Table 1 Characteristics of the identified studies
From: High mortality in patients with Mycobacterium avium complex lung disease: a systematic review
Data set | Country and year | Diagnosis | N | Age (years) | Female sex (%) | NB (%) | FC (%) | NB + FC (%) | Unknown, unclassified or other (%) | Therapy | Five-year mortality rate (%) (95% CI) |
|---|---|---|---|---|---|---|---|---|---|---|---|
Retrospective medical chart reviews | |||||||||||
1 | USA, 1973 [12] | MAC lung diseaseb | 45 | 49% > 50 | 0 | NR | 81.0 (multiple cavities in 50%) | NR | 11.0 (unknown) | 1–3 drugs: 53% ≥4 drugs: 47% Adjunctive surgical treatment: 42% Duration: 5 years | 40 (21.5–58.5) |
2 | Japan, 2012 [13] | Newly-diagnosed MAC lung disease‡ | 634 | 68.9 (mean) ± 11.4 (SD) | 58.5 | 82.9 | 11.5 | 3.3 | 2.3 (unclassified) | First-line antibiotic therapy: 50.9% Duration > 3 months | 23.9 (20.1–27.7) |
3 | Japan, 2012 [14] | Newly diagnosed MAC lung disease‡ | 78 | 65.2 (mean) ± 12.6 (SD) | 60.3 | 59.0 (bronchiectatic) | 26.0 | NR | NR | Various treatment regimens: 69% Untreated: 31% Duration NR | 25.6 (14.4–36.8) |
4 | Japan, 2013 [15] | Rheumatoid arthritis and MAC lung disease‡ | 82 | 67.6 (mean) ± 10.3 (SD) | 70.7 | 59.8 | 13.4 | 18.3 | 8.5 (other) | 1 or 2 drug regimens, Treatment for rheumatic disease Duration > 3 months | 32.8 (20.4–45.2) |
5 | Japan, 2014 [16] | MAC lung disease‡ | 309 | 67.0 (mean) ± 13.7 (SD) | 64.7 | NR | NR | NR | NR | Standard 3-drug regimen including clarithromycin: 131 patients (42.4%) Duration > 6 months for 108 regimens. Pulmonary resection: 5.1% | 10.0 (6.8–13.1) |
6 | UK, 2014 [17] | Non-cystic fibrosis bronchiectasis and coexisting MAC infection | 52 | 63.1 ± 12.7 | 69.2 | NR | NR | NR | NR | NR | 21 (8.5–33.5) |
7 | Japan, 2015 [18] | Nodular/ bronchiectatic MAC lung disease, based on HRCT of the chest‡ | 782 | 68.1 (mean) ± 11.1 (SD) | 68.5 | NR | 15.0 | NR | NR | First line antibiotic therapy, 1–5 drug regimen: 19.6% Duration > 3 months | 12.5 (10.0–15.0) |
8 | Japan, 2017 [19],a | MAC lung disease | 368 | 72 (mean) ± 10 (SD) | 59.0 | 81.0 | 11.1 | 1.6 | 9.5 | 165 treated patients; Clarithromycin + ethambutol + rifampicin (79.3%); other regimens (20.7%) | 23 (17.7–27.3) |
9 | Japan, 2017 [19],a | MAC lung disease | 118 | 70 (mean) ± 10 (SD) | 55 | 85.6 | 11.9 | 0 | 2.5 | 66 treated patients; Clarithromycin + ethambutol + rifampicin (79.3%); other regimens (20.7%) | 15 (7.8–21.6) |
Retrospective population registry analyses | |||||||||||
10 | Denmark, 2010 [20] | Prevalent NTM-PD‡ (MAC subgroup considered) | 425 | 61.2 (mean) ± 16.5 (SD) | 41.0 | NR | NR | NR | NR | NR | 39.7 (33.7–45.7) |
11 | Canada, 2017 [21] | MAC lung disease‡ | 5543 | 70 (median), IQR 50–78 | 53.0 | NR | NR | NR | NR | NR | 33.3 (31.8–34.8) |
12 | Japan, 2017 [22] | NTM-PD§ | 125 | 60 (median) IQR 49–66 | 66.0% | NR | NR | NR | NR | ≥3 drug regimen including clarithromycin 76%; 2 drug regimen including clarithromycin 2%; clarithromycin monotherapy 4%; non-clarithromycin regimen 5% | 16 (7.8–21.6) |
13 | USA 2017 [23],a | NTM-PD (meeting ATS/IDSA criteria) treated with pulmonary resection‖ | 178 | 66.1 (mean) ±14.6 (SD) | 60 | NR | NR | NR | NR | 37 (27.6–45.4) | |
14 | USA, 2017 [23],a | NTM-PD (not meeting ATS/IDSA criteria) treated with pulmonary resection‖ | 138 | 62.4 (mean) ±17.3 (SD) | 51 | NR | NR | NR | NR | NR | 33 (23.7–43.0) |
Prospective, randomized studies | |||||||||||
15 | UK and Scandinavia, 2002 [24] | MAC lung disease¶ | 75 | 64 (mean) | 46.7 | NR | 61 | NR | NR | Rifampicin +ethambutol ±isoniazid Duration: 2 years | 36.0 (22.4–49.6) |
16 | UK, Denmark, Sweden and Italy, 2008 [25],a | MAC lung disease¶ | 83 | 65 (mean) | 51.8 | NR | 69 | NR | NR | Rifampicin +ethambutol +clarithromycin ±immunotherapy Duration: 2 years | 48.0 (33.1–62.9) |
17 | UK, Denmark, Sweden and Italy, 2008 [25],a | MAC lung disease¶ | 87 | 65 (mean) | 49.4 | NR | 66 | NR | NR | Rifampicin +ethambutol +ciprofloxacin ±immunotherapy Duration: 2 years | 30.0 (18.5–41.5) |