Nontuberculous Mycobacterial Lung Disease Increasing, More Common in Women, Older People

By Reuters Staff

December 20, 2019

NEW YORK (Reuters Health) - Nontuberculous mycobacterial (NTM) lung disease is on the rise across the U.S., especially among women and older people, new research shows.

"The annual incidence and prevalence of NTM lung disease significantly increased from 2008 to 2015; the average rates of yearly change were +5.2% and +7.5%, respectively," Dr. Kevin L. Winthrop of Oregon Health and Sciences University in Portland and colleagues write in the Annals of the American Thoracic Society (ATS).

The ATS and the Infectious Diseases Society of America issued joint guidelines on the diagnosis, treatment and prevention of NTM lung disease in 2007. People over 50 and those with chronic lung disease are known to be at increased risk, Dr. Winthrop and colleagues note, and most cases in the U.S. are due to Mycobacterium avium complex.

The authors reviewed 2007-2016 data from a large nationwide health plan on the incidence and prevalence of NTM lung disease. There were 16,872 plan members with at least one claim coded for NTM lung disease, of whom 9,476 fulfilled case criteria for NTM lung disease.

Almost 70% of the cases were women and nearly 90% were over 50. About 80% had underlying lung disease, most commonly bronchiectasis or chronic obstructive pulmonary disease (COPD).

Annual incidence rose from 3.13 per 100,000 person-years in 2008 to 4.73 per 100,000 in 2015. Incidence among members under 65 rose from 1.34 to 1.82 per 100,000 person-years, while it increased from 12.70 to 18.37 per 100,000 person-years in those 65 and older.

From 2008-2015, annual prevalence increased from 6.78 to 11.70 per 100,000 persons. Prevalence among people under 65 increased from 3.79 to 6.45 per 100,000 person years. In older people, prevalence rose from 30.27 to 47.48 per 100,000 people.

Prevalence among women was about three times as high as in men, and was also higher in Medicare plan members than commercial-plan members.

Increases in the incidence and prevalence of NTM lung disease occurred in most U.S. states during the study period.

The study was sponsored in part by Insmed, a biopharmaceutical company. Two of the authors are employed by Insmed.

SOURCE: Annals of the American Thoracic Society, online December 13, 2019.