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Original Research |

Lung Function Decline According to Clinical Course in Nontuberculous Mycobacterial Lung Disease

Hye Yun Park, MD; Byeong-Ho Jeong, MD; Hae Ri Chon, MD; Kyeongman Jeon, MD; Charles L. Daley, MD; Won-Jung Koh, MD
Author and Funding Information

Conflict of Interest Statement: None of the authors has a financial relationship with a commercial entity that has an interest in the subject of this manuscript.

Funding information: This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and future Planning (NRF-2015R1A2A1A01003959) and by a grant of the Korea Health technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (HI15C2778).

1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

2Division of Mycobacterial and Respiratory Infections, Department of Medicine, National Jewish Health, Denver, Colorado, United States

Correspondence to: Won-Jung Koh, MD, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul 06351, South Korea.


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016. doi:10.1016/j.chest.2016.06.005
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Abstract

Background  There are few data regarding the impact of nontuberculous mycobacterial lung disease (NTM-LD) on lung function during the clinical course of disease. This study aimed to assess the impact of NTM-LD on lung function decline.

Methods  Treatment outcomes and spirometry data at diagnosis and at least three years later were obtained from 358 patients who were diagnosed as NTM-LD between January 1999 and November 2011 using the prospective NTM registry cohort. For analysis, patients were divided into three groups: observed without treatment, treatment success, and treatment failure.

Results  The treatment failure group (n = 68) had a significantly more rapid decline in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) compared with the observation (n = 118) and treatment success (n = 172) groups (–52.2, –30.8, and –28.2 mL/yr, respectively, P = .023 for FEV1 decline; –50.4, –28.8, and –26.0 mL/yr, respectively, P = .002 for FVC decline). After adjusting for confounding factors, patients with treatment failure had greater FEV1 and FVC declines than those observed without treatment (adjusted P = .026 for FEV1 decline; adjusted P = .022 for FVC decline) or treated successfully (adjusted P = .004 for FEV1 decline; adjusted P = .002 for FVC decline). Patients treated successfully had similar declines in FEV1 and FVC to those in the observation group.

Conclusions  The change of lung function was variable over a median 5-year follow-up period. Treatment failure was associated with a substantial decline in lung function in NTM-LD.


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