Abstract
Background Certain patients are at greater risk of developing non-tuberculous mycobacterial pulmonary disease (NTM-PD), including those with lung conditions such as bronchiectasis. Testing for non-tuberculous mycobacteria (NTM) in patients at risk is necessary to identify NTM-PD and start appropriate management. The aim of this survey was to evaluate current testing practices for NTM and identify testing triggers.
Methods Physicians (n=455) who see ≥1 patient with NTM-PD in a typical 12-month period and test for NTM as part of practice from Europe, the USA, Canada, Australia, New Zealand and Japan participated in a 10-min anonymised survey on NTM testing practices.
Results Bronchiectasis, chronic obstructive pulmonary disease (COPD) and use of immunosuppressants were the factors most likely to prompt testing among physicians in this survey (90%, 64% and 64%, respectively) with radiological findings the most common reason leading to considering NTM testing in patients with bronchiectasis and COPD (62% and 74%, respectively). Macrolide monotherapy in patients with bronchiectasis and inhaled corticosteroid use in patients with COPD were not important triggers for testing (15% and 9% of physicians, respectively). Persistent cough and weight loss triggered testing in >75% of physicians. Testing triggers were markedly different for physicians in Japan, with CF prompting testing in fewer physicians compared with other regions.
Conclusions Testing for NTM is influenced by underlying disease, clinical symptoms or radiological changes, but clinical practice varies considerably. Adherence to guideline recommendations for NTM testing is limited in certain patient subgroups and varies across regions. Clear recommendations on NTM testing are needed.
Footnotes
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Conflict of interest: MRL reports receiving honorarium from Insmed, Astra Zeneca, Chiesi, Grifols, Savara, Armata, Parion, Zambon, 30T, Electromed and AN2 Therapeutics; JvI reports honorarium for speaking or advisory boards from Boehringer-Ingelheim, Janssen Pharmaceuticals, Insmed, Spero Therapeutics, Paratek and AN2 Therapeutics; RvdL is an employee of Insmed B.V.; MO is an employee of Insmed Germany GmbH.
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- Received December 22, 2022.
- Accepted February 14, 2023.
- Copyright ©The authors 2023
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