New research suggests that the BACES score was associated with clinical outcomes and overall clinical/radiological response in patients with Mycobacterium avium complex lung disease (MAC-LD). However, the tool was not associated with culture conversion or radiological worsening. The study was presented at the CHEST Annual Meeting in Boston, Massachusetts.
“A priori prediction of treatment outcomes in patients with MAC-LD remains challenging for clinicians,” wrote the authors, led by Mounika Reddy Vadiyala. The BACES score is based on (body mass index, age, cavity presence, erythrocyte sedimentation rate, and sex). It can predict mortality in Canadian and Asian patients with non-tuberculous mycobacteria (NTM) lung disease. The current authors aimed to test the usefulness of the BACES score in MAC-PD patients in the United States, using a retrospective cohort study.
They analyzed clinical, microbiological, and radiological treatment outcomes in 123 patients with MAC-LD (median age=68.8 years; median body mass index=22.5 kg/m2). Other inclusion criteria were those without significant cavitary disease who did (n=73) or did not (n=49) receive guideline-based antibiotics for two years. Those who did not have antimicrobial treatment received active airway clearance.
The analysis revealed declining outcomes with worsening BACES scores. Patients with BACES scores of 0, 1, 2, and 3 had clinical improvement rates of 94.3%, 96.4%, 85.2%, and 50%, respectively (P=0.034). Clinical-radiological response rates were 94.3%, 96.4%, 84.6%, and 50%, respectively (P=0.031). Although it did not reach statistical significance, a trend was noted for worsening radiological response rates by BACES scores: 8.8%, 14.8%, 17.4%, and 50%, respectively. Finally, rates of sputum culture persistence did not change significantly according to BACES scores.
“Our study findings suggest that BACES score holds promise as a candidate for predictor of clinical and radiological response but not microbiological response associated with treatment outcomes,” the authors concluded. They called for prospective studies to determine the tool’s predictive value.
Reference
Vadiyala MR, Conley E, Arias-Sanchez P,et al. Treatment outcomes and BACES score in patients with Mycobacterium avium complex lung disease. Abstract #A1628-A1629. Presented at the CHEST Annual Meeting; October 6-9, 2024; Boston, Massachusetts.
