Two regimens deliver high sputum conversion rates in M. xenopi pulmonary infection

CaMoMy, the first clinical study to evaluate the 6-month sputum conversion rate in patients with Mycobacterium xenopi pulmonary infection, demonstrated a high conversion rate for 2 treatment regimens, consisting of ethambutol, rifampicin, and either clarithromycin or
moxifloxacin.

“Individuals who have a pulmonary infection with Mycobacterium xenopi have a poor prognosis, with a 5-year mortality rate of 69% [1],” expressed Prof. Claire Andrejak (CHU Amiens, France). “It occurs mainly in patients with chronic respiratory disease. Unfortunately, the optimal treatment is unknown.” The phase 3 CaMoMy trial (NCT01298336) included patients with M. xenopi pulmonary infection (n=92) who were randomised to a regimen of ethambutol plus rifampicin plus clarithromycin or to a regimen of ethambutol plus rifampicin plus moxifloxacin [2]. The primary objective was to determine the 6-month sputum conversion rate.

In the overall population, the 6-month sputum conversion rate was 93.2%. “Next to this, we observed clinical improvements after 6 months, with an anorexia rate of 19.2% versus 28% at baseline, a weight loss rate of 15.4% versus 48.3% at baseline, and a fatigue rate of 34.6% versus 58.5% at inclusion,” said Prof. Andrejak.

There was no difference between the 2 treatment regimens concerning the 6-month sputum conversion rate, fatigue rate, weight loss, or anorexia rate. Severe adverse events were documented in 18.6% of the participants in the clarithromycin arm and 20.0% of those in the moxifloxacin arm. “These events were mostly related to the use of ethambutol,” explained Prof. Andrejak.

“We saw a high 6-month sputum conversion rate for 2 treatment regimens in our severely sick patient population, with the majority of patients having the cavitary form and a positive smear,” decided Prof. Andrejak.

1. Griffith DE, et al. Am J Respir Crit Care. 2007;175(4):367-416.
2. Andrejak C, et al. xenopi pulmonary infection: a randomized clinical trial comparing rifampin plus ethambutol plus either clarithromycin or moxifloxacin: the CaMoMy study. Late-breaking abstracts: science that will impact clinical care. ATS 2024, 17–22 May, San Diego, USA.

Medical writing support was provided by Robert van den Heuvel.

Copyright ©2024 Medicom Medical Publishers



Posted on 10 June 202410 June 2024