Amikacin liposome Inhalation effective in Treating Resistant Mycobacterium abscessus Lung disease

Mycobacterium abscessus poses a significant challenge to patients and clinicians alike due to its resistance to many oral antibiotics. Moreover, treatment success rates are notably low when macrolide resistance is in the mix. However, a recent study published in Chest Journal offers hope in the form of a novel treatment approach.

In an open-label clinical trial, researchers administered ALIS, a nebulized formulation of the antibiotic amikacin, alongside standard multidrug therapy to a group of 33 patients. These individuals ranged in age from 14 to 81 years and had varying degrees of lung disease, including some with cystic fibrosis and cavitary disease.

The primary goal of this treatment was to achieve sputum culture conversion, defined as three consecutive monthly tests showing negative results. Encouragingly, 50% of the patients with evaluable data exhibited culture conversion, and 67% of them maintained this improvement throughout the 12-month treatment period. Mutational amikacin resistance  affected 18% of the patients using clofazimine alone or in combination with azithromycin as part of their therapy.

Despite these potential challenges, ALIS demonstrated a relatively low rate of serious adverse events. Some dosage adjustments were made, with 52% of patients reducing their intake to three times weekly. The treatment was generally well-tolerated.

This research represents a significant stride forward in addressing the complex issue of Mycobacterium abscessus infections. ALIS appears to be a promising addition to the therapeutic toolkit, especially for patients who face limited alternatives due to macrolide resistance. The study's findings provide hope for those grappling with this challenging lung condition and pave the way for further research and treatment innovations.

Reference: 

Siegel, S. A. R., Griffith, D. E., Philley, J. V., Brown-Elliott, B. A., Brunton, A. E., Sullivan, P. E., Fuss, C., Strnad, L., Wallace, R. J., Jr., & Winthrop, K. L. (2023). Open-Label Trial of Amikacin Liposome Inhalation Suspension in Mycobacterium abscessus Lung Disease. In CHEST (Vol. 164, Issue 4, pp. 846–859). Elsevier BV. https://doi.org/10.1016/j.chest.2023.05.036