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Treatments For NTM Lung Disease - WebMD
If you're diagnosed with nontuberculous mycobacterial lung disease, your doctor will discuss the right treatment for you.
Some people with NTM lung disease don't need treatment. Others require ongoing treatments to keep their disease under control.
Your doctor may decide to watch and wait rather than treat your infection. They can check your symptoms and look at X-rays to make sure your lungs don't start to show damage.
Why wouldn't you want to treat your infection even if it's mild? You'll need to take antibiotics. They have side effects. And you'll probably need more than one type because the bacteria often become resistant to drugs. Your doctor will weigh the pros and cons of treating your disease right away.
If your doctor does choose to treat it, you'll take the medicine for a while. The doctor will run a sputum culture test every month or two to look for bacteria. You'll cough up some mucus and they'll send it to a lab for tests. You can stop taking the meds when the results have come back negative for a year.
Your doctor will decide which antibiotic to try first based on:
Most people with an NTM lung infection start with a combination of antibiotics that they take three times a week. You may have to change medications if the bacteria become resistant to your doctor's first choice, but they have several options to choose from.
Doctors treat mycobacterium avium complex (MAC) disease, the most common NTM lung infection, with a combination of three antibiotics:
If you have more severe MAC disease that results from cavities in your lungs, your doctor may try rifabutin (Mycobutin) instead of rifampin (Rifadin, Rimactane). They might add amikacin or streptomycin three times a week early in your treatment.
If you have HIV, too, you're at higher risk for disseminated MAC disease. It causes symptoms all over your body, like night sweats, weight loss, fever, and anemia. Treatment involves taking two medications. Studies show that using just one medicine is not effective and causes bacterial resistance. You'll be given azithromycin or clarithromycin along with ethambutol. This is called double therapy. If needed, you might also take rifabutin, which is considered triple therapy.
If you have AIDS and CD4+ T-lymphocyte counts less than 50 cells/microliter, you can try to prevent disseminated MAC disease with azithromycin or clarithromycin. Rifabutin is another option, but it may be harder on your system.
If you're infection is from M. Kansasii bacteria, you'll probably take a mix of azithromycin, ethambutol, and rifampin once a day for 1 year or until your sputum test is negative.
If you have an M. Abscessus lung infection, antibiotics alone may not work. Clarithromycin, along with other drugs, may help control your symptoms and keep the disease from getting worse. You might need surgery to remove damaged parts of your lung, too.
All antibiotics for NTM lung disease have side effects. They can be hard on your liver or kidneys, cause hearing loss or tinnitus (ringing in your ears), or severe upset stomach.
Your doctor may need to switch your medicines or lower your dose if one medicine causes a serious reaction. If you notice sudden problems with your hearing or eyesight, or pain or numbness in your hands or feet, call them right away.
Antibiotics alone may not clear up your infection or ease your symptoms. Some people also need surgery to take out damaged lung tissue.
Surgery along with antibiotics can clear up an NTM lung infection in many people.
But if you cough up blood after you've taken antibiotics, surgery may be a next step.
There are other things you can try to ease your symptoms and help clear up your infection. You don't do them instead of your medicines, but as an add-on. Talk to your doctor first if you'd like to try any of these therapies:
You can also:
Once you treat your NTM lung disease, you can take steps to prevent another infection. These bacteria are often found in water or moist places, so take these easy steps:
Lung disease symptoms and the treatments for them may make you feel awful at times. At any point in your life with lung disease, ask your doctor about palliative care to help you feel more comfortable.
Palliative care is any treatment that helps to ease symptoms or just make you feel better. You may need oxygen therapy to help you breathe more easily, take meds for your upset stomach, or see a counselor to deal with stress.
Counseling or support groups of other people with lung disease can help you manage depression or anxiety. Check out groups in your area or online. Let your doctor know if your lung disease makes you feel depressed or hopeless, so you can get treatment right away.
What's The Outlook For Mycobacterium Avium Complex? - WebMD
More people around the world have nontuberculous mycobacteria (NTM) infections now than in the past. The infection most often comes from a type of NTM known as mycobacterium avium complex (MAC). MAC is often hard to get rid of. You'll most likely need treatment for a year or more to cure it and it sometimes comes back. But your outlook depends on many factors. Here's what you need to know.
How Does Diagnosis Affect My Outlook?Generally, the earlier you get diagnosed with a MAC infection, the better you'll do. But diagnosis often doesn't happen right away. That's because the infection can look like pneumonia or other lung conditions.
But once doctors realize that could be what you have, it's possible to treat. The sooner this happens, the more likely it is that you'll get the right treatment. You'll also be more likely to have a good outcome.
If you're worried you might have MAC, let your doctor know. Signs to watch for include:
You're more likely to have MAC if you have other health conditions affecting your lungs or immune system. But anyone can get it. If you have these symptoms and they aren't going away, see a doctor who specializes in diagnosing and treating lung conditions. A lung or infectious disease specialist also will have more experience treating MAC infections.
How Do Other Health Conditions Affect My Outlook?Most people get exposed to the bacteria that cause MAC infections. You're more likely to get sick from them if you have other health conditions. Your general health and other chronic conditions also will affect your outlook.
Some factors that may affect how you'll do with treatment include other lung conditions such as:
You're also at more risk and may have a worse outlook with MAC infection if you have a weakened immune system due to conditions including:
You also may be at greater risk for the infection and have a worse outlook if you've had a bone marrow, stem cell, or organ transplant. If you have other health conditions or have had a transplant, ask your doctor how this will affect your outlook with MAC.
What Other Factors Affect My Outlook?Doctors often take other conditions and your symptoms into account when deciding to treat MAC. But some of those same factors also can affect your outlook. You may have a worse outlook if you have:
Doctors may consider these factors when they choose to start treatment. But when you have other health conditions, you may not do as well even with treatment.
It's a good idea to talk to your doctors about your outlook and what you should expect from treatment. Treatment can sometimes get rid of the infection for good. But treatment may also help to keep the infection stable even if it doesn't go away. It may also help you with symptoms of the infection.
What Are the Mortality Rates for MAC?One review of studies found that 1 in 4 people with MAC die within 5 years. But the cause of death wasn't necessarily the infection itself, since many people with MAC have other health conditions, too. The risk also varies a lot from one study to the next.
Your risk of a poorer outcome may be greater if you:
Yes. Your outlook will depend on the specific bacteria causing your infection. MAC infections often don't respond as well to antibiotics as other infections do. Your doctor may do tests to find out what type of bacteria is causing your infection. They may also do tests to see how well the bacteria responds to treatment with antibiotics.
If you treat the infection with one antibiotic, the bacteria causing your infection are more likely to develop resistance. Your outlook will improve if you take two or three antibiotics at once. It's a good idea to see a specialist or other doctor with experience treating MAC to make sure you're taking a combination of medicines that's most likely to work. You'll need to treat the infection for at least a year, and often longer, to be sure the infection is gone.
What if the Infection Comes Back?Your doctor will consider the infection cured once there's no sign of it for at least a year. But sometimes the infection goes away and then comes back. If that happens, it could mean that the infection wasn't really gone. The bacteria may have developed resistance to treatment.
Some studies found that infection with MAC recurs up to 50% of the time. Most of the time that's because of a new infection or reinfection. But it's also possible to have a relapse if the bacteria are still there and bounce back after treatment ends. For some people, the infection can become chronic even with treatment.
What Can I Do to Improve My Outlook With MAC?Even if you get rid of the infection, your lungs may still have lasting damage. But taking steps to care for your lungs and general health can help in your recovery and improve your outlook. Here are some tips to help you improve your chances of a good outcome:
To stay on top of your infection, it helps to be informed. Here are some questions you may want to ask your doctor to make sure you're doing all you can to improve your outlook:
MAC Lung Disease Market Poised For Growth Across The 7MM During The Forecast Period (2025-2034) Amid Rising Prevalence And New Therapeutic Solutions Delveinsight - MENAFN.COM
(MENAFN- PR Newswire)The MAC lung disease market is predicted to grow in the coming years. This growth is mainly driven by the launch of innovative therapies such as MNKD-101, Bedaquiline fumarate (TMC207), and SPR720, among others. Furthermore, the increasing prevalence of MAC lung disease, influenced by host factors like advanced age, COPD, thoracic abnormalities, and environmental exposure to MAC in soil, water, and aerosol-generating activities, is expected to expand the MAC lung disease market potential.
LAS VEGAS, May 20, 2025 /PRNewswire/ -- Mycobacterium avium Complex (MAC) refers to a group of bacteria, primarily Mycobacterium avium and Mycobacterium intracellulare, that are responsible for MAC lung disease. Accurate identification typically requires genetic testing. MAC is the leading cause of nontuberculous mycobacterial (NTM) lung infections in the United States and can affect people of all ages, although it is more common in older adults, postmenopausal women, smokers, and individuals with weakened immune systems or pre-existing lung conditions such as bronchiectasis, COPD, cystic fibrosis, emphysema, or a prior history of tuberculosis.
DelveInsight estimates that in 2023, there were around 119K diagnosed prevalent cases of MAC lung disease across the 7MM, with the United States accounting for approximately 64% of these cases. In 2023, there were an estimated 151K diagnosed prevalent cases of NTM lung disease across the 7MM, with the number expected to rise by 2034.
Treatment for MAC lung disease typically involves a combination of multiple antibiotics, most often including a macrolide (such as azithromycin or clarithromycin), a rifamycin (such as rifampin or rifabutin), and ethambutol . This regimen works by inhibiting protein synthesis, disrupting the bacterial cell wall, and preventing replication of the mycobacteria. Therapy generally continues for 12 to 18 months, depending on the severity of the disease and the pathogen's drug susceptibility.
Supportive therapies play an important role, especially for patients with preexisting lung conditions. Chest physiotherapy, mucolytic agents, and bronchodilators help clear mucus and alleviate airway obstruction. Additionally, devices like positive expiratory pressure (PEP) masks and high-frequency chest wall oscillation (HFCWO) devices can assist in reducing bacterial burden.
Learn more about the MAC lung disease treatment @ New Treatment for MAC Lung Disease
ARIKAYCE is the first FDA-approved therapy specifically for MAC lung disease. It is a once-daily inhaled formulation of amikacin, delivered using Insmed's proprietary PULMOVANCE technology to directly target the lungs while reducing systemic exposure. The treatment is administered through the Lamira Nebulizer System and was granted orphan drug status by the FDA in 2013.
In May 2024, new data from the ARISE study were presented at ATS 2024, highlighting outcomes in MAC lung disease patients who had not previously received antibiotic therapy. ARIKAYCE is approved in the US, European Union, and Japan, and is currently being studied in the Phase III ENCORE trial , which focuses on newly diagnosed or relapsed MAC patients who have not begun antibiotic treatment. Topline results from this study are anticipated in the first quarter of 2026.
Find out more on FDA-approved MAC lung disease drugs @ MAC Lung Disease Treatment Options
The scarcity of FDA-approved therapies for MAC lung disease, with only ARIKAYCE being the only approved option, limits treatment options, complicates management of resistant strains, and highlights the need for new therapies.
MannKind Corporation, Janssen Pharmaceutical, and Spero Therapeutics are progressing through various stages of clinical trials, driving innovation in the MAC lung disease market. This activity is creating a dynamic environment, offering significant opportunities for the MAC lung disease market expansion and growth. Among the emerging therapies, MNKD-101 , a nebulized formulation of clofazimine , is currently in Phase III clinical development and is expected to launch in the market by 2027.
Discover which therapies are expected to grab major MAC lung disease market share @ MAC Lung Disease Market Report
MNKD-101 is a nebulized formulation of clofazimine being developed to treat severe, chronic, and recurrent lung infections, such as nontuberculous mycobacterial lung disease. This inhaled version is anticipated to provide therapeutic benefits over the existing oral form. MannKind is also working on a dry-powder variant using its proprietary Technosphere platform. In May 2024, the U.S. FDA granted Fast Track Designation to MNKD-101 for NTM lung disease, following its earlier designations as an orphan drug and a Qualified Infectious Disease Product (QIDP) .
The FDA approved the Investigational New Drug (IND) application for MNKD-101 in April 2024, paving the way for a Phase III clinical trial. Similarly, Japan's PMDA authorized the Phase III ICoN-1 trial in September 2024, enabling the global trial to move forward.
Bedaquiline fumarate , marketed as SIRTURO , is a diarylquinoline antimycobacterial agent used in combination regimens to treat pulmonary tuberculosis caused by Mycobacterium tuberculosis strains resistant to both rifampin and isoniazid. It is approved for use in adults and children aged 5 years and older, weighing at least 15 kg.
Bedaquiline is currently being studied in a Phase II/III clinical trial as part of a treatment regimen with clarithromycin and ethambutol for adults with treatment-refractory Mycobacterium avium complex lung disease (MAC-LD).
Spero Therapeutics is developing SPR720 , an oral therapy for NTM pulmonary disease. SPR720 is a stable prodrug that is rapidly converted into SPR719, which targets the ATPase subunits of gyrase and topoisomerase, mechanisms distinct from fluoroquinolones. Preclinical data have demonstrated SPR720's broad-spectrum activity against key NTM pathogens such as MAC, M. Kansasii, and M. Abscessus, in both treatment-refractory and treatment-naïve patients. The FDA has granted SPR720 Fast Track status, orphan drug designation, and QIDP designation .
Discover more about drugs for MAC lung disease in development @ MAC Lung Disease Clinical Trials
The anticipated launch of these emerging therapies for MAC lung disease are poised to transform the market landscape in the coming years. As these cutting-edge therapies continue to mature and gain regulatory approval, they are expected to reshape the MAC lung disease market landscape, offering new standards of care and unlocking opportunities for medical innovation and economic growth.
DelveInsight estimates that the market size for MAC lung disease is expected to grow from USD 474 million in the 7MM in 2023 at a significant CAGR by 2034. The market growth across the 7MM is expected to be fueled by the introduction of novel treatments such as MNKD-101, Bedaquiline fumarate (TMC207), and SPR720, among others. Additionally, the rising incidence of MAC lung disease driven by factors like aging populations, COPD, structural lung abnormalities, and exposure to MAC through soil, water, and aerosol-generating activities will likely contribute to an expanding MAC lung disease market opportunity.
DelveInsight's latest published market report, titled as MAC Lung Disease Market Insight, Epidemiology, and Market Forecast – 2034 , will help you to discover which market leader is going to capture the largest market share. The report provides comprehensive insights into the MAC lung disease country-specific treatment guidelines, patient pool analysis, and epidemiology forecast to help understand the key opportunities and assess the market's underlying potential. The MAC lung disease market report proffers epidemiological analysis for the study period 2020–2034 in the 7MM segmented into:
The report provides an edge while developing business strategies by understanding trends shaping and driving the 7MM MAC lung disease market. Highlights include:
Download this MAC lung disease market report to assess the epidemiology forecasts, understand the patient journeys, know KOLs' opinions about the upcoming treatment paradigms, and determine the factors contributing to the shift in the MAC lung disease market. Also, stay abreast of the mitigating factors to improve your market position in the MAC lung disease therapeutic space.
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