Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.
Department of Internal Medicine, Seoul National University, Seoul National University College of Medicine, Seoul, South Korea.
Clin Infect Dis. 2024 Jun 14;78(6):1690-1697. doi: 10.1093/cid/ciae131.
Improving health-related quality of life (HRQOL) has emerged as a priority in the management of nontuberculous mycobacterial pulmonary disease (NTM-PD). We aimed to evaluate HRQOL and its changes after 6 months' treatment in patients with NTM-PD.
The NTM-KOREA is a nationwide prospective cohort enrolling patients initiating treatment for NTM-PD in 8 institutions across South Korea. We conducted the Quality of Life-Bronchiectasis (QOL-B) at 6-month intervals and evaluated baseline scores (higher scores indicate better quality of life) and changes after 6 months' treatment. Multivariate logistic regression was performed to identify factors associated with improvement in the QOL-B physical functioning and respiratory symptoms domains.
Between February 2022 and August 2023, 411 patients were included in the analysis. Baseline scores (95% confidence interval [CI]) for physical functioning and respiratory symptoms were 66.7 (46.7-86.7) and 81.5 (70.4-92.6), respectively. Among 228 patients who completed the QOL-B after 6 months' treatment, improvements in physical functioning and respiratory symptoms were observed in 61 (26.8%) and 71 (31.1%) patients, respectively. A lower score (adjusted odds ratio; 95% CI) for physical functioning (0.93; 0.91-0.96) and respiratory symptoms (0.92; 0.89-0.95) at treatment initiation was associated with a greater likelihood of physical functioning and respiratory symptom improvement, respectively; achieving culture conversion was not associated with improvement in physical functioning (0.62; 0.28-1.39) or respiratory symptoms (1.30; 0.62-2.74).
After 6 months of antibiotic treatment for NTM-PD, HRQOL improved in almost one-third, especially in patients with severe initial symptoms, regardless of culture conversion.
ClinicalTrials.gov identifier: NCT03934034.
提高与健康相关的生活质量（HRQOL）已成为非结核分枝杆菌肺病（NTM-PD）管理的重点。我们旨在评估 NTM-PD 患者治疗 6 个月后的 HRQOL 及其变化。
NTM-KOREA 是一项全国性前瞻性队列研究，在韩国 8 家机构招募开始治疗 NTM-PD 的患者。我们每 6 个月进行一次生活质量-支气管扩张症（QOL-B）评估，并评估基线评分（得分越高表示生活质量越好）和治疗 6 个月后的变化。采用多变量逻辑回归分析确定与 QOL-B 生理功能和呼吸症状领域改善相关的因素。
2022 年 2 月至 2023 年 8 月期间，共纳入 411 例患者进行分析。生理功能和呼吸症状的基线评分（95%置信区间[CI]）分别为 66.7（46.7-86.7）和 81.5（70.4-92.6）。在 228 例完成治疗 6 个月后 QOL-B 评估的患者中，生理功能和呼吸症状分别有 61 例（26.8%）和 71 例（31.1%）得到改善。治疗开始时生理功能（调整后优势比；95%CI）和呼吸症状（0.93；0.91-0.96）得分较低与生理功能和呼吸症状改善的可能性更大相关；而培养转换与生理功能改善（0.62；0.28-1.39）或呼吸症状改善（1.30；0.62-2.74）无关。
在开始治疗 NTM-PD 抗生素治疗 6 个月后，近三分之一的患者的 HRQOL 得到改善，尤其是初始症状严重的患者，无论培养是否转换。
ClinicalTrials.gov 标识符：NCT03934034。
