The 2020 ATS/ERS/ESCMID/IDSA NTM Guidelines
strongly recommend adding ARIKAYCE1

  • The 2020 Guidelines strongly recommend adding ARIKAYCE to treatment for patients with MAC lung disease who remain culture positive after 6 months of treatment1
  • ARIKAYCE is the first and only therapy studied in and FDA-approved for patients who fail to achieve culture conversion after 6 months of initial standard treatment2

MAC lung disease diagnosed

The 2020 Guidelines recommend treatment initiation rather than “watchful waiting” for diagnosed patients, especially in those with positive AFB sputum smears and/or cavitary disease.

The 2020 Guidelines recommend that MAC* lung disease should be treated with a multidrug regimen that includes at least a macrolide and ethambutol.

  • Guidelines recommend a 3-drug regimen of azithromycin, ethambutol, and rifampicin to treat MAC lung disease

1 → 5 months after treatment initiation

The 2020 Guidelines recommend that sputum cultures be obtained every 1 to 2 months during the treatment of MAC lung disease to assess response and determine duration of therapy and whether the regimen needs to be adjusted.

6 months after treatment initiation

Retrospective studies have shown that most MAC patients who convert on treatment do so within 6 months after starting treatment.3-5

Culture conversion is a key indicator for therapeutic success or failure. Study data indicate that if a patient remains culture positive, it may be an early sign of future radiographic progression and a decline in lung function (FEV1 and FVC).6-8

NO

YES

If your patients are not responding to treatment

Add ARIKAYCE
at 6 months1

ARIKAYCE (amikacin liposome inhalation suspension) 590 mg/8.4 mL Limited Population logo

If your patients are responding to treatment

Continue
multidrug
regimen1

The 2020 Guidelines recommend continuing MAC* treatment for 12 months beyond culture conversion1

12 months icon
Footnotes

*In patients with macrolide-susceptible MAC pulmonary disease.1

AFB=acid-fast bacilli; ATS=American Thoracic Society; ERS=European Respiratory Society; ESCMID=European Society of Clinical Microbiology and Infectious Diseases; FEV1=forced expiratory volume in the first second; FVC=forced expiratory volume; IDSA=Infectious Diseases Society of America; MAC=Mycobacterium avium complex.

References

  1. Daley CL, Iaccarino JM Jr, Lange C, et al. Treatment of nontuberculous mycobacterial pulmonary disease: an official ATS/ERS/ESCMID/IDSA clinical practice guideline: executive summary. Clin Infect Dis. 2020. doi:10.1093/cid/ciaa241.
  2. ARIKAYCE [package insert]. Bridgewater, NJ: Insmed Incorporated; 2020.
  3. Moon SM, Jhun BW, Daley CL, Koh WJ. Unresolved issues in treatment outcome definitions for nontuberculous mycobacterial pulmonary disease. Letter. Eur Respir J. 2019;53(5). doi:10.1183/13993003.01636-2018.
  4. Furuuchi K, Morimoto K, Kurashima A, et al. Treatment duration and disease recurrence following the successful treatment of patients with Mycobacterium avium complex lung disease. Letter. Chest. 2020. doi:10.1016/j.chest.2019.12.016.
  5. Koh WJ, Moon SM, Kim SY, et al. Outcomes of Mycobacterium avium complex lung disease based on clinical phenotype. Eur Respir J. 2017;50(3). doi:10.1183/13993003.02503-2016.
  6. Griffith DE, Aksamit T, Brown-Elliott BA, et al; ATS Mycobacterial Diseases Subcommittee. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med. 2007;175(4):367-416.
  7. Park HY, Jeong BH, Chon HR, Jeon K, Daley CL, Koh WJ. Lung function decline according to clinical course in nontuberculous mycobacterial lung disease. Chest. 2016;150(6):1222-1232.
  8. Pan SW, Shu CC, Feng JY, et al. Microbiological persistence in patients with Mycobacterium avium complex lung disease: the predictors and the impact on radiographic progression. Clin Infect Dis. 2017;65(6):927-934.