PURPOSE: Physicians are often conflicted whether to treat patients with MAC. Symptoms are often minimal or nonspecific and treatment is prolonged and associated with side effects. Since many of these patients have abnormal PF (which can precede or result from MAC) improvement in PF would be an indication to treat. This study evaluated PF after treatment in a community setting.
METHODS: The medical records and PFT's of 8 patients who received standard MAC treatment were reviewed. The patients are followed in a clinic or private office in Queens, New York. 6 patients completed over 13 months of therapy, 1 is presently on the 12th month and another the 9th month. Spirometry pre and post bronchodilator (BD) were obtained for all patients. Lung volumes and DLCO obtained for 3 patients. Percent predicted values for FEV1 and FVC were used to monitor changes. The largest values FEV1, FVC and FEV1/FVC of either pre or post BD were used.
RESULTS: There were 6 males, 5 ex-smoker, 3 life-time non-smokers. Age range 49 to 81 years old. BMI 21 to 29. DLCO increased by 4, 16 and 27%. TLC% increased by 3, 5 and 6%. FRC% decreased by 9 and increased by 21 and 25%. For FEV1: 6 patients had increases from 6 to 17%; 2 a decrease, 4 and 9% (one a lifetime non-smoker). For FVC: 6 patients had increases from 5 to 17%, 2 had a decrease, 5 and 11%. FEV1/FVC: 6 patients had increases from 0 to 9%, 2 had a decrease, 1 and 3%. 6 patients had abnormal PF and these had mean increases: FEV1 of 13%; FVC of 13% and FEV1/FVC of 7.5% . 2 had normal PF and these had minimal change in FEV1, FVC and FEV1/FVC.
CONCLUSION: 75% of patients had increases in FEV1, FVC and FEV1/FVC ratio. 3/3 had an increase in DLCO.
CLINICAL IMPLICATIONS: In these community based patients, treatment of MAC improved PF in those patients whose spirometry PF was abnormal to begin with.
DISCLOSURE: Zinobia Khan, None.