Work

Treatment outcomes of nontuberculous mycobacterial infection in the Danish Cystic Fibrosis Cohort 2012-23

Year: 2025

Type: article

Abstract: BACKGROUND: Nontuberculous mycobacteria (NTM) infections in people with cystic fibrosis (CF) can lead to pulmonary disease (NTM-PD), impacting lung function and quality of life. This study aimed to assess the prevalence, time to clearance and impact on lung function of NTM-PD in the Danish CF Cohort over time, including the period before and after the introduction of highly effective modulator therapy (HEMT). METHODS: This cohort study used data from the Danish CF Registry, microbiological culture data, and medical records from 2007 to 2023. Epidemiological analyses covered the period 2012-2023, and spirometry data were available from 2010 to 2023. RESULTS: For all people with CF in Denmark, the prevalence of NTM-PD decreased from 5.4 % in 2012 to 1.5 % in 2023, with a notable decline following the introduction of HEMT in 2020. Among 52 individuals diagnosed with NTM-PD in the study period, the median NTM clearance time was 3.6 years. Thirteen (25 %) received short NTM treatment (< 1 year), however, their time to clearance was similar to those with longer treatment. Throughout the study period, lung function was lower in those with NTM-PD compared to those without, although lung function for all rose after the introduction of HEMT. CONCLUSION: While causality cannot be demonstrated, declining incidence and prevalence rates of NTM were observed during the study period in which HEMT was introduced. Improved respiratory outcomes were observed in those with NTM-PD. These findings support reconsideration of current treatment thresholds for NTM-PD in CF in the context of the HEMT era.

Source: Journal of Cystic Fibrosis

DOI: 10.1016/j.jcf.2025.12.008