Five-Year Outcomes among U.S. Bronchiectasis and NTM Research Registry Patients
Timothy R. Aksamit, Nicholas Locantore, Doreen Addrizzo‐Harris, Juzar Ali, Alan R. Barker, Ashwin Basavaraj, Megan Behrman, Amanda E. Brunton, Sarah Chalmers, Radmila Choate, Nathan C. Dean, Angela DiMango, David Fraulino, Margaret M. Johnson, N. Lapinel, Diego J. Maselli, Pamela J. McShane, Mark L. Metersky, Bruce E. Miller, Edward T. Naureckas, Anne E. O’Donnell, Kenneth N. Olivier, Elly Prusinowski, Marcos I. Restrepo, C. Richards, Gloria Rhyne, Andreas Schmid, George M. Solomon, Ruth Tal‐Singer, Byron Thomashow, Gregory Tino, K. Tsui, Sumith Abraham Varghese, Heather E. Warren, Kevin Winthrop, Beth Shoshanna Zha
Abstract
Abstract Rationale Nontuberculous mycobacteria (NTM) are prevalent among patients with bronchiectasis. However, the long-term natural history of patients with NTM and bronchiectasis is not well described. Objectives To assess the impact of NTM on 5-year clinical outcomes and mortality in patients with bronchiectasis. Methods Patients in the Bronchiectasis and NTM Research Registry with ⩾5 years of follow-up were eligible. Data were collected for all-cause mortality, lung function, exacerbations, hospitalizations, and disease severity. Outcomes were compared between patients with and without NTM at baseline. Mortality was assessed using Cox proportional hazards models and the log-rank test. Measurements and Main Results In total, 2,634 patients were included: 1,549 (58.8%) with and 1,085 (41.2%) without NTM at baseline. All-cause mortality (95% confidence interval) at Year 5 was 12.1% (10.5%, 13.7%) overall, 12.6% (10.5%, 14.8%) in patients with NTM, and 11.5% (9.0%, 13.9%) in patients without NTM. Independent predictors of 5-year mortality were baseline FEV1 percent predicted, age, hospitalization within 2 years before baseline, body mass index, and sex (all P < 0.01). The probabilities of acquiring NTM or Pseudomonas aeruginosa were approximately 4% and 3% per year, respectively. Spirometry, exacerbations, and hospitalizations were similar, regardless of NTM status, except that annual exacerbations were lower in patients with NTM (P < 0.05). Conclusions Outcomes, including exacerbations, hospitalizations, rate of loss of lung function, and mortality rate, were similar across 5 years in patients with bronchiectasis with or without NTM.