P92 Outcomes of non-tuberculous mycobacterial pulmonary disease in an East London cohort

<h3>Introduction</h3> Prevalence of non-tuberculous mycobacterial pulmonary disease (NTM-PD) is increasing. The diagnosis and treatment of NTM-PD present challenges as long treatment regimens with multiple agents can induce intolerable side effects, especially in the elderly. Our primary aim was to compare mortality outcomes between NTM-PD patient groups with chronic obstructive pulmonary disease (COPD), bronchiectasis, both, or neither. <h3>Methods</h3> This is a retrospective observational study including individuals aged 18 or over with NTM-PD according to the ATS definition of NTM-PD, and two or more positive NTM isolates in sputum, broncho-alveolar lavage or biopsy. Outcomes are defined according to the 2018 NTM-NET consensus statement. <h3>Results</h3> We present outcome data on 59 individuals with NTM-PD treated at a tertiary centre. Out of 59 patients, 26 patients were male (44%). The median age was 69 years (IQR 56.5–77). Fourteen (24%) patients had a background of COPD, 22 (37%) patients had bronchiectasis, eight patients (14%) had both COPD and bronchiectasis, and 15 patients had neither. In the COPD group, four (29%) were smoking at the time of diagnosis, eight (57%) were ex-smokers and two (14%) never smoked. Two (14%) of the 14 patients with only COPD were of mild severity, five (36%) were moderate, three (21%) were severe and four (29%) were very severe. Thirty-seven patients (63%) of the total cohort had Mycobacterium avium complex, ten patients (17%) had Mycobacterium kansasii, nine patients (15%) had Mycobacterium abscessus and three patients (5%) had other mycobacteria. During the six year period, the mortality rate in patients with COPD was 50% which was significantly higher (p&lt;0.05) when compared to patients with bronchiectasis (9%), and patients with both COPD and bronchiectasis (25%). Of the patients who died, 57% had severe to very severe COPD. There was no mortality reported in patients who had neither COPD nor bronchiectasis. In nine patients (15%), treatment was discontinued due to side effects. <h3>Conclusion</h3> This study confirms that the overall outcomes in patients with NTM-PD remains poor and patients with a background of COPD have a significantly higher mortality rate than patients with bronchiectasis.