In a late-breaking oral session, Prof. David Griffith (University of Texas Health Science Center, USA) reported the longer-term results from the ongoing, randomised, open-label, phase 3 CONVERT study of ALIS in patients with refractory Mycobacterium avium complex (MAC) lung disease. The addition of ALIS to GBT eliminated evidence of MAC infection in sputum by month 6 in 29.0% of patients, compared with 8.9% of patients on GBT alone (P<0.0001). The new data presented in this session showed that among patients who achieved culture conversion by month 6, 80.0% (52/65) of those receiving ALIS plus GBT sustained culture conversion for up to 12 months of treatment after the first dose that defined culture conversion, compared with 30.0% (3/10) of patients receiving GBT alone (P=0.0014). Three months after the completion of treatment, 63.1% (41/65) of patients receiving ALIS plus GBT maintained durable culture conversion, compared with 0.0% (0/10) of patients receiving GBT alone (P=0.0002).
No new safety signals were associated with continued ALIS use in the study. Treatment-emergent adverse events (AEs) were reported by 98.2% of patients who received ALIS plus GBT and by 91.1% of patients who received GBT alone. The most common treatment-emergent AEs were dysphonia (46.6% for patients receiving ALIS plus GBT vs 1.8% for GBT alone), cough (38.1% vs 15.2%), dyspnoea (21.5% vs 8.9%), and haemoptysis (18.4% vs 14.3%). Serious treatment-emergent AEs occurred in 20.2% of patients who received ALIS plus GBT and in 20.5% of patients who received GBT alone.
"These longer-term findings from the CONVERT study suggest that the culture conversion achieved by many patients during the first 6 months of taking ALIS combined with GBT could be maintained throughout the course of therapy," said Prof. Griffith. "Importantly, the data also suggest that many patients who complete the full course of therapy may be able to maintain durable culture conversion 3 months off all treatment, which would be an important advance in the treatment of refractory MAC lung disease."
- Griffith DE, et al. A7359, ATS 2019, 17-22 May, Dallas, Texas, USA.
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Table of Contents: ATS 2019
Featured articles
Letter from the Editor
Interview with Prof. Christian Bergmann
Treatable Traits in Chronic Inflammatory Airway Disease: Back to Basics
Treatable traits in chronic inflammatory airway disease: back to basics
Critical Care Medicine
Distinguishing between 4 different subtypes of sepsis sets the stage for individualised treatment
Stem cell therapy in acute respiratory distress syndrome improves 28-day mortality
SPICE III trial: Early sedation with dexmedetomidine in critically ill patients
SAATELLITE trial: Suvratoxumab prevents ventilator-associated Staphylococcus Aureus pneumonia in intensive care unit patients
Sleep Medicine
Million-patient study reveals gaps in long-term adherence among various sub-populations
Sleep apnoea severity has a non-linear relationship with acute myocardial infarction risk
Obstructive sleep apnoea affects morning spatial navigational memory processing in asymptomatic older individuals
Pulmonary Vascular Disease and Interstitial Lung Disease
Nintedanib reduces lung function decline in systemic sclerosis-associated ILD
Pulmonary arterial hypertension: early treatment with selexipag most effective
Long-term safety and efficacy of recombinant human pentraxin-2 in patients with idiopathic pulmonary fibrosis
Infection
Dupilumab improves outcomes in patients with severe chronic rhinosinusitis with nasal polyps and comorbid asthma
Durability of culture conversion in patients receiving ALIS for treatment-refractory MAC lung disease
E-cigarette use disrupts normal immune response to viral infections, particularly in women
Paediatric Pulmonary Medicine
Bacterial pneumonia predicts ongoing lung problems in infants hospitalised for acute respiratory failure
Aspergillus and early cystic fibrosis lung disease: does it need to be treated?
COPD
CORTICO-COP trial: eosinophil-guided therapy reduces systemic corticosteroid exposure
A randomised controlled trial of a smoking cessation smartphone application
Benralizumab does not ameliorate COPD exacerbations (GALATHEA/TERRANOVA trials)
Aclidinium bromide delays COPD exacerbation without increased MACE risk
Bench-to-Bedside (Pre-Clinical)
Human lung organoids to study foetal RSV infection
CRISPR/Cas9 genome editing therapy of hereditary pulmonary alveolar proteinosis
Cilia diagnostics in primary ciliary dyskinesia
Tuberous sclerosis complex 2 may be a novel target in pulmonary arterial hypertension therapy
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