Nontuberculous mycobacterial pulmonary disease added burden to COPD and bronchiectasis in Japan

Abstract

Nontuberculous mycobacterial pulmonary disease (NTM-PD) prevalence in Japan is among the highest worldwide. Chronic obstructive pulmonary disease (COPD) and bronchiectasis are common comorbidities among patients with NTM-PD, and it is challenging to treat NTM-PD in patients with these conditions. There are limited data on the incremental burden that NTM-PD adds to underlying COPD or bronchiectasis in Japan. Therefore, the objective of this study was to assess the incremental burden associated with NTM-PD in patients with pre-existing COPD and/or bronchiectasis.This nested case-control study was based on JMDC, Inc. (JMDC) claims data (2015–2020). Patients with COPD and/or bronchiectasis with NTM-PD (cases) were age and sex matched 1:3 to patients with COPD and/or bronchiectasis without NTM-PD (controls), resulting in 3 mutually exclusive patient groups (COPD, bronchiectasis, or both, with/without NTM-PD). Incremental burden of NTM-PD was assessed within each group by comparing hospitalisations during the 1-year period after NTM-PD diagnosis (index) between cases and controls with both univariate analysis and multivariate analysis adjusting for pre-index comorbidities.Univariate analyses in the 3 patient groups consistently demonstrated incremental hospitalisation burden in casesversuscontrols (eg, COPD group: 20% of 492 casesversus13% of 1476 controls had all-cause hospitalisations; 11%versus5% had respiratory-related hospitalisations; and 6%versus2% had COPD-related hospitalisations). Subsequent multivariate analysis further confirmed the findings.The substantial incremental burden of hospitalisation associated with NTM-PD in patients with COPD and/or bronchiectasis highlights the urgent need for appropriate management of NTM-PD in Japan.