use of amikacin liposome inhalation suspension associated with lower risk of hospitalizations and emergency room visits in refractory Mycobacterium avium complex lung disease.

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.